Iodine-Induced Hypothyroidism and Long-Term Risks of Incident Heart Failure.
Iodine-Induced Hypothyroidism and Long-Term Risks of Incident Heart Failure.
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DOI：
10.1161/jaha.123.030511
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发表时间：
2023-10-17
影响因子：
5.4
通讯作者：
中科院分区：
文献类型：
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尽管大多数人可以适应大量的碘负荷并保持甲状腺功能正常，但接触碘后可能会出现甲状腺功能减退症。甲状腺功能减退症与不良心血管后果有关，包括心力衰竭。本研究旨在探讨碘引起的甲状腺功能减退症与心力衰竭之间的关系。美国退伍军人健康管理局的这项队列研究（1998-2021）包括年龄≥18岁的成年人，血清促甲状腺激素（促甲状腺激素）服用碘造影剂<60天，基线血清促甲状腺激素正常<1年。 Cox比例风险回归确定了碘诱发的甲状腺功能减退症后发生心力衰竭的风险，调整了年龄、性别、种族和民族、体重指数以及冠心病、血脂异常、糖尿病和高血压病史。在 45-470 名退伍军人中（平均±标准差年龄，61.1±14.1 岁；88% 为男性），3361 名（7.4%）患有碘诱发的甲状腺功能减退症。中位随访时间为 3.6 年（四分位数范围，1.9-7.2 年），5685 名患者（12.5%）出现心力衰竭。调整危险因素后，与碘暴露后甲状腺功能正常的患者相比，碘诱发的甲状腺功能减退症与心力衰竭风险增加相关（调整后的风险比 [HR]，1.11 [95% CI，1.01-1.22]）。女性的风险高于男性（调整后的 HR：女性，1.65 [95% CI，1.13–2.40]；男性，1.08 [95% CI，0.98–1.19]；交互作用 P，0.02）。在美国关于这一主题的最大研究中，碘暴露后的甲状腺功能减退症与心力衰竭风险增加相关，特别是在女性中。这些发现支持需要进一步研究来解决这个问题的临床意义，包括在更多样化的数据集和研究人群中可能发生心力衰竭的性别特异性风险。
Although most individuals can adapt to a large iodine load and remain euthyroid, hypothyroidism can develop after iodine exposure. Hypothyroidism is associated with adverse cardiovascular consequences, including heart failure. This study was performed to investigate the relationships between iodine‐induced hypothyroidism and incident heart failure. This cohort study of the US Veterans Health Administration (1998–2021) included adults aged ≥18 years with a serum thyroid‐stimulating hormone (thyrotropin) <60 days of iodine contrast administration, and <1 year of a baseline normal serum thyroid‐stimulating hormone. Cox proportional hazards regression ascertained risk of incident heart failure following iodine‐induced hypothyroidism, adjusting for age, sex, race and ethnicity, body mass index, and history of coronary heart disease, dyslipidemia, diabetes, and hypertension. Of 45 470 veterans (mean±SD age, 61.1±14.1 years; 88% men), 3361 (7.4%) developed iodine‐induced hypothyroidism. Heart failure developed in 5685 (12.5%) individuals over a median follow‐up of 3.6 years (interquartile range, 1.9–7.2 years). Adjusted for risk factors, iodine‐induced hypothyroidism was associated with increased risk of heart failure, compared with those who remained euthyroid after iodine exposure (adjusted hazard ratio [HR], 1.11 [95% CI, 1.01–1.22]). Women were at greater risk than men (adjusted HR: women, 1.65 [95% CI, 1.13–2.40]; men, 1.08 [95% CI, 0.98–1.19]; P for interaction, 0.02). In the largest US study of this topic, hypothyroidism following iodine exposure was associated with an increased risk of incident heart failure, particularly in women. These findings support the need for further research to address the clinical significance of this issue, including the possible sex‐specific risks of incident heart failure in more diverse data sets and study populations.
影响因子：
39
作者：
Willard, Devina L.;Leung, Angela M.;Pearce, Elizabeth N.
通讯作者：
Pearce, Elizabeth N.