Investigation of thyroid function and blood pressure in school-aged subjects without overt thyroid disease

Abstract

This study was performed to ascertain whether a relationship exists between thyroid function and blood pressure in school-aged Chinese subjects without overt thyroid disease. A cross-sectional survey of 880 subjects (541 females and 339 males) aged 7-18 years in Bengbu, Anhui province was conducted. The investigation, which was based on a stratified random cluster sampling method, included a questionnaire and measurements of blood pressure, height, and body weight. Fasting blood samples were taken for measurements of thyroid-stimulating hormone (TSH), free 3,5,3'-triiodothyronine (FT(3)) and free thyroxine (FT(4)). Serum TSH and FT(3) were positively correlated with systolic and diastolic blood pressure Z scores (SBP-Z and DBP-Z) even after adjusting for body mass index (BMI) (P < 0.05) but no correlation was observed between FT(4) and SBP-Z or DBP-Z after comparable adjustments (P > 0.05). SBP-Z and DBP-Z in subjects with subclinical hypothyroidism were significant higher than in euthyroid subjects (P < 0.05). Both SBP-Z and DBP-Z increased linearly with TSH concentration in boys after adjusting BMI (P < 0.05); however, a similar linear trend was not observed in girls. Our findings support the hypothesis that elevated TSH and FT(3) concentrations increase blood pressure in school-aged Chinese subjects without overt thyroid disease; this increase may be even more significant in boys.

Effects of Recombinant Human Thyrotropin Administration on 24-Hour Arterial Pressure in Female Undergoing Evaluation for Differentiated Thyroid Cancer

“…Moreover, many studies have correlated subclinical hypothyroidism with atherosclerosis, endothelial dysfunction, and coronary heart disease [2, 3]. Recently, it has been shown that thyroid stimulating hormone (TSH) levels even within the normal range are positively associated with systolic and diastolic blood pressure [4, 5]. This may suggest a direct action of TSH on the cardiovascular system especially as extrathyroidal actions of TSH have been reported [6].…”

Maternal thyroid hormones during pregnancy, childhood adiposity and cardiovascular risk factors: the Generation R Study

“…High‐normal TSH levels have been associated with higher weight, BMI and alterations in body fat distribution . A positive association of TSH levels and blood pressure has also been reported . Higher levels of serum FT4 in euthyroid individuals have been associated with lower BMI and abdominal subcutaneous fat mass area .…”

“…32,33 A positive association of TSH levels and blood pressure has also been reported. 34,35 Higher levels of serum FT4 in euthyroid individuals have been À0Á11 (À0Á20, À0Á02)* À0Á07 (À0Á15, 0Á02) Reference À0Á08 (À0Á17, 0Á01) À0Á09 (À0Á17, 0) 0 (À0Á03, 0Á02)…”

The debate on treating subclinical hypothyroidism

“…Cerbone et al described no relationship between TSH levels and IQ or behaviour in children with SCH. (124) Verbal fluency and encoding test scores were also not affected by SCH in another case-control study by Ergür et al (126) Pubertal delay was not found to be associated with SCH by Cerbone et al and Rapa et al (124,127) Cardiovascular risk factors SCH was associated with hypertension in children and adolescents in two cross-sectional studies by Chen et al and Ittermann et al (128,129) Furthermore, triglyceride levels, homocysteine levels and waist-to-hip ratios were higher in children with SCH compared to controls in another crosssectional study by Cerbone et al, which also found that highdensity lipoprotein cholesterol was lower in SCH patients. (130) …”