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Pulsatility index in carotid arteries is increased in levothyroxine-treated Hashimoto disease

M Owecki1, N Sawicka-Gutaj1, M K Owecki2

  • 1Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznań, Poland.

Hormone and Metabolic Research = Hormon- Und Stoffwechselforschung = Hormones Et Metabolisme
|February 12, 2015
PubMed

Insights

Women with Hashimoto thyroiditis (HT) on levothyroxine (L-T4) replacement therapy show increased carotid artery pulsatility indexes, indicating arterial stiffness. This suggests hypothyroidism, not autoimmune thyroiditis itself, impacts vascular health.

Area of Science:

  • Vascular Medicine
  • Endocrinology
  • Cardiovascular Health

Background:

  • Hashimoto thyroiditis (HT) is an autoimmune disorder affecting the thyroid gland.
  • Cardiovascular risk factors and hemodynamic changes in HT patients require further investigation.
  • Levothyroxine (L-T4) is a common treatment for hypothyroidism associated with HT.

Purpose of the Study:

  • To evaluate carotid hemodynamic variables and traditional cardiovascular risk factors in women with HT.
  • To compare women with HT on L-T4 therapy to euthyroid women with HT not on L-T4.
  • To determine if hypothyroidism or autoimmune thyroiditis itself influences arterial stiffness.

Main Methods:

  • A case-control study involving 31 women with HT on L-T4 and 26 euthyroid women with HT without L-T4.
  • Measurement of carotid intima-media thickness (CIMT), carotid extra-media thickness (CEMT), and carotid artery pulsatility indexes (PI CCA, PI ICA).
  • Assessment of traditional cardiovascular risk factors including BMI, waist circumference, lipid profile, glucose, insulin, and thyroid function parameters (TSH, FT4, TPOAbs).

Main Results:

  • The treated HT group had higher free thyroxine (FT4) levels compared to the untreated group.
  • Pulsatility indexes in the common carotid artery (PI CCA) and internal carotid artery (PI ICA) were significantly higher in women with HT on L-T4 therapy.
  • Carotid intima-media thickness (CIMT) and carotid extra-media thickness (CEMT) were similar between the groups.
  • Adjusted analyses confirmed significantly higher PI ICA and PI CCA in the study group.

Conclusions:

  • Women with HT on L-T4 replacement therapy exhibit increased pulsatility in the common and internal carotid arteries compared to untreated euthyroid HT patients.
  • These findings suggest that hypothyroidism, rather than autoimmune thyroiditis per se, is associated with increased arterial stiffness.
  • Further research is warranted to elucidate the long-term cardiovascular implications of altered carotid hemodynamics in HT patients.

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