Abstract

Subclinical hypothyroidism (SH) is associated with hemodynamic and metabolic abnormalities that cause endothelial dysfunction and atherosclerotic cardiovascular diseases. Aortic velocity propagation (AVP), epicardial fat thickness (EFT), and carotid intima-media thickness (CIMT) may provide additional information in SH patients. This study aimed to evaluate thyroid stimulating hormone (TSH), AVP, EFT, and CIMT in SH patients, and determine the associations among these parameters. Eighty patients with SH and 43 euthyroid (EU) individuals were enrolled. Blood samples were collected to measure laboratory parameters. Patients were divided into two groups based on their TSH values (TSH ≥10 or TSH <10 mIU/L). AVP, EFT, and CIMT were measured and compared between the study groups. A multivariate linear regression model was used for analysis of the independent predictors of AVP (beta = -0.298; 95% confidence interval = -0.946 to -0.287; p < 0.001). AVP was significantly lower in SH patients than the control group (43.7 ± 12.5 and 62.6 ± 13.8, respectively; p < 0.001). EFT values were similar between the SH and control groups (0.7 ± 0.3 and 0.6 ± 0.2, respectively; p = 0.10). SH patients had higher CIMT values than the control group (0.8 ± 0.3 and 0.5 ± 0.2, respectively; p < 0.001). In the multivariate linear analysis, TSH was an independent predictor of AVP. AVP was lower and CIMT was higher in SH patients compared to EU individuals. The increased CIMT and decreased AVP levels were significantly associated with TSH levels in SH patients.

Highlights

  • Subclinical hypothyroidism (SH) is defined as elevated levels of thyroid-stimulating hormone (TSH) and normal levels of free thyroid hormones

  • Aortic velocity propagation (AVP) was significantly lower in SH patients compared to the control group (43.7 ± 12.5 and 62.6 ± 13.8, respectively; p < 0.001)

  • AVP was lower in SH patients compared to the control group, and AVP decreased significantly with an increase in TSH levels

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Summary

Introduction

Subclinical hypothyroidism (SH) is defined as elevated levels of thyroid-stimulating hormone (TSH) and normal levels of free thyroid hormones. SH is associated with hemodynamic and metabolic abnormalities, which increase the risk for atherosclerotic cardiovascular diseases [2] and endothelial dysfunction [3, 4]. Decreased thyroid hormones are associated with increased arterial stiffness and systemic vascular resistance [5]. SH patients have lower aortic distensibility and higher aortic stiffness index than euthyroid (EU) individuals [6]. Masaki et al [7] demonstrated that the cardio-ankle vascular index was increased in SH patients, suggesting that increased arterial stiffness may be associated with cardiovascular diseases. TSH levels were inversely correlated with endothelium-dependent dilatation [8]. AVP was negatively associated with coronary and carotid atherosclerosis [9]

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