Abstract
Subclinical hypothyroidism (SCH) plays a crucial role in the development and progression of coronary heart disease (CAD). Retinol-binding protein 4 (RBP4) is an adipokine correlated with cardiovascular diseases. Recent studies found that RBP4 levels are increased in patients with SCH. However, the relationship of RBP4 with CAD in SCH patients remains unclear. A total of 199 SCH patients (148 with CAD and 51 without CAD) and 102 healthy controls were enrolled in this study. Serum RBP4 was increased in SCH patients than controls. Moreover, serum RBP4 was higher in SCH patients with CAD. Although there was no significant difference of metabolic parameters between SCH patients with and without CAD, serum RBP4 was positively correlated with body mass index, total cholesterol, and low-density lipoprotein cholesterol, as well as thyroid stimulating hormone. Multivariable logistic regression analyses revealed elevated RBP4 was correlated with increased risk for CAD in SCH patients. Serum RBP4 levels were also increased as the number of stenosed vessels increased. Furthermore, increased RBP4 was positively correlated with the severity of CAD quantified by the Gensini score. Our findings demonstrate that serum RBP4 is associated with the presence and severity of CAD in patients with SCH.
Highlights
Coronary artery disease (CAD) remains the leading cause of morbidity and mortality worldwide, especially in the elderly population [1]
No statistically significant differences were observed between Subclinical hypothyroidism (SCH) patients and control subjects regarding age, sex, body mass index (BMI), smoking, hypertension, diabetes, blood pressure, and the levels of Total cholesterol (TC), TG, LDL‐C, Apolipoprotein A (ApoA), fasting blood glucose (FBG), alanine aminotransferase (ALT), aspartate aminotransferase (AST), Cr, and uric acid (UA)
No statistically significant differences were found between these two groups regarding age, sex, BMI, smoking, hypertension, diabetes, blood pressure, and the levels of TC, TG, high-density lipoprotein cholesterol (HDL-C), LDLC, FBG, ALT, AST, Cr, UA, free triiodothyronine (FT3), free thyroxine (FT4), and T4
Summary
Coronary artery disease (CAD) remains the leading cause of morbidity and mortality worldwide, especially in the elderly population [1]. It is generally accepted that thyroid hormone (TH) has anti-atherosclerotic effects and hypothyroidism accelerates the process of atherogenesis [3]. Epidemiological studies have suggested an increased risk and severity of CAD in patients with hypothyroidism [4]. Subclinical hypothyroidism (SCH) is an early, mild form of hypothyroidism with a state of increased thyroid stimulating hormone (TSH) levels but normal total or free thyroxine (T4) levels [5]. SCH is a common health problem, with a prevalence of about 10% in the www.aging-us.com population without known thyroid disease [5]. The prevalence of SCH increased with age and ranged from 7% to 26% in the elderly [6]. Due to lack of explicit clinical signs and symptoms, novel and convenient markers are needed for the prediction of CAD in patients with SCH
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