Subclinical hypothyroidism and risk of cerebral small vessel disease: A hospital‐based observational study

Zhang, Xiaohao; Xie, Yi; Ding, Caixia; Xiao, Jing; Tang, Yong; Jiang, Xuemei; Shan, Hua; Lin, Yinyao; Zhu, Yujia; Li, Chuanyou; Hu, Dan; Ling, Zhi-xiang; Xu, Gelin; Sheng, Lei

doi:10.1111/cen.13383

Cited by 22 publications

(17 citation statements)

References 35 publications

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“…Subclinical thyroid dysfunction is a common endocrine condition among general population, including a prevalence reaching up to 15% for subclinical hypothyroidism (SHypo), and 12% for subclinical hyperthyroidism (SHyper) [6–9]. The cardio-cerebral vascular system is one of the major targets of thyroid hormones [6, 10, 11]. SHypo has been displayed to propagate vascular risk factors, such as hyperlipidemia [12], metabolic syndrome [13] and vascular stiffness [14].…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of subclinical thyroid dysfunction in ischemic stroke patients treated with intravenous thrombolysis

Zhang

Gong

Sheng

et al. 2019

Aging

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Data regarding the association between subclinical thyroid dysfunction and clinical outcomes in ischemic stroke patients with intravenous thrombolysis (IVT) are limited. We aimed to investigate the predictive value of subclinical thyroid dysfunction in END, functional outcome and mortality at 3 months among IVT patients. We prospectively recruited 563 IVT patients from 5 stroke centers in China. Thyroid function status was classified as subclinical hypothyroidism, subclinical hyperthyroidism (SHyper) and euthyroidism. The primary outcome was END, defined as ≥ 4 point in the NIHSS score within 24 h after IVT. Secondary outcomes included 3-month functional outcome and mortality. Of the 563 participants, END occurred in 14.7%, poor outcome in 50.8%, and mortality in 9.4%. SHyper was an independent predictor of END [odd ratio (OR), 4.35; 95% confidence interval [CI], 1.86–9.68, P = 0.003], 3-month poor outcome (OR, 3.24; 95% CI, 1.43–7.33, P = 0.005) and mortality [hazard ratio, 2.78; 95% CI, 1.55–5.36, P = 0.003]. Subgroup analysis showed that there was no significant relationship between SHyper and clinical outcomes in IVT patients with endovascular therapy. In summary, SHyper is associated with increased risk of END, and poor outcome and mortality at 3 months in IVT patients without endovascular therapy.

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Section: Introductionmentioning

confidence: 99%

Prognostic value of subclinical thyroid dysfunction in ischemic stroke patients treated with intravenous thrombolysis

Zhang

Gong

Sheng

et al. 2019

Aging

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“…However, much is still unknown about how TH dysregulation is correlated with brain pathologies in old age. TH dysregulation has been implicated in or comorbid with cardiovascular disease, stroke, hippocampal sclerosis of aging/cerebral age-related TDP-43 with sclerosis (CARTS), autoimmune disease(s), and, possibly, Alzheimer’s disease (AD) (Chaker et al, 2017; Chaker et al, 2016b; Collet et al, 2012; de Jong et al, 2009; Frohlich and Wahl, 2017; Mafrica and Fodale, 2008; Nelson et al, 2016a; Squizzato et al, 2005; Tan and Vasan, 2009; Zhang et al, 2017). Prospective studies are few in number and lack pathologic endpoints, so cohorts that follow patients to autopsy are required to provide needed insights into how TH disease affects the aged brain.…”

Section: Introductionmentioning

confidence: 99%

Treated hypothyroidism is associated with cerebrovascular disease but not Alzheimer's disease pathology in older adults

Brenowitz

Han

Kukull

et al. 2018

Neurobiology of Aging

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Thyroid hormone disease is common among older adults and is associated with cognitive impairment. However, pathologic correlates are not well understood. We studied pathologic and clinical factors associated with hypothyroidism, the most common manifestation of thyroid disease, in research subjects seen annually for clinical evaluations at U.S. Alzheimer's Disease Centers. Thyroid disease and treatment status were assessed during clinician interviews. Among autopsied subjects, there were 555 participants with treated hypothyroidism and 2146 without known thyroid disease; hypothyroidism was associated with severe atherosclerosis (odds ratio: 1.35; 95% confidence interval: 1.02, 1.79) but not Alzheimer's disease pathologies (amyloid plaques or neurofibrillary tangles). Among participants who did not undergo autopsy (4598 with treated hypothyroidism and 20,945 without known thyroid hormone disease), hypercholesterolemia and cerebrovascular disease (stroke and/or transient ischemic attack) were associated with hypothyroidism, complementing findings in the smaller autopsy sample. This is the first large-scale evaluation of neuropathologic concomitants of hypothyroidism in aged individuals. Clinical hypothyroidism was prevalent (>20% of individuals studied) and was associated with cerebrovascular disease but not Alzheimer's disease-type neuropathology.

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“…Subclinical HT or HT could be risk factors for plaque ulceration, and therefore, may lead to increased cerebrovascular events [22]. Moreover, subclinical HT may increase the risk of small vessel disease [23]. Poor thyroid function is also associated with increased risks of fibrosis [24], endothelial dysfunction, and chronic inflammation [25,26].…”

Section: Discussionmentioning

confidence: 99%

Hypothyroidism and risks of cerebrovascular complications among patients with head and neck cancer after radiotherapy

et al. 2021

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Background Hypothyroidism (HT) and carotid artery stenosis (CAS) are complications of radiotherapy (RT) in patients with head and neck cancer (HNC). The impact of post-RT HT on CAS progression remains unclear. Methods Between 2013 and 2014, HNC patients who had ever received RT and were under regular follow-up in our hospital were initially screened. Patients were categorized into euthyroid (EU) and HT groups. Details of RT and HNC were recorded. Total plaque scores and degrees of CAS were measured during annual extracranial duplex follow-up. Patients were monitored for CAS progression to > 50 % stenosis or ischemic stroke (IS). Cumulative time to CAS progression and IS between the 2 groups were compared. Data were further analyzed based on the use or nonuse of thyroxine of the HT group. Results 333 HNC patients with RT history were screened. Finally, 216 patients were recruited (94 and 122 patients in the EU and HT groups). Patients of the HT group received higher mean RT doses (HT vs. EU; 7021.55 ± 401.67 vs. 6869.69 ± 425.32 centi-grays, p = 0.02). Multivariate Cox models showed comparable CAS progression (p = 0.24) and IS occurrence (p = 0.51) between the 2 groups. Moreover, no significant difference was observed in time to CAS progression (p = 0.49) or IS (p = 0.31) among patients with EU and HT using and not using thyroxine supplement. Conclusions Our results did not demonstrate significant effects of HT and thyroxine supplementation on CAS progression and IS incidence in patients with HNC after RT.

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Subclinical hypothyroidism and risk of cerebral small vessel disease: A hospital‐based observational study

Abstract: These findings showed that SCH might be associated with the presence of WMLs, CMBs, as well as cSVD burden in patients with minor stroke or TIA.

Cited by 22 publications

References 35 publications

Prognostic value of subclinical thyroid dysfunction in ischemic stroke patients treated with intravenous thrombolysis

Prognostic value of subclinical thyroid dysfunction in ischemic stroke patients treated with intravenous thrombolysis

Treated hypothyroidism is associated with cerebrovascular disease but not Alzheimer's disease pathology in older adults

Hypothyroidism and risks of cerebrovascular complications among patients with head and neck cancer after radiotherapy

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