The Association of Thyroid Function and Heart Valve Sclerosis. Results from a Population-Based Study

Abstract

Abstract. Objectives: Thyroid dysfunction is associated with detrimental cardiovascular effects. We analyzed whether thyroid status is associated with aortic valve sclerosis (AVS) and mitral annular calcification (MAC) as markers of generalized atherosclerosis. Design: Data of 2065 subjects (923 women and 1142 men) aged ≥45 years from the Study of Health in Pomerania (SHIP) were analyzed with respect to low, medium and high TSH levels. Logistic regression models were adjusted for major confounders of atherosclerosis. Main outcome: In women, the prevalence of AVS was the highest in those with low TSH (35.1% vs. 26.7% in medium TSH; p<0.05), while there was a higher prevalence of MAC in men with high TSH levels (9.2% vs. 5.2% in medium TSH; p<0.05). Compared with euthyroid men there was an increased adjusted odds ratio for MAC (OR 2.07; 95% CI 1.12-3.89, p<0.05), for the combination of AVS and MAC (OR 2.13; 95% CI 1.08-4.21, p<0.05) or for one of both (OR 1.47; 95% CI 1.02-2.13, p<0.05) among men with high TSH. No such association was found in women. Conclusions: There was an association between thyroid function and valvular sclerosis. Men with high TSH values had increased odds for AVS or MAC, and the combination of both. These findings may reflect an increased atherosclerotic state in affected subjects.

High levels of thyroid-stimulating hormone are associated with aortic wall thickness in the general population

“…However, so far no studies investigated whether and to which extent measurements of aortic and carotid wall thickness are correlated. Furthermore, the results of our study are in agreement with several other population-based studies which reported associations between high TSH and markers closely related to atherosclerosis such as endothelial dysfunction [32], heart valve sclerosis [33], retinal arteriolar narrowing [34] and oxidized low-density lipoprotein [35]. Hence, there is some evidence that serum TSH levels are positively associated with atherosclerosis, which is further supported by the results of our study.…”

Relationship of thyroid function with intracranial arterial stenosis and carotid atheromatous plaques in ischemic stroke patients with euthyroidism

“…Our results are consistent with previous studies showing associations between low fT4 levels and elevated levels of inflammatory markers [17], mitral annular calcification [24], and thickening of the carotid intima media [18–21] in stroke patients with euthyroidism. Since our findings were obtained with a relatively large and inclusive sample of ischemic stroke patients, we strengthen the case for targeted screening of ischemic stroke patients with low-normal thyroid function for carotid atheromatous plaques.…”

Thyroid functional disease: an under-recognized cardiovascular risk factor in kidney disease patients

“…In the general population, hypothyroidism is associated with increased serum osteoprotegerin levels, an inhibitor of vascular calcification in experimental studies but a marker of vascular calcification, atherosclerosis and cardiovascular events in clinical studies, which may normalize with exogenous thyroid hormone treatment [122][123][124][125][126]. Elevated TSH and low FT4 have been associated with valvular and coronary artery calcification [127,128].…”