Abstract
The role of thyroid hormones (THs) in the cardiovascular (CV) system, through several direct and indirect effects is recognized. Even very small modification in TH levels (as those observed in subclinical hypothyroidism or hyperthyroidism, and low triiodothyronine syndrome) may adversely affect the CV system, whereas thyroid hormones benefit the CV system and improve the prognosis. There is also evidence of vitamin D effects on cardiometabolic disease (e.g., through modulation of endothelial and smooth muscle cell activity, renin-angiotensin-aldosterone system, nitric oxide, oxidative stress, and inflammatory response), as well as an association between vitamin D [25(OH)D] deficiency and autoimmune thyroid diseases or cancer, and a relationship between vitamin D concentration and titers of antibodies and thyroid autoimmunity replacement. Interestingly, experimental data indicate a direct effect of vitamin D on Type 2 deiodinase expression causing subsequential peripheral conversion of T4 into T3. However, the functional links among THs, vitamin D and the cardiovascular system, and clinical effects of coexisting abnormalities in this new troublesome triad, have not yet been reviewed. The main aim of this review is to discuss pathophysiology of this relationship, proposing new mechanistic insights involving vitamin D in the modulation of cardiometabolic disease and thyroid profile.
Highlights
The roles of thyroid hormones (THs) in cardiovascular (CV) disease, such as heart failure (HF) or acute myocardial infarction (MI), through several direct and indirect effects are well-known (Jabbar et al, 2017; Abdel-Moneim et al, 2020)
The classical roles of vitamin D are related to the regulation of bone turnover and phospho-calcium homeostasis (Caprio et al, 2017)
Vitamin D receptors are present in a variety of cells and tissues, including cardiomyocytes, vascular smooth muscle (VSMC) and endothelial cells, suggesting many extra-skeletal effects of this vitamin, over the traditional calcium and phosphorus homeostasis (GouniBerthold and Berthold, 2021)
Summary
The roles of thyroid hormones (THs) in cardiovascular (CV) disease, such as heart failure (HF) or acute myocardial infarction (MI), through several direct and indirect effects are well-known (Jabbar et al, 2017; Abdel-Moneim et al, 2020). Vitamin D, THs and CV Triad infarct size and improve myocardial function after acute myocardial infarction (AMI), increasing clinical evidence which indicates that the manifestations of subtle thyroid abnormalities (e.g., low T3 syndrome) during AMI course are associated with adverse prognosis (Razvi et al, 2018). In this context, the classical roles of vitamin D are related to the regulation of bone turnover and phospho-calcium homeostasis (Caprio et al, 2017). The main aim of this review is to discuss pathophysiology of this triangle, proposing new mechanistic insights involving vitamin D in the onset and development of cardiometabolic disease and TH function
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