The Association of Thyroid Hormones with Coronary Atherosclerotic
                    Severity in Euthyroid Patients

Na Yu; Linjie Wang; Yong Zeng; Yuxing Zhao; Shi Chen; Hui Pan; Fengying Gong; Huijuan Zhu

doi:10.1055/a-1718-6283

Hormone and Metabolic Research, Inhaltsverzeichnis

Horm Metab Res 2022; 54(01): 12-19
DOI: 10.1055/a-1718-6283

Endocrine Care

The Association of Thyroid Hormones with Coronary Atherosclerotic Severity in Euthyroid Patients

Na Yu

¹Key Laboratory of Endocrinology of National Health Commission, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China

,

Linjie Wang

¹Key Laboratory of Endocrinology of National Health Commission, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China

,

Yong Zeng

²Department of Cardiology, Capital Medical University, Beijing, China

,

Yuxing Zhao

¹Key Laboratory of Endocrinology of National Health Commission, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China

,

Shi Chen

¹Key Laboratory of Endocrinology of National Health Commission, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China

,

Hui Pan

¹Key Laboratory of Endocrinology of National Health Commission, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China

,

Fengying Gong

¹Key Laboratory of Endocrinology of National Health Commission, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China

,

Huijuan Zhu

¹Key Laboratory of Endocrinology of National Health Commission, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China

› Institutsangaben

Abstract

The aim of the work was to explore the correlation between thyroid hormones and coronary atherosclerotic severity. This cross-sectional study included 340 euthyroid patients who underwent diagnostic coronary artery angiography (CAG). Gensini Score (GS) was applied to assess the severity of coronary atherosclerosis. Thyroid hormones and routine biochemical parameters were measured. The associations between thyroid hormones and coronary atherosclerosis severity were analyzed. Thyroid hormones levels or parameters were taken as both continuous variables and tertiles into analysis, and the lowest tertile was usually used as the reference (OR=1) for medium and highest tertiles. Free triiodothyronine (FT3) level was associated with GS≥22 (Median GS) in Model I adjusted for age and sex [Continuous: OR=0.46, 95% CI (0.23, 0.92), p=0.029; Tertile 3: OR=0.54, 95% CI (0.30, 0.97), p=0.038], and Model II adjusted for all known risk factors of coronary artery disease (CAD) [Continuous: OR=0.44, 95% CI (0.20, 0.95), p=0.036; Tertile 3: OR=0.49, 95% CI (0.25, 0.96), p=0.039]. Subjects with highest tertile of FT3 to free thyroxine (FT4) ratio (FT3/FT4 ratio) appeared to have the remarkably decreased risk of CAD in both Non-adjusted Model [OR=0.49, 95% CI (0.24, 0.98), p=0.044] and Model I [OR=0.45, 95% CI (0.22, 0.93), p=0.031]. Higher FT3 level within normal range was independently and negatively associated with severity of coronary atherosclerosis. Besides, FT3/FT4 ratio was remarkably correlated with the prevalence of CAD in euthyroid population.

Key words

coronary artery disease - Gensini score - free triiodothyronine - FT3/FT4 ratio - euthyroid

Volltext

Referenzen

References
1 Mendis SPP, Norrving B. (eds) Global atlas on CVD prevention and control. Geneva, Switzerland: World Health Organization; 2011. Updated February 20, 2018. Available from: http://www.who.int/cardiovasculardiseases/publications/atlas_cvd/en/
2 Razvi S, Jabbar A, Pingitore A. et al. Thyroid hormones and cardiovascular function and diseases. J Am Coll Cardiol 2018; 71: 1781-1796
3 Cooper DS, Biondi B. Subclinical thyroid disease. Lancet 2012; 379: 1142-1154
4 Beyer C, Plank F, Friedrich G. et al. Effects of hyperthyroidism on coronary artery disease: a computed tomography angiography study. Can J Cardiol 2017; 33: 1327-1334
5 Steinberger E, Pilz S, Trummer C. et al. Associations of thyroid hormones and resting heart rate in patients referred to coronary angiography. Horm Metab Res 2020; 52: 850-855
6 Zhou BY, Guo YL, Wu NQ. et al. Free triiodothyronine in relation to coronary severity at different ages: Gensini score assessment in 4206 euthyroid patients. J Geriatr Cardiol 2016; 13: 978-983
7 Daswani R, Jayaprakash B, Shetty R. et al. Association of thyroid function with severity of coronary artery disease in euthyroid patients. J Clin Diagn Res 2015; 9: OC10-OC13
8 Ertaş F, Kaya H, Soydinç MS. Low serum free triiodothyronine levels are associated with the presence and severity of coronary artery disease in the euthyroid patients: an observational study. Anadolu Kardiyol Derg 2012; 12: 591-596
9 Ling Y, Jiang J, Gui M. et al. Thyroid function, prevalent coronary heart disease, and severity of coronary atherosclerosis in patients undergoing coronary angiography. Int J Endocrinol 2015; 708272
10 Kim ES, Shin JA, Shin JY. et al. Association between low serum free thyroxine concentrations and coronary artery calcification in healthy euthyroid subjects. Thyroid 2012; 22: 870-876
11 Dullaart RP, de Vries R, Roozendaal C. et al. Carotid artery intima media thickness is inversely related to serum free thyroxine in euthyroid subjects. Clin Endocrinol (Oxf) 2007; 67: 668-673
12 Boggio A, Muzio F, Fiscella M. et al. Is thyroid-stimulating hormone within the normal reference range a risk factor for atherosclerosis in women?. Intern Emerg Med 2014; 9: 51-57
13 Cappola AR, Arnold AM, Wulczyn K. et al. Thyroid function in the euthyroid range and adverse outcomes in older adults. J Clin Endocrinol Metab 2015; 100: 1088-1096
14 Gensini GG. A more meaningful scoring system for determining the severity of coronary heart disease. Am J Cardiol 1983; 51: 606
15 Wang L, Chen T, Yu J. et al. Clinical associations of thyroid hormone levels with the risk of atherosclerosis in euthyroid type 2 diabetic patients in central China. Int J Endocrinol 2020; 2172781
16 Yuan D, Zhang C, Jia S. et al. Predictive value of free triiodothyronine (FT3) to free thyroxine (FT4) ratio in long-term outcomes of euthyroid patients with three-vessel coronary artery disease. Nutr Metab Cardiovasc Dis 2020; 31: 579-586
17 Hyland KA, Arnold AM, Lee JS. et al. Persistent subclinical hypothyroidism and cardiovascular risk in the elderly: the cardiovascular health study. J Clin Endocrinol Metab 2013; 98: 533-540
18 Rakov H, De Angelis M, Renko K. et al. Aging is associated with low thyroid state and organ-specific sensitivity to thyroxine. Thyroid 2019; 29: 1723-1733
19 Miyashita K, Murakami M, Iriuchijima T. et al. Regulation of rat liver type 1 iodothyronine deiodinase mRNA levels by testosterone. Mol Cell Endocrinol 1995; 115: 161-167
20 Strich D, Karavani G, Edri S. et al. FT3 is higher in males tah in females and decreases over the lifespan. Endocr Pract 2017; 23: 803-807
21 Ichiki T. Thyroid hormone and vascular remodeling. J Atheroscler Thromb 2016; 23: 266-275
22 Chadarevian R, Bruckert E, Leenhardt L. et al. Components of the fibrinolytic system are differently altered in moderate and severe hypothyroidism. J Clin Endocrinol Metab 2001; 86: 732-737
23 Klieverik LP, Janssen SF, van Riel A. et al. Thyroid hormone modulates glucose production via a sympathetic pathway from the hypothalamic paraventricular nucleus to the liver. Proc Natl Acad Sci U S A 2009; 106: 5966-5971
24 Samuel S, Zhang K, Tang YD. et al. Triiodothyronine potentiates vasorelaxation via PKG/VASP signaling in vascular smooth muscle cells. Cell Physiol Biochem 2017; 41: 1894-1904
25 Zwaveling J, Pfaffendorf M, van Zwieten PA. The direct effects of thyroid hormones on rat mesenteric resistance arteries. Fundam Clin Pharmacol 1997; 11: 41-46
26 Lekakis J, Papamichael C, Alevizaki M. et al. Flow-mediated, endothelium-dependent vasodilation is impaired in subjects with hypothyroidism, borderline hypothyroidism, and high-normal serum thyrotropin (TSH) values. Thyroid 1997; 7: 411-414
27 Taddei S, Caraccio N, Virdis A. et al. Impaired endothelium-dependent vasodilatation in subclinical hypothyroidism: beneficial effect of levothyroxine therapy. J Clin Endocrinol Metab 2003; 88: 3731-3737
28 Papaioannou GI, Lagasse M, Mather JF. et al. Treating hypothyroidism improves endothelial function. Metabolism 2004; 53: 278-279
29 Gaynullina DK, Schubert R, Tarasova OS. Changes in endothelial nitric oxide production in systemic vessels during early ontogenesis - a key mechanism for the perinatal adaptation of the circulatory system. Int J Mol Sci 2019; 20

Zusatzmaterial

Supplementary Material