Associations between thyroid-stimulating hormone and hypertension according to thyroid cyst status in the general population: a cross-sectional study

Yuji Shimizu,Yuko Nabeshima-Kimura,Yasuhiro Nagata,Naomi Hayashida,Shin-Ya Kawashiri,Yuko Noguchi,Takahiro Maeda

doi:10.1186/s12199-020-00910-4

Abstract

BackgroundThe absence of thyroid cysts may indicate latent thyroid damage, as demonstrated in our previous study. However, the association between the absence of thyroid cysts and latent functional damage of the thyroid is unknown. At low thyroid hormone productivity, which may be associated with latent functional damage of the thyroid, the association between thyroid-stimulating hormone (TSH) and hypertension might be enhanced. Therefore, we evaluated the association between TSH level and hypertension stratified by thyroid cyst status.MethodsWe conducted a cross-sectional study of 1724 euthyroid Japanese individuals aged 40–74 years who participated in an annual health checkup in 2014.ResultsIn the study population, 564 and 686 participants had thyroid cysts and hypertension, respectively. A significant positive association was observed between TSH and hypertension in subjects without a thyroid cyst but not in subjects with thyroid cysts. There was a significant positive association between hypertension and TSH in subjects without a thyroid cyst (odds ratio [OR] 1.27; 95% confidence intervals [CI] 1.01, 1.61) but not in subjects with thyroid cysts (OR 0.79; CI 0.57, 1.09) in the model fully adjusted for known confounding factors. The correlation between the TSH and free triiodothyronine (fee T3) levels (simple correlation coefficient [r] = − 0.13, p < 0.01) was stronger in the subjects without thyroid cysts than in those with thyroid cysts (r = − 0.03, p = 0.525).ConclusionsTSH is positively associated with hypertension only in individuals without thyroid cysts. The correlation between the TSH and free T3 levels was stronger in the subjects without thyroid cysts than in those with thyroid cysts. Therefore, the absence of thyroid cysts could be related to the association between TSH level and hypertension, possibly by indicating that the subjects without thyroid cysts had limited thyroid hormone reserves. Therefore, the absence of thyroid cysts could indicate the latent functional damage of the thyroid.

Highlights

The absence of thyroid cysts may indicate latent thyroid damage, as demonstrated in our previous study
This study shows that thyroid-stimulating hormone (TSH) had a significant positive association with hypertension only in subjects without thyroid cyst
The absence of thyroid cysts could be related to the association between TSH level and hypertension, possibly by indicating the latent functional damage of the thyroid

Summary

Introduction

The absence of thyroid cysts may indicate latent thyroid damage, as demonstrated in our previous study. At low thyroid hormone productivity, which may be associated with latent functional damage of the thyroid, the association between thyroid-stimulating hormone (TSH) and hypertension might be enhanced. The absence of thyroid cysts is associated with antithyroid peroxidase antibody (TPO-Ab), possibly by resulting in latent thyroid damage [1]. The association between the absence of thyroid cysts and latent functional damage of the thyroid is unknown. There could be a significant association between the manifestation of thyroid cysts and hypertension, thereby indicating a lesser influence of latent thyroid damage on hypertension. Low thyroid function such as congenital hypothyroidism is associated with slow growth [8]

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Conclusion