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Associations Between Subclinical Thyroid Dysfunction and Cardiovascular Risk Factors According to Age and Sex.

Oliver Baretella1,2, Manuel R Blum1,2, Nazanin Abolhassani1,3

  • 1Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland.

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Subclinical thyroid dysfunction (ScTD) shows similar cardiovascular risk factors (cvRFs) to euthyroid individuals. Observed differences in blood pressure and LDL-cholesterol are too small to explain ScTD

Keywords:
LDL-cholesterolarterial hypertensiondyslipidemiahigh-sensitivity C-reactive proteinsubclinical hyperthyroidismsubclinical hypothyroidism

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Area of Science:

  • Endocrinology
  • Cardiovascular Medicine
  • Epidemiology

Background:

  • Subclinical thyroid dysfunction (ScTD), encompassing subclinical hypothyroidism (SHypo) and subclinical hyperthyroidism (SHyper), is linked to elevated cardiovascular event risk.
  • Understanding the relationship between ScTD and cardiovascular risk factors (cvRFs) is crucial for risk stratification and management.

Purpose of the Study:

  • To investigate the associations between ScTD and key cvRFs, including blood pressure, lipid profiles, and high-sensitivity C-reactive protein (hs-CRP).
  • To examine these associations stratified by age and sex.

Main Methods:

  • Analysis of pooled data from large, prospective cohort studies within the Thyroid Studies Collaboration.
  • Inclusion of participants aged 18 to 103 years, categorized into SHypo, SHyper, and euthyroid groups based on TSH and fT4 levels.
  • Assessment of cvRFs: blood pressure (BP), lipid levels (total, HDL, LDL-cholesterol, triglycerides), and hs-CRP.

Main Results:

  • The study included 69,006 participants; 5.4% had SHypo and 5.0% had SHyper.
  • No significant differences in systolic and diastolic blood pressure, lipid levels, or hs-CRP were observed between ScTD groups and euthyroid participants, with minor exceptions.
  • Women with SHyper had lower diastolic BP, and men with SHyper had lower systolic BP. Women with SHyper also showed lower LDL-cholesterol compared to euthyroid individuals.

Conclusions:

  • The cvRFs in individuals with ScTD are largely similar to those in euthyroid individuals.
  • The observed differences in cvRFs are minimal and unlikely to account for the previously reported increased cardiovascular risk associated with ScTD.
  • Further research may be needed to elucidate the mechanisms underlying the cardiovascular risk in ScTD.