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是一个有争议的问题。新出现的甲状腺功能标志物，包括反T3（rT3），二碘甲状腺原氨酸（T2）和T1甲状腺原氨酸（T1AM）可能会细化外周甲状腺功能障碍的定义，并因此可能提高心血管疾病相关性分析的有效性。T2和T1AM水平与心血管疾病。该项目的总体目标是证实血清rT3、T2和T1AM水平与心血管危险因素和疾病相关的假设。具体来说，我们将讨论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水平与静息和运动诱发高血压的假定关联。其次，将研究与动脉粥样硬化亚临床标志物的关系。这些标志物包括MR血管造影定义的动脉粥样硬化壁改变、颈动脉内膜中层厚度、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（包括收缩和舒张功能受损以及运动能力受限）的相关性，根据SHIP数据集中心血管表型的可用性，将在横断面或纵向基础上进行统计分析。所有的分析都将调整主要的混杂因素，并将解决建立和新兴的外周甲状腺功能标志物之间的潜在平衡，从该项目中，我们期望更深入地了解甲状腺功能和心血管疾病之间的关联。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策。

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.