The relationship between circulating TRAIL and endothelial dysfunction in subclinical hypothyroidism

Tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) is associated with atherosclerosis. Subclinical hypothyroidism (sHT) is associated with the increased prevalence of atherosclerotic lesions and cardiovascular events. Therefore, we hypothesized that circulating TRAIL levels are associated with endothelial dysfunction in sHT patients. Two hundred and four patients with newly diagnosed sHT and 52 healthy subjects were recruited. Circulating TRAIL concentration was measured by an ELISA, and flow-mediated dilation (FMD) of brachial artery was measured using high-resolution ultrasound. The mean value of circulating TRAIL in newly diagnosed sHT patients was 67.2 pg/ml, which was lower than that in controls (78.5 pg/ml, p < 0.001). By dividing the distribution of FMD levels into quartiles, TRAIL levels were increased gradually with the increase of FMD levels (p < 0.001). Multivariate regression analysis demonstrated that serum TRAIL levels were independently associated with FMD (p = 0.007). By logistic regression analysis, the odds ratio for lower FMD levels was reduced by 12.1 % per 1 pg/ml increase in serum TRAIL concentration after adjustment for multivariate metabolic factors [OR (95 % CI); 0.879 (0.721-0.973)]. Circulating TRAIL level decreased in newly diagnosed sHT patients and is positively associated with endothelial function, suggesting that circulating TRAIL level may be a protective marker of endothelial function in sHT patients.