Abstract
Objective: There is little literature about whether antihypertensive drugs would affect thyroid function in patients with euthyroid type 2 diabetes, which was significant in maintaining a proper balance of thyroid function. A retrospective cohort study was conducted to evaluate the influence of antihypertensive drugs on thyroid function in patients with type 2 diabetes with euthyroidism. Design and Methods: The study involved dividing 698 patients with antihypertensive monotherapy into five groups according to the antihypertensive drugs they were treated with. Antihypertensive drugs included in this study were β-blockers, angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), and calcium channel blockers (CCB). The clinical data and thyroid function level between or within groups were compared. Multiple logistic regression analysis was conducted to evaluate the association of antihypertensive drugs with thyroid function level. Results: Selective β1- adrenergic receptor blockers treatment was related to thyroid-stimulating hormone (TSH), increasing in patients with diabetes and euthyroidism as shown by multiple logistic regression analysis. The association existed after adjustment for confounding factors. No significant influence on thyroid function was found among other antihypertensive drugs. Conclusion: These data show the TSH-lifting effect of selective β1-adrenergic receptor blockers in patients with type 2 diabetes with euthyroidism.
Highlights
Subjects with type 2 diabetes experience an elevated cardiovascular morbidity and mortality at present, associated with a high prevalence of hypertension, obesity, and dyslipidemia (Punthakee et al, 2007; Zhang et al, 2009)
Serum thyroid-stimulating hormone (TSH), fT3, fT4, thyroid antibodies, serum lipid profile, Fasting blood glucose (FBG), Hemoglobin A1c (HbA1c), Cr, and estimated glomerular filtration rate (eGFR) were superimposable among the five groups (p > 0.05)
diastolic blood pressure (DBP) and systolic blood pressure (SBP) was higher in antihypertensive treatment groups (p < 0.05), as well as the duration of hypertension was longer in antihypertensive treatment groups (p < 0.05), and no significant difference of DBP, SBP and duration of hypertension was found among the four antihypertensive treatment groups (p > 0.05)
Summary
Subjects with type 2 diabetes experience an elevated cardiovascular morbidity and mortality at present, associated with a high prevalence of hypertension, obesity, and dyslipidemia (Punthakee et al, 2007; Zhang et al, 2009). Thyroid hormones play a crucial role in regulating many cardiovascular functions (Klein and Ojamaa, 2001). Previous literatures have revealed that decreased endothelial function, high-density lipoprotein cholesterol (HDL-C) level, and increased low-density lipoprotein cholesterol (LDL-C) level, triglycerides (TGs) level, and blood pressure (BP) were observed in persons with higher thyroid-stimulating hormone (TSH) level even when TSH level was still in reference range (Lekakis et al, 1997; Bakker et al, 2001; Asvold et al, 2007a; Asvold et al, 2007b). Accurately evaluating thyroid function in patients with type 2 diabetes, even when. Antidiabetic and antihypertensive treatments are both necessary in diabetes patients with hypertension. Various drugs could influence thyroid function through different mechanisms (Andjelkovic et al, 2016). The influence of medication should not be ignored. Literatures about whether antihypertensive drugs would affect thyroid function were limited, especially in persons with euthyroidism
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