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Published on: March 17, 2023
Cardiovascular risk in chronic autoimmune thyroiditis and subclinical hypothyroidism patients. A cluster analysis
Giovanni Carbotta1, Francesco Tartaglia2, Alessandro Giuliani3
1"Sapienza" University of Rome, Department of Experimental Medicine, Rome, Italy.
Insights
Subclinical hypothyroidism and chronic autoimmune thyroiditis may indicate unrecognized coronary heart disease (CHD). Elevated thyroid antibodies (TPO-Ab) with specific metabolic and cardiovascular markers suggest hidden CHD risk.
Area of Science:
- Endocrinology
- Cardiology
- Metabolic Syndrome
Background:
- Subclinical hypothyroidism (SCH) and chronic autoimmune thyroiditis (CAT) are associated with increased atherosclerosis and coronary heart disease (CHD) risk.
- Patients with SCH or CAT often lack overt CHD symptoms, potentially masking underlying cardiovascular risks.
Purpose of the Study:
- To identify early markers of CHD in patients with SCH or CAT.
- To explore correlations between thyroid function tests and cardiovascular parameters in asymptomatic patients.
Main Methods:
- Evaluated 30 patients (19 CAT, 11 SCH) and 13 controls, measuring 34 thyroid, metabolic, and cardiovascular parameters.
- Utilized oblique principal components clustering (OPC) for statistical analysis.
Main Results:
- A significant cluster emerged, linking thyroid peroxidase antibodies (TPO-Ab), homocysteine levels, and mean absolute values of the second intermetatarsal space (MAPSE).
- Elevated TPO-Ab, reduced MAPSE, increased intima-media thickness (IMT), and higher homocysteine may indicate unrecognized CHD in these patients.
Conclusions:
- Preliminary findings suggest specific markers can identify clinically unrecognized CHD in thyroid patients.
- Further research in larger cohorts could support hormone therapy for CHD prevention in these individuals.
Background:
Subclinical hypothyroidism (SCH) and chronic autoimmune thyroiditis (CAT) are linked to an increased risk of atherosclerosis and coronary heart disease (CHD). The aim of this study was to look for positive markers of CHD and correlations with thyroid blood tests in patients with SCH or CAT, but no symptoms of CHD, so as to identify CHD risk conditions that otherwise would likely be missed.
Methods:
We measured a series of thyroid, clinical-metabolic and cardiovascular parameters in 30 consecutive endocrinology patients enrolled in our ambulatory endocrinological referral center of "Sapienza" University of Rome. (19 with CAT, 11 with SCH) from January 2015 to March 2015. 13 asymptomatic subjects were enrolled as controls. In each patient, we measured a series of 34 thyroid, clinical-metabolic and cardiovascular parameters.
Results:
in the statistical analysis of collected data, the oblique principal components clustering procedure (OPC) revealed the presence of an interesting mixed cluster, composed of a thyroid parameter (TPO-Ab), a metabolic parameter (homocysteine level) and a cardiovascular parameter (MAPSE), in which we assessed the relationships between the single components. Our preliminary results indicate that in both groups of patients elevated TPO-Ab, when accompanied by reduced MAPSE and increased IMT and homocysteine values, may be taken to indicate the presence of clinically unrecognized CHD.
Conclusions:
Confirmation of these results in larger series of patients could justify hormone therapy for prevention of CHD in these thyroid patients versus placebo treatment.
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