Association between high normal-range thyrotropin concentration and carotid intima-media thickness in euthyroid premenopausal, perimenopausal and postmenopausal women
Association between high normal-range thyrotropin concentration and carotid intima-media thickness in euthyroid premenopausal, perimenopausal and postmenopausal women
复制标题
DOI：
10.1016/j.maturitas.2020.10.022
复制
发表时间：
2021-02-01
期刊：
影响因子：
4.9
通讯作者：
Murakami, Masami
中科院分区：
文献类型：
--
作者：
Sakamaki, Koji;Tsunekawa, Katsuhiko;Murakami, Masami
目的：目前，在与颈动脉粥样硬化相关的参考区间内，还没有确定促甲状腺激素（TSH）的临界水平，以预防心血管疾病的发生。本研究旨在确定甲状腺功能正常的绝经前、围绝经期和绝经后妇女的TSH临界值与颈动脉最大内膜中层厚度（最大IMT）的关系。我们对468名甲状腺功能正常的妇女进行了一项横断面研究，她们没有接受过心血管疾病的治疗或诊断，在日本日高医院参加综合医学检查的1221名日本妇女中，测量受试者的体重、血压、血糖、血清脂蛋白、游离甲状腺素和TSH，并进行月经情况访谈。结果：随着绝经状态的进展，最大IMT显着逐步增加（p 0.001）。颈动脉斑块定义为最大IMT >= 1.1 mm（p = 0.038），血清TSH水平明显高于颈动脉斑块，多变量logistic回归分析显示血清TSH水平与颈动脉斑块独立相关（β =1.218，p = 0.036）。在绝经后妇女中，血清TSH >= 2.5 μ IU/mL的妇女颈动脉最大IMT值显著高于血清TSH = 2.5 μ IU/mL的妇女，这可能有助于评估动脉粥样硬化的风险，尤其是在绝经后妇女中。
Objective: There are currently no established cutoff levels for thyrotropin (TSH) within the reference intervals associated with carotid atherosclerosis to prevent the onset of cardiovascular diseases. The present study aimed to determine the TSH cutoff level associated with carotid maximum intima-media thickness (max IMT) in euthyroid premenopausal, perimenopausal and postmenopausal women.Study design: We conducted a cross-sectional study of 468 euthyroid women who had not been treated for or diagnosed with cardiovascular diseases and/or metabolic disorders among 1221 Japanese women who participated in a comprehensive medical examination at the Hidaka Hospital, Japan. Participants' weight, blood pressure, plasma glucose, serum lipoprotein, free thyroxine and TSH were measured and an interview about menstruation was conducted. Carotid ultrasonography was performed to determine max IMT.Results: Max IMT significantly increased stepwise as menopausal status progressed (p 0.001). Serum TSH levels were significantly higher in participants with carotid plaques, defined as max IMT >= 1.1 mm (p = 0.038), and were independently associated with the presence of carotid plaque using multivariate logistic regression analysis (beta =1.218, p = 0.036). In postmenopausal women, significantly higher carotid max IMT values were observed in women with serum TSH >= 2.5 mu IU/mL compared with women with concentrations = 2.5 mu IU/mL may be useful to assess risk of atherosclerosis, especially in postmenopausal women.