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Association of thyroid hormone sensitivity index with stroke in patients with coronary artery disease
Guangwei Pan1, Guoyuan Zhao2, Lin Li1
1Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin 301617, China.
Insights
Thyroid hormone sensitivity indexes are linked to stroke risk in coronary heart disease (CHD) patients. Higher central sensitivity and lower peripheral sensitivity indicate increased stroke risk.
Area of Science:
- Endocrinology
- Cardiology
- Neurology
Background:
- Thyroid hormones (THs) influence stroke occurrence and prognosis.
- Research on THs sensitivity indexes and stroke in coronary heart disease (CHD) patients is limited.
Purpose of the Study:
- To investigate the relationship between central and peripheral THs sensitivity indexes and stroke risk in CHD patients.
Main Methods:
- Assessed central THs sensitivity using thyroid feedback quantile index (TFQI), thyroid stimulating hormone index (TSHI), and thyrotropin thyroxine resistance index (TT4RI).
- Evaluated peripheral THs sensitivity by the ratio of serum free triiodothyronine (FT3) to serum free thyroxine (FT4).
- Analyzed the association with stroke using logistic regression in 30,160 CHD patients.
Main Results:
- Increased central THs sensitivity indexes (TSHI, TFQI) correlated positively with stroke risk.
- Decreased peripheral THs sensitivity (lower FT3/FT4 ratio) correlated negatively with stroke risk.
- Higher risks were observed in younger (<65 years), male, and diabetic subgroups for central indexes; lower risks in older (>65 years), female, and prediabetic subgroups for peripheral indexes.
Conclusions:
- Elevated central THs sensitivity and reduced peripheral THs sensitivity are associated with increased stroke risk in CHD patients.
- These findings offer novel insights for assessing stroke risk in this population.
Background And Aims:
Thyroid hormones (THs) will affect the occurrence and prognosis of stroke, and the research on THs sensitivity index and stroke in patients with coronary heart disease (CHD) is scarce. The goal of this study is to look into the relationship between central and peripheral THs sensitivity index and stroke in patients with CHD.
Methods:
Between January 1, 2014, and September 30, 2020, 30,160 patients with CHD were enrolled in this study. By computing the thyroid feedback quantile index (TFQI), thyroid stimulating hormone index (TSHI), and thyrotropin thyroxine resistance index (TT4RI), the central sensitivity indexes to THs was assessed, and the ratio of serum free triiodothyronine (FT3) to serum free thyroxine (FT4) was used to assess peripheral THs sensitivity. The relationship between central and peripheral THs sensitivity index and stroke was investigated using logistic regression, especially in different types of stroke, ages, sexes, and blood glucose levels.
Results:
Stroke risk is positive associated with TSHI, TFQI, and PTFQI. In subgroup analysis, the OR values of these relationships are higher in people younger than 65 years old, male, and diagnosed with diabetes. In addition, stroke risk was negatively associated with FT3/FT4, and the OR values of these relationships were lower in people older than 65 years, female, and diagnosed with prediabetes.
Conclusions:
This study demonstrates that the increase in the central THs sensitivity index and the decrease in the peripheral THs sensitivity index are associated with a higher risk of stroke in CHD patients, and provides new ideas for the assessment of stroke in patients with CHD.
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