[The effect of hypothyroidism on cardiovascular events and type 2 diabetes mellitus developing in rheumatoid
L V Kondratyeva1, T V Popkova1, E L Nasonov1,2
1Nasonova Research Institute of Rheumatology.
Insights
Hypothyroidism is common in rheumatoid arthritis (RA) patients, particularly those with abdominal obesity. While not independently linked to severe cardiovascular events, both hypothyroid and euthyroid RA patients face elevated cardiovascular and type 2 diabetes risks.
Area of Science:
- Rheumatology
- Endocrinology
- Cardiology
Background:
- Rheumatoid arthritis (RA) is associated with increased cardiovascular disease (CVD) risk.
- Hypothyroidism is a common comorbidity that may influence CVD risk factors.
Purpose of the Study:
- To compare cardiovascular events (CVE), cardiovascular death risk (mSCORE), and type 2 diabetes mellitus (DM) risk (FINDRISC) in RA patients with and without hypothyroidism.
Main Methods:
- 149 RA patients (125 women, 24 men) were assessed for traditional CVD risk factors, glucose metabolism disorders, mSCORE, and FINDRISC.
- Hypothyroidism status was determined, and patients were categorized into groups based on thyroid function.
Main Results:
- Hypothyroidism was present in 17.4% of RA patients, more frequent in those with abdominal obesity (AO).
- Hypothyroid RA patients showed higher rates of AO and lower dietary fiber intake.
- While not statistically significant, hypothyroid patients had a higher incidence of CVE (11.5% vs 6.5%) and a trend towards higher mSCORE and FINDRISC risk.
Conclusions:
- Thyroid function screening is recommended for RA patients, especially those with AO, due to high hypothyroidism prevalence.
- Hypothyroidism did not independently increase severe CVE rates or risk scores (mSCORE, FINDRISC) in this RA cohort.
- Most RA patients, regardless of thyroid status, fell into moderate to very high-risk categories for cardiovascular events and type 2 diabetes.
Aim:
To compare the frequency of cardiovascular events (CVE), to assess the risk of cardiovascular death using the mSCORE and the development of type 2 diabetes mellitus (DM) using the FINDRISC in patients with rheumatoid arthritis (RA) with and without hypothyroidism.
Materials And Methods:
The study included 149 patients (125 women, 24 men) with RA (median age - 57 [52; 61] years). In all patients, traditional factors of cardiovascular risk and glucose metabolism disorders (age, smoking status, total blood cholesterol, blood pressure, overweight, abdominal obesity - AO, heredity burdened by diabetes, insufficient physical activity, the lack of the necessary amount of berries, fruits and vegetables in the daily diet, history of hyperglycemia episodes), the 10-year risk of death from cardiovascular causes according to the mSCORE and the risk of developing type 2 DM according to the FINDRISС were assessed, a history of CVE (myocardial infarctions, and its revascularization, stroke) was recorded.
Results:
Hypothyroidism was diagnosed in 17.4% of RA patients. Patients with hypothyroidism (group 1) were more likely to have AO and less likely to consume unsufficient dietary fiber than patients with euthyroidism (group 2). Moderate, high and very high risk of development according to the mSCORE and FINDRISC was detected in 61.5% of hypothyroid patients and 48.8% euthyroid patients, according to mSCORE alone - in 30.8 and 44.7%, according to FINDRISC - in 0 and 2.4%, respectively (p>0.05 in all cases); 11.5% of patients in group 1 and 6.5% in group 2 suffered from CVE (OR 1.875, 95% CI 0.462-7.607; p=0.63).
Conclusion:
It is necessary to evaluate the thyroid gland function, especially in patients with AO due to the high frequency of hypothyroidism in RA. Hypothyroidism did not have an independent effect on the severe CVЕ rates, as well as risk assessment according to the score and FINDRISC in RA patients. Theses, with and without hypothyroidism, were predominantly in the moderate, high, very high risk groups according to both scales.
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