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Low serum free thyroxine concentrations associate with increased arterial stiffness in euthyroid subjects: a population-based cross-sectional study

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Abstract

Some studies suggest that even in euthyroid subjects, thyroid function may affect arteriosclerotic risk factors. We aimed to determine whether thyroid hormones or thyroid autoantibodies are associated with arterial stiffness in middle-aged and elderly Chinese subjects with euthyroidism. A cross-sectional, population-based study was conducted in Nanjing, China. A total of 812 euthyroid subjects (mean age [56.75 ± 8.34] years; 402 men) without vascular disease and major arteriosclerotic risk factors were included. Clinical factors, oral glucose tolerance test results, homeostasis model assessment for insulin resistance (HOMA-IR) results, and serum levels of lipids, free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), and thyroid autoantibodies were measured. Arterial stiffness was assessed using brachial-ankle pulse wave velocity (baPWV). In Pearson correlation analyses, baPWV correlated inversely with FT4 (r = −0.146, P < 0.001), but not with FT3 (r = 0.008, P = 0.816) or TSH (r = 0.055, P = 0.118). Subsequently, a multiple stepwise regression analysis revealed a significant and independent association of FT4 with baPWV in euthyroid subjects (β = −0.076, P = 0.005). After adjusting for potential cardiovascular risk factors, mean diastolic blood pressure (DBP), HOMA-IR, and baPWV levels decreased across increasing FT4 quartiles (DBP, P < 0.001; HOMA-IR, P < 0.001; baPWV, P = 0.003). No difference in baPWV was observed between the positive and the negative thyroid antibody groups (15.23 ± 3.30 m/s vs. 15.73 ± 3.05 m/s, P > 0.05). FT4 levels were inversely associated with arterial stiffness in euthyroid subjects. A prospective study is warranted to validate whether subjects with low-normal FT4 levels have a high incidence of cardiovascular disease.

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Acknowledgments

This study was supported by the grants from the National Clinical Research Center for Metabolic Diseases (2013BAI09B13), the National Key New Drug Creation and Manufacturing Program of Ministry of Science and Technology (2012ZX09303006-001), Jiangsu Provincial Special Program of Medical Science (BL2012026), and the Priority Academic Program Development of Jiangsu Higher Education Institutions.

Ethics standards

This study was approved by the ethics committee of the First Affiliated Hospital with Nanjing Medical University. Participants gave their informed written consent.

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The authors declare no conflicts of interest.

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    Authors and Affiliations

    1. Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China

      Jian Wang, Xuqin Zheng, Min Sun, Zhixiao Wang, Qi Fu, Yun Shi, Mengdie Cao, Zhenxin Zhu, Chuchen Meng, Jia Mao, Fan Yang, Xiaoping Huang, Jingjing Xu, Hongwen Zhou, Yu Duan, Wei He, Mei Zhang & Tao Yang

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    1. Jian Wang
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    The REACTION Study Group

    Corresponding author

    Correspondence to Tao Yang.

    Additional information

    Jian Wang, Xuqin Zheng, and Min Sun have contributed equally to this study.

    The members of the REACTION study group are listed in the Appendix.

    Appendix

    Appendix

    Steering Committee

    Guang Ning (Principle Investigator), National Clinical Research Center for Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Yiming Mu, People’s Liberation Army General Hospital, Beijing, China; Jiajun Zhao, Shandong Provincial Hospital, Jinan, China; Weiqing Wang, National Clinical Research Center for Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Chao Liu, Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China; Yufang Bi, National Clinical Research Center for Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Donghui Li, Department of Gastrointestinal Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, TX, USA; Shenghan Lai, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Zachary T. Bloomgarden, Mount Sinai School of Medicine, New York, USA.

    Working Group

    Weiqing Wang, Yufang Bi, Jieli Lu, National Clinical Research Center for Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Yiming Mu, People’s Liberation Army General Hospital, Beijing, China; Jiajun Zhao, Shandong Provincial Hospital, Jinan, China; Chao Liu, Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China; Lulu Chen, Wuhan Xiehe Hospital, Huazhong University of Science and Technology School of Medicine, Wuhan, China; Lixin Shi, Affiliated Hospital of Guiyang Medical College, Guiyang, China; Qiang Li, The Second Affiliated Hospital of Haerbin Medical University, Haerbin, China; Tao Yang, The First Affiliated Hospital with Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China; Li Yan, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; Qin Wan, The Affiliated Hospital of Luzhou Medical College, Luzhou, China; Shengli Wu, Xinjiang Kelamayi Peoples Hospital, Kelamayi, China; Guixia Wang, The First Hospital of Jilin University, Changchun, China; Zuojie Luo, The First Affiliated Hospital of Guangxi Medical University, Nanning, China; Xulei Tang, The First Hospital of Lanzhou University, Lanzhou, China; Gang Chen, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China; Yanan Huo, Jiangxi People’s Hospital, Nanchang, China; Zhengnan Gao, Dalian Municipal Central Hospital, Dalian, China; Qing Su, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Zhen Ye, Zhejiang Center for Disease Control, China; Youmin Wang, The First Affiliated Hospital of Anhui Medical University, Hefei, China; Guijun Qin, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Huacong Deng, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Xuefeng Yu, Wuhan Tongji Hospital, Huazhong University of Science and Technology School of Medicine, Wuhan, China; Feixia Shen, The First Affiliated Hospital of Wenzhou Medical University, The First Provincial Wenzhou Hospital of Zhejiang, Wenzhou, China; Li Chen, Qilu Hospital, University of Shandong School of Medicine, Jinan, China.

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    Wang, J., Zheng, X., Sun, M. et al. Low serum free thyroxine concentrations associate with increased arterial stiffness in euthyroid subjects: a population-based cross-sectional study. Endocrine 50, 465–473 (2015). https://doi.org/10.1007/s12020-015-0602-1

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