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Investigation of thyroid function and blood pressure in school-aged subjects without overt thyroid disease

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Abstract

This study was performed to ascertain whether a relationship exists between thyroid function and blood pressure in school-aged Chinese subjects without overt thyroid disease. A cross-sectional survey of 880 subjects (541 females and 339 males) aged 7–18 years in Bengbu, Anhui province was conducted. The investigation, which was based on a stratified random cluster sampling method, included a questionnaire and measurements of blood pressure, height, and body weight. Fasting blood samples were taken for measurements of thyroid-stimulating hormone (TSH), free 3,5,3′-triiodothyronine (FT3) and free thyroxine (FT4). Serum TSH and FT3 were positively correlated with systolic and diastolic blood pressure Z scores (SBP-Z and DBP-Z) even after adjusting for body mass index (BMI) (P < 0.05) but no correlation was observed between FT4 and SBP-Z or DBP-Z after comparable adjustments (P > 0.05). SBP-Z and DBP-Z in subjects with subclinical hypothyroidism were significant higher than in euthyroid subjects (P < 0.05). Both SBP-Z and DBP-Z increased linearly with TSH concentration in boys after adjusting BMI (P < 0.05); however, a similar linear trend was not observed in girls. Our findings support the hypothesis that elevated TSH and FT3 concentrations increase blood pressure in school-aged Chinese subjects without overt thyroid disease; this increase may be even more significant in boys.

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References

  1. I. Klein, K. Ojamaa, Thyroid hormone and the cardiovascular system. N. Engl. J. Med. 344, 501–509 (2001)

    Article  PubMed  CAS  Google Scholar 

  2. S. Danzi, I. Klein, Thyroid hormone and blood pressure regulation. Curr. Hypertens. Rep. 5, 513–520 (2003)

    Article  PubMed  Google Scholar 

  3. H.J. Gallowitsch, Thyroid and cardiovascular system. Wien. Med. Wochenschr. 155, 436–443 (2005)

    Article  PubMed  Google Scholar 

  4. A.R. Cappola, P.W. Ladenson, Hypothyroidism and atherosclerosis. J. Clin. Endocrinol. Metab. 88, 2438–2444 (2003)

    Article  PubMed  CAS  Google Scholar 

  5. L.M. Prisant, J.S. Gujral, A.L. Mulloy, Hyperthyroidism: a secondary cause of isolated systolic hypertension. J. Clin. Hypertens. 8, 596–599 (2006)

    Article  Google Scholar 

  6. R. Luboshitzky, A. Aviv, P. Herer, L. Lavie, Risk factors for cardiovascular disease in women with subclinical hypothyroidism. Thyroid 12, 421–425 (2002)

    Article  PubMed  Google Scholar 

  7. T. Nagasaki, M. Inaba, Y. Kumeda, Y. Hiura, K. Shirakawa, S. Yamada, Y. Henmi, E. Ishimura, Y. Nishizawa, Increased pulse wave velocity in subclinical hypothyroidism. J. Clin. Endocrinol. Metab. 91, 154–158 (2006)

    Article  PubMed  CAS  Google Scholar 

  8. B.O. Asvold, T. Bjøro, T.I. Nilsen, L.J. Vatten, Association between blood pressure and serum thyroid-stimulating hormone concentration within the reference range: a population-based study. J. Clin. Endocrinol. Metab. 92, 841–845 (2007)

    Article  PubMed  Google Scholar 

  9. D. Liu, F. Jiang, Z. Shan, B. Wang, J. Wang, Y. Lai, Y. Chen, M. Li, H. Liu, C. Li, H. Xue, N. Li, J. Yu, L. Shi, X. Bai, X. Hou, L. Zhu, L. Lu, S. Wang, Q. Xing, W. Teng, A cross-sectional survey of relationship between serum TSH level and blood pressure. J. Hum. Hypertens. 24, 134–138 (2010)

    Article  PubMed  CAS  Google Scholar 

  10. Y. Duan, W. Peng, X. Wang, W. Tang, X. Liu, S. Xu, X. Mao, S. Feng, Y. Feng, Y. Qin, K. Xu, C. Liu, C. Liu, Community-based study of the association of subclinical thyroid dysfunction with blood pressure. Endocrine 35, 136–142 (2009)

    Article  PubMed  CAS  Google Scholar 

  11. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents, The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 114, 555–576 (2004)

    Google Scholar 

  12. P.J. Owen, C. Rajiv, D. Vinereanu, T. Mathew, A.G. Fraser, J.H. Lazarus, Subclinical hypothyroidism, arterial stiffness, and myocardial reserve. J. Clin. Endocrinol. Metab. 91, 2126–2132 (2006)

    Article  PubMed  CAS  Google Scholar 

  13. Y. Duan, X. Wang, W. Peng, Y. Feng, W. Tang, X. Wu, X. Mao, R. Bo, W. Li, J. Chen, Y. Qin, C. Liu, C. Liu, Gender-specific associations between subclinical hypothyroidism and blood pressure in Chinese adults. Endocrine. 36, 438–444 (2009)

    Article  PubMed  CAS  Google Scholar 

  14. O. Gumieniak, T.S. Perlstei, P.N. Hopkins, N.J. Brown, L.J. Murphey, X. Jeunemaitre, N.K. Hollenberg, G.H. Williams, Thyroid function and blood pressure homeostasis in euthyroid subjects. J. Clin. Endocrinol. Metab. 89, 3455–3461 (2004)

    Article  PubMed  CAS  Google Scholar 

  15. M. Dörr, B. Wolff, D.M. Robinson, U. John, J. Lüdemann, W. Meng, S.B. Felix, H. Völzke, The association of thyroid function with cardiac mass and left ventricular hypertrophy. J. Clin. Endocrinol. Metab. 90, 673–677 (2005)

    Article  PubMed  Google Scholar 

  16. A.R. Cappola, L.P. Fried, A.M. Arnold, M.D. Danese, L.G. Kuller, G.L. Burke, R.P. Tracy, P.W. Ladenson, Thyroid status, cardiovascular risk, and mortality in older adults. JAMA 295, 1033–1041 (2006)

    Article  PubMed  CAS  Google Scholar 

  17. R.D. Lindeman, D.S. Schade, A. LaRue, L.J. Romero, H.C. Liang, R.N. Baumgartner, K.M. Koehler, P.J. Gary, Subclinical hypothyroidism in a biethnic, urban community. J. Am. Geriatr. Soc. 47, 703–709 (1999)

    PubMed  CAS  Google Scholar 

  18. J. Kvetny, P.E. Heldgaard, E.M. Bladbjerg, J. Gram, Subclinical hypothyroidism is associated with a low-grade inflammation, increased triglyceride levels and predicts cardiovascular disease in males below 50 years. Clin. Endocrinol. 61, 232–238 (2004)

    Article  CAS  Google Scholar 

  19. K. Ojamaa, J.D. Klemperer, I. Klein, Acute effects of thyroid hormone on vascular smooth muscle. Thyroid 6, 505–512 (1996)

    Article  PubMed  CAS  Google Scholar 

  20. S. Stabouli, S. Papakatsika, V. Kotsis, Hypothyroidism and hypertension. Expert Rev. Cardiovasc. Ther. 8, 1559–1565 (2010)

    Article  PubMed  Google Scholar 

  21. K.W. Park, H.B. Dai, K. Ojamaa, E. Lowenstein, I. Klein, F.W. Sellke, The direct vasomotor effect of thyroid hormones on rat skeletal muscle resistance arteries. Anesth. Analg. 85, 734–738 (1997)

    PubMed  CAS  Google Scholar 

  22. O. Gumieniak, S. Hurwitz, T.S. Perlstein, U.C. Ngumezi, P.N. Hopkins, X. Jeunemaitre, G.H. Williams, Aggregation of high-normal thyroid-stimulating hormone in hypertensive families. J. Clin. Endocrinol. Metab. 90, 5985–5990 (2005)

    Article  PubMed  CAS  Google Scholar 

  23. S.I. García, P.I. Porto, G. Dieuzeide, M.S. Landa, T. Kirszner, Y. Plotquin, C. Gonzalez, C.J. Pirola, Thyrotropin-releasing hormone receptor (TRHR) gene is associated with essential hypertension. Hypertension 38, 683–687 (2001)

    Article  PubMed  Google Scholar 

  24. M.S. Landa, M.L. Schuman, A. Burgueno, A.L. Alvarez, S.I. Garcia, C.J. Pirola, SiRNA-mediated silencing of the diencephalic thyrotropin-releasing hormone precursor gene decreases the arterial blood pressure in the obese agouti mice. Front. Biosci. 12, 3431–3435 (2007)

    Article  PubMed  CAS  Google Scholar 

  25. M.S. Landa, S.I. García, M.L. Schuman, A. Burgueño, A.L. Alvarez, F.E. Saravia, C. Gemma, C.J. Pirola, Knocking down the diencephalic thyrotropin-releasing hormone precursor gene normalizes obesity-induced hypertension in the rat. Am. J. Physiol. Endocrinol. Metab. 292, E1388–E1394 (2007)

    Article  PubMed  CAS  Google Scholar 

  26. M.M. Mitsnefes, Hypertension in children and adolescents. Pediatr. Clin. North Am. 53, 493–512 (2006)

    Article  PubMed  Google Scholar 

  27. S. Ruhla, M.O. Weickert, A.M. Arafat, M. Osterhoff, F. Isken, J. Spranger, C. Schöfl, A.F. Pfeiffer, M. Möhlig, A high normal TSH is associated with the metabolic syndrome. Clin. Endocrinol. 72, 696–701 (2010)

    Article  CAS  Google Scholar 

  28. V. Kotsis, M. Alevizaki, S. Stabouli, V. Pitiriga, Z. Rizos, M. Sion, N. Zakopoulos, Hypertension and hypothyroidism: results from an ambulatory blood pressure monitoring study. J. Hypertens. 25, 993–999 (2007)

    Article  PubMed  CAS  Google Scholar 

  29. E. Fommei, G. Iervasi, The role of thyroid hormone in blood pressure homeostasis: evidence from short-term hypothyroidism in humans. J. Clin. Endocrinol. Metab. 87, 1996–2000 (2002)

    Article  PubMed  CAS  Google Scholar 

  30. M. Ferreira, F. Teixeira, V.A. Mansur, V.S. Reuters, C.P. Almeida, M. Vaisman, Ambulatory blood pressure monitoring in normotensive patients with subclinical hypothyroidism. Arq. Bras. Cardiol. 94, 806–812 (2010)

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by a Medical Key Subject grant from Jiangsu Province, China. Chao Liu was supported by grants RC2002047 and LJ200619 from Jiangsu Province, China. We are grateful to all patients and medical staff who participated in the study.

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Authors and Affiliations

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

    Huanhuan Chen, Bin Song, Xiaoyun Liu, Xiaodong Mao, Jie Li, Hongmei Shen, Wei Tang & Yu Duan

  2. Department of Endocrinology, Third People’s Hospital of Bengbu, Bengbu, Anhui Province, 233000, China

    Qian Xi

  3. Department of Cardiology, First Affiliated Hospital, Nanjing Medical University, Nanjing, 210029, China

    Hao Zhang

  4. Department of Endocrinology, Jiangsu province Hospital on Integration of Chinese and Western Medicine, Nanjing, 210028, China

    Jiaming Zhang, Zhiguo Wang & Chao Liu

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  1. Huanhuan Chen
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  2. Qian Xi
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  3. Hao Zhang
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  4. Bin Song
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  11. Zhiguo Wang
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  12. Yu Duan
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  13. Chao Liu
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Correspondence to Yu Duan or Chao Liu.

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Chen, H., Xi, Q., Zhang, H. et al. Investigation of thyroid function and blood pressure in school-aged subjects without overt thyroid disease. Endocrine 41, 122–129 (2012). https://doi.org/10.1007/s12020-011-9517-7

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  • DOI: https://doi.org/10.1007/s12020-011-9517-7

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