Association of serum reverse triiodothyronine, diiodothyronine and thyronamine levels with cardiovascular risk factors and disorders

甲状腺功能正常或亚临床功能障碍受试者的甲状腺功能与心血管疾病的潜在相关性一直存在争议和持续的争议。新出现的甲状腺功能标记物包括反T3(RT3)、二碘甲状腺原氨酸(T2)和t1甲状腺原氨酸(T1AM)可能完善外周甲状腺功能障碍的定义，从而可能提高心血管疾病关联分析的有效性。该项目的总体目标是确认这一假设，即血清RT3、T2和T1AM水平与心血管危险因素和疾病有关。具体地说，我们将解决心血管疾病的三个主要领域。首先，我们将评估血清rt3、t2和t1AM水平与静息和运动性高血压之间的可能联系。其次，探讨与动脉粥样硬化亚临床标志物的关系。这些标记物包括MR主动脉造影术定义的动脉粥样硬化壁改变、颈动脉内中膜厚度、颈动脉斑块、踝臂指数和内皮功能障碍。最后，将分析血清RT3、T2和T1AM水平与心力衰竭亚临床先兆的关系，包括收缩和舒张期心脏功能受损和运动能力有限。根据SHIP数据集中心血管表型的可用性，将进行横断面或纵向的统计分析。所有分析将针对主要混杂因素进行调整，并将解决已建立的和新出现的外周甲状腺功能标记物之间的潜在平衡。通过该项目，我们期待对甲状腺功能和心血管疾病之间的联系有更深入的了解。特别是，该项目的发现可能有助于临床医生为亚临床甲状腺功能障碍患者找到正确的治疗决定。

Potential associations of thyroid function with cardiovascular disorders in subjects with euthyroidism or subclinical dysfunction are the matter of debate and ongoing controversy. Emerging markers of thyroid function including reverse T3 (rT3), diiodothyronine (T2) and T1 thyronamine (T1AM) may refine the definition of peripheral thyroid dysfunction and may hence improve the validity of association analyses for cardiovascular disorders.The comprehensive examination program of the population-based Study of Health in Pomerania (SHIP) offers unique options to analyze the complex associations of serum rT3, T2 and T1AM levels with cardiovascular disorders. The overall aim of the project is to confirm the hypothesis that serum rT3, T2 and T1AM levels are associated with cardiovascular risk factors and disorders. Specifically, we will address three major areas of cardiovascular disorders. First, we will assess the putative associations of serum rT3, T2 and T1AM levels with resting and exercise induced hypertension. Second, the relations with subclinical markers of atherosclerosis will be investigated. These markers include atherosclerotic wall alterations as defined by MR aortography, carotid intima-media thickness, carotid plaques, ankle-brachial index and endothelial dysfunction. Finally, associations of serum rT3, T2 and T1AM levels with subclinical precursors of heart failure including impaired systolic and diastolic ventricular function and limited exercise capacity will be analyzed.Depending on the availability of cardiovascular phenotypes in the SHIP data set, statistical analyses will be done on a cross-sectional or longitudinal basis. All analyses will be adjusted for major confounders and will address the potential balance between established and emerging markers of peripheral thyroid function.From the project we expect deeper insight into the association between thyroid function and cardiovascular disorders. Particularly, findings from this project may help clinicians in finding the right treatment decisions for patients with subclinical thyroid dysfunction.