scholarly journals Specific impact of cardiovascular risk factors on coronary microcirculation in patients with subclinical hypothyroidism

2021 ◽  
Author(s):  
Mirjana Stojković ◽  
Biljana Nedeljković-Beleslin ◽  
Milorad Tesic ◽  
Zoran Bukumiric ◽  
Jasmina Ciric ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Thyroid Hormones ◽  
Cardiovascular Risk Factors ◽  
Subclinical Hypothyroidism ◽  
Thyroid Stimulating Hormone ◽  
Normal Serum ◽  
Free Triiodothyronine ◽  
Flow Reserve ◽  
The Impact

Background: Although thyroid hormones have significant effect on cardiovascular system, the impact of subtle thyroid dysfunction such as subclinical hypothyroidism (SCH) remains to be determined. We investigated coronary flow reserve (CFR) in patients with subclinical hypothyroidism. Methods: Thirty-two subjects with SCH and eighteen control subjects with normal serum thyroid hormones and thyroid-stimulating hormone (TSH) levels were included in the study. TSH, free thyroxine, free triiodothyronine, glucose, insulin, HbA1c, cholesterol, triglyceride and plasma levels of C-reactive protein were measured. Coronary diastolic peak flow velocities in left anterior descending coronary artery were measured at baseline and after adenosine infusion. CFR was calculated as the ratio of hyperemic to baseline diastolic peak velocity. Results: CFR values were not significantly different between the two groups (SCH 2.76 ± 0.35 vs controls 2.76 ± 0.42). There was a significant correlation of CFR with waist to hip ratio, hypertension, smoking habits, markers of glucose status (glucose level, HbA1c, insulin level, HOMA IR), cholesterol, LDL-cholesterol and triglyceride levels in SCH group, whereas only cholesterol level showed significant correlation with CFR in controls. There was no correlation between CFR and thyroid hormones. Conclusion: We concluded that there is a different impact of cardiovascular risk factors on CFR in SCH patients compared to healthy control and that these two groups behave differently in the same circumstances under the same risk factors. The basis for this difference could be that the altered thyroid axis “set point” changes the sensitivity of the microvasculature in patients with SCH to known risk factors.

scholarly journals Subclinical Hypothyroidism and Cardiovascular Risk – An Overview of Current Understanding

2010 ◽  
Vol 7 (1) ◽  
pp. 53 ◽  
Author(s):  
Ulla Feldt Rasmussen ◽  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Subclinical Hypothyroidism ◽  
Large Scale ◽  
Thyroid Stimulating Hormone ◽  
Individual Variability ◽  
Overt Hypothyroidism ◽  
Therapeutic Trial ◽  
Treatment Benefit

Subclinical or mild hypothyroidism is often associated with adverse cardiovascular risk factors, such as high cholesterol, together with hypertension, endothelial dysfunction and other atherosclerotic cardiovascular risk factors. The ischaemic abnormalities are probably related to long-term consequences of a slowly progressing development of hypothyroidism. In recent years, it has become evident that a consensus on the exact limits for cut-off between normal and subclinically hypothyroid individuals is not currently possible. The main reasons for this are differences for measurement of serum thyroid-stimulating hormone (TSH), that reference populations are very different and that a person’s intra-individual variability is much narrower than any population-based interval. Finally, the prevalence of subclinical hypothyroidism varies from 4 to 17% in different normal populations. Available evidence indicates that patients with subclinical hypothyroidism have developed or are at risk of developing an adverse cardiovascular profile and subclinical hypothyroidism is most likely a mild variant of overt hypothyroidism. There is currently no evidence for a treatment benefit, but studies to demonstrate the expected minor improvements have not been performed on a sufficiently large scale. Patients should be informed about the disease and based on a combined clinical and laboratory judgement, should be offered a therapeutic trial in case of even vague symptoms.

scholarly journals Subclinical Hypothyroidism and Cardiovascular Risk—An Overview of Current Understanding

2010 ◽  
Vol 06 (01) ◽  
pp. 92 ◽  
Author(s):  
Ulla Feldt-Rasmussen ◽  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Subclinical Hypothyroidism ◽  
Large Scale ◽  
Thyroid Stimulating Hormone ◽  
Individual Variability ◽  
Overt Hypothyroidism ◽  
Therapeutic Trial ◽  
Treatment Benefit

Subclinical or mild hypothyroidism is often associated with adverse cardiovascular risk factors, such as high cholesterol, together with hypertension, endothelial dysfunction and other atherosclerotic cardiovascular risk factors. The ischemic abnormalities are probably related to long-term consequences of a slowly progressing development of hypothyroidism. In recent years, it has become evident that a consensus on the exact limits for cut-off between normal and subclinically hypothyroid individuals is not currently possible. The main reasons for this are differences for measurement of serum thyroid-stimulating hormone (TSH), that reference populations are very different, and that a person’s intra-individual variability is much narrower than any population-based interval. Finally, the prevalence of subclinical hypothyroidism varies from 4 to 17% in different normal populations. Available evidence indicates that patients with subclinical hypothyroidism have developed or are at risk for developing an adverse cardiovascular profile, and subclinical hypothyroidism is most likely a mild variant of overt hypothyroidism. There is currently no evidence for a treatment benefit, but studies to demonstrate the expected minor improvements have not been performed on a sufficiently large scale. Patients should be informed about the disease and, based on a combined clinical and laboratory judgement, should be offered a therapeutic trial in case of even vague symptoms.

scholarly journals The relationship between serum thyroid-stimulating hormone, insulin resistance, and cardiovascular risk factors in obese patients with subclinical hypothyroidism

2021 ◽  
Vol 16 (8) ◽  
pp. 630-635
Author(s):  
N.V. Pasiechko ◽  
Yu.V. Yevstratieva
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Subclinical Hypothyroidism ◽  
Thyroid Stimulating Hormone ◽  
Obese Patients ◽  
Obese People ◽  
The Relationship ◽  
Tsh Levels

Background. The epidemic of overweight and obesity presents a major challenge to chronic disease prevention and health across the life course around the world. The putative relationships between thyroid hormones, body weight, and adipose tissue homeostasis have been the focus of several studies in recent years, but the causal relationships between these parameters have not been well established. The purpose of the study: to investigate the relationship between serum thyroid-stimulating hormone (TSH), insulin resistance (IR), and cardiovascular risk factors in a sample of obese people with subclinical hypothyroidism. Materials and methods. A retrospective, longitudinal analysis of 145 obese patients was performed. The TSH and free thyroxine (fT4) levels, anthropometric measurements, and laboratory test results were analyzed. Results. Twenty-three individuals presented with TSH levels above the normal level (subclinical hypothyroidism). Their waist circumference (WC) was significantly higher than that of euthyroid individuals. Serum TSH positively correlated with the homeostasis model assessment of insulin resistance (HOMA-IR) index, triglycerides, and high-density lipoprotein cholesterol (HDL-C). Using TSH and body mass index as independent variables, TSH levels were shown to be independently related to HOMA-IR (p = 0.002) and triglycerides (p = 0.006). Among euthyroid subjects, individuals with TSH values < 2.5 mIU/ml exhibited statistically significant decreases in waist-to-hip ratio, HDL-C levels, and HOMA-IR scores and a tendency toward lower WC values. Conclusions. Subclinical hypothyroidism in overweight and obese people appears to be associated with excess weight, especially visceral weight. In the present sample of obese patients, TSH levels appear to be associated with insulin resistance.

Abstract 003: Change in Cardiovascular Risk Factors Associated with Weight Gain in the Dallas Heart Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Tiffany M Powell ◽  
Colby R Ayers ◽  
James A de Lemos ◽  
Amit Khera ◽  
Susan G Lakoski ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Weight Gain ◽  
Cardiovascular Risk Factors ◽  
Average Weight ◽  
Men And Women ◽  
Significant Weight Gain ◽  
Heart Study ◽  
Dallas Heart Study ◽  
The Impact

Background: Concerning trends in weight gain from 2000-2009 exist in the Dallas Heart Study (DHS), a probability-based sample of Dallas County residents aged 30-65. However, the impact of significant weight gain (≥ 5% increase in body weight) on cardiovascular risk factors (CVRF) in this contemporary, multi-ethnic population is not known. Methods: We measured weight, LDL-c, blood pressure (SBP and DBP), and fasting glucose (FG) in 2,022 DHS participants (58% female) at study entry in 2000 and in 2009. Using logistic regression stratified by sex and race/ethnicity, we determined the age-adjusted odds of worsening CVRF (any increase in LDL-c, SBP, DBP or FG) for people who gained significant weight compared to those who did not. Results: Among women, 43% (N=500) gained significant weight, compared to 42% of men (N=355). Despite similar average weight gain (9.7±5.8 kg for women vs. 10±5.6 kg for men, p=0.4), women who gained significant weight had almost twice as large an increase in LDL-c (14±34 vs. 8±39 mg/dl, p=0.01) and SBP (12±18 vs. 6±19 mmHg, p<0.001) compared with men who gained significant weight. Increases in DBP (5±10 vs. 4±11 mmHg, p=0.05) and FG (4±29 vs. 2±32 mg/dl, p=0.30) were not significantly different between men and women. Among those with significant weight gain who were not on medications, SBP and LDL-c increases were higher in women compared with men (p<0.05). Differences in the amount of weight gained stratified by race and sex were modest (Table). Black women who gained significant weight were likely to have a worsening of all CVRF, while Hispanic women had the highest likelihood of having an increase in SBP associated with weight gain. In contrast, significant weight gain among men was not associated with worsening CVRF. Conclusions: Significant weight gain was associated with a deleterious impact on CVRF among women but not men. Disparate effects of weight gain between men and women highlight the importance of targeting aggressive weight control interventions toward women to help prevent adverse cardiac outcomes.

Factor XIII Val34Leu polymorphism and the risk of myocardial infarction under the age of 36 years

2008 ◽  
Vol 99 (06) ◽  
pp. 1085-1089 ◽  
Author(s):  
Marianna Politou ◽  
Christoforos Komporozos ◽  
Demosthenes Panagiotakos ◽  
Chrisoula Belessi ◽  
Anthi Travlou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Factor Xiii ◽  
Control Group ◽  
Lower Prevalence ◽  
Premature Coronary Heart Disease ◽  
Acute Mi ◽  
The Impact

SummaryThere are limited and controversial data regarding the impact of factor XIII (FXIII) Val34Leu polymorphism in the pathogenesis of premature myocardial infarction (MI). We examined whether FXIII Val34Leu polymorphism is associated with the development of early MI.We recruited 159 consecutive patients who had survived their first acute MI under the age of 36 years (mean age=32.1 ± 3.6 years, 138 were men). The control group consisted of 121 healthy individuals matched with cases for age and sex, without a family history of premature coronary heart disease (CHD). FXIII Val34Leu polymorphism was tested with polymerase chain reaction and reverse hybridization. There was a lower prevalence of carriers of the Leu34 allele in patients than in controls (30.2 vs. 47.1%, p=0.006). FXIII Val34Leu polymorphism was associated with lower risk for acute MI after adjusting for major cardiovascular risk factors (odds ratio [OR] = 0.51, 95% confidence interval [CI] 0.27–0.95, p=0.03). Subgroup analysis according to angiographic findings (“normal” coronary arteries [n=29] or significant CHD [n=130]) showed that only patients with MI and significant CHD had lower prevalence of carriers of the Leu34 allele compared to controls after adjusting for major cardiovascular risk factors (OR = 0.42, 95% CI 0.22–0.83, p=0.01). Our data indicate that FXIII Val34Leu polymorphism has a protective effect against the development of MI under the age of 36 years, particularly in the setting of significant CHD.

The impact of pancreas and kidney transplant on cardiovascular risk factors (analyzed by mode of immunosuppression and exocrine drainage)

2009 ◽  
Vol 23 (5) ◽  
pp. 616-620 ◽  
Author(s):  
Colin Davenport ◽  
Nadira Hamid ◽  
Eoin P. O'Sullivan ◽  
Padraig Daly ◽  
Ponnusamy Mohan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Kidney Transplant ◽  
The Impact
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