Abstract
BackgroundThe relationship between TSH and the lipid profile is contradictory because few studies have excluded the potential influence of the thyroid hormones (TH). The aim of the present study was to evaluate the relationship between serum TSH levels and the lipid profile independent of TH.Methods1302 CHD patients diagnosed by coronary angiography were retrospectively studied. The prevalence and distribution of thyroid dysfunction were analyzed first. To assess the impact of TSH on serum lipids, Pearson’s correlation analysis was performed after adjustments for classic factors and TH. To calculate the extent of the effect of TSH on the serum cholesterol level, the partial least squares method and additional statistical methods were used.ResultsAfter the exclusions, a total of 568 patients (270 males and 298 females with a mean age of 63.56 ± 11.376 years) were selected. The prevalence of thyroid dysfunction among the patients was 18.66%, and the prevalence of hypothyroidism (15.32%) was higher than that of hyperthyroidism (3.34%). Even after adjusting for confounding factors, such as sex, age, smoking status, fasting plasma glucose levels and TH, a significant positive impact of TSH on the serum total cholesterol (TC) level was revealed (r = 0.095, p = 0.036). Each 1 mIU/L increase in the TSH level might be linked to a 0.015580712 mmol/L elevation of the serum TC value.ConclusionsTSH can increase the TC level in CHD patients independent of TH. The present study suggests a potential physiological role of TSH and the importance of maintaining an appropriate TSH level in CHD patients.
Highlights
The relationship between thyroid stimulating hormone (TSH) and the lipid profile is contradictory because few studies have excluded the potential influence of the thyroid hormones (TH)
The normal TSH levels were stratified into three groups (0.27–1.57 mIU/L, 1.58–2.88 mIU/L and 2.89–4.19 mIU/L), and the patients with coronary heart disease (CHD) were divided into 5 groups according to the serum TSH concentrations
In conclusion, we found that serum TSH levels are positively and linearly associated with serum total cholesterol (TC) levels after adjustments for the thyroid hormones in CHD patients
Summary
The relationship between TSH and the lipid profile is contradictory because few studies have excluded the potential influence of the thyroid hormones (TH). Abnormal thyroid hormone metabolism may lead to different forms of heart disease and hypothyroidism, in particular, is a wellknown cause of accelerated coronary atherosclerosis [2,3]. Elevated TSH levels have recently aroused interest due to the potential for TSH to induce injury, especially in patients with coronary heart disease (CHD). Even within the reference range, serum free thyroxine (FT4) levels near the upper limit have been associated with different metabolic markers in euthyroid subjects and patients with coronary artery disease [13,14]. Few studies have excluded the potential influences of the thyroid hormones when assessing the relationship between TSH and the lipid status
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