Thyroid function has a complex relationship with atherogenesis. Higher concentrations of thyroid hormones (TG) are usually associated with systolic hypertension and hypercoagulability.
This population-based cohort study of middle-aged and elderly people examined the association of thyroid function with atherosclerosis in all parameters, including coronary artery calcification (CAC) as a well-diagnosed marker of subclinical atherosclerosis, atherosclerotic cardiovascular events (ACCV) as an indicator of the severity of clinical atherosclerosis and mortality from atherosclerotic complications.
In the article estet-portal.com you can get acquainted in detail with the results of the study of the role of thyroid pathology in atherogenesis.
Population cohort study
The Rotterdam Study was started in 1989 in the Netherlands. Complete data on thyroid function and the presence of atherosclerosis were available from 9420 participants over 50 years of age.
Thyroid stimulating hormone (TSH), free thyroxine (fT4) and anti-thyroperoxidase antibodies (anti-TPO) levels were measured. Reference ranges for serum TSH (0.40-4.0 mIU/L) and serum fT4 (0.86-1.94 ng/dl; equivalent to 11-25 pmol/L) were determined based on national guidelines.
Watch the most interesting videos on our channel in Youtube
Confirmation of the existence of a link between thyroid hormones and atherosclerosis
During a median follow-up of 8.8 years (interquartile interval 4.5 to 11.8 years), there were 934 atherosclerotic cardiovascular events (fatal and non-fatal myocardial infarction or stroke) and 612 deaths from coronary heart disease and cerebrovascular events. or other atherosclerotic diseases.
Attention to the face: signs of possible thyrotoxicosis in patients
Free thyroxine levels were significantly associated with high coronary artery calcification > 100 AU — aortic calcification score in Agatston units (AU) (odds ratio (OR) 2.28; confidence interval (CI) 95%, 1.30–4.02) and ASCC incidents (OR 1.87; CI 1 .34–2.59).
The risk of death from ASCC increased linearly with higher free thyroxine (OR 2.41, CI 1.68-3.47 per ng/dl) and lower TSH (OR 0.92; CI 0. 84–1.00).
Thyrotoxicosis associated with atherosclerosis
In this large population-based cohort study, higher fT4 levels (thyrotoxicosis) were associated with an increased risk of atherosclerosis, independent of CVD risk factors. The relationship was consistent across all parameters of atherosclerosis, from subclinical atherosclerosis to death from atherosclerotic complications.
Various cardiovascular risk factors have been implicated in the pathogenesis of the association between thyroid function and atherosclerosis.
To date, it has been suggested that thyroid autoantibodies may target the arterial wall and ultimately exacerbate the development of atherosclerotic plaque. However, these studies did not find any association between antiTPO and atherosclerosis.
How is the connection between the thyroid gland and atherosclerosis
Possible mechanisms that may link high thyroid function to atherosclerosis include endothelial damage, thrombosis, and hemodynamic changes.
First,, excessive concentrations of TSH can increase the production of reactive oxygen species, which further induce the expression of adhesion molecules on endothelial cells.
Second,, TSH regulates the synthesis of procoagulant proteins. Excessive levels of fT4 are associated with elevated concentrations of various procoagulant proteins, namely von Willebrand factor, fibrinogen, and factors VIII and IX, which can lead to vulnerability and rupture of atherosclerotic plaque.
Third, high TSH levels can cause increased heart contractility and workload, increasing myocardial oxygen demand, which can eventually lead to heart attack and death.
Prophylactic strategies to screen for thyroid function may reduce the risk of atherosclerosis.
Thank you for staying with estet-portal.com. Read other interesting articles in the "Endocrinology" section. You may be interested in Worrying symptoms of thyrotoxicosis. Thyrotoxicosis treatment methods
Share:
Add a comment