The Relationship between Serum Cholesterol and Serum Thyrotropin in Women with Peripheral Arterial Disease

Abstract

REFERENCESVan Dieijen-Visser MP, Salemans T, Van Wersch J WJ, Schellekeus LA, Brombacher PJ. Glycosylated serum proteins and glycosylated haemoglobin in normal pregnancy. Ann Clin Biochem 1986; 23: Lloyd DR, Marples J. Glycosylated The relationship between serum cholesterol and serum thyrotropin in women with peripheral arterial disease Recently it has been suggested that, in subjects over 40 years old with suspected hypothyroidism, thyroid hormones control about 15% of the variability of serum cho1esterol.l Thyrotropin is the most reliable of the thyroid analytes2 and can therefore be used to assess the setting of thyroid gland activity in individuals. We have previously used thyrotropin levels to assess occult hypothyroidism in elderly women with intermittent c l a~d i c a t i o n .~ Amongst these patients we noted a significant correlation of thyrotropin (TSH) with cholesterol even when TSH was within the normal range, 0.2-4.0mU/L.3 We have extended these observations to over 200 postmenopausal women patients with symptomatic arterial disease. The serum cholesterol and TSH was measured in women attending the Charing Cross arterial clinic, over a period of 3 years, 1986-1989. The patients were all over 50 years old and had presented with symptomatic arterial disease in the aorto-distal circulation (claudication, rest pain or gangrene) or the carotid arteries (transient ischaemic attacks or stroke).Patients with known thyroid disease or heterozygous for familial hypercholesterolaemia (family history and LDL-receptor genotyping) were excluded from the study group as were patients with initial TSH > 4 rnU/L. The patients returned to clinic every 12 months for follow up of their arterial disease. At each annual visit a fasting blood sample was taken and the patient's height and weight measured. The mean age of the 202 patients studied, on entry, was 69 -t 8 years. An immunoradiometric assay was used to determine TSH, the coefficient of variation being 6.3% at a level of 1.2 mU/L and 28% at a level of 0.2 mU/L.The intraindividual coefficients of variation for cholesterol and TSH were calculated from estimates of precision between pairs of results. The intraindividual coefficient of variation was 9% for cholesterol and 18% for TSH. No patient had a weight change of > 5 % during the period of follow up. A positive correlation was observed between serum cholesterol and TSH, r=0.42, P<O.001 (see Fig. 1).Although the hypercholesterolaemia of hypothyroidism is well recognized, control of cholesterol metabolism by thyroid hormones in euthyroid subjects has not previously been appreciated. Control of serum cholesterol is often considered as being equally divided between environmental and genetic factors. The correlation coefficient between serum cholesterol l o 1 .. . . .

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

“…Thus, the cross-sectional Rotterdam Study [23] demonstrated an association between subclinical hypothyroidism and a greater age-adjusted prevalence of radiographic aortic atherosclerosis (OR 1.7; 95% CI 1.1-2.6) and myocardial infarction (OR 2.3; 95% CI 1.3-4.0) in women [23]. Likewise, a small casecontrol study showed a relation between subclinical hypothyroidism and peripheral arterial disease in women [24], and two case-control studies revealed an association between subclinical hypothyroidism and coronary artery disease in elderly women [25,26]. However, an important limitation of the above mentioned studies [25,26] might have been that they included only women, and therefore gender-specific analyses have not been performed.…”