Skip to main content
Log in

Is autoimmune thyroiditis a risk factor for early atherosclerosis in premenopausal women even if in euthyroid status?

  • Original Article
  • Published:
Endocrine Aims and scope Submit manuscript

Abstract

Autoimmune thyroiditis (AIT) is a systemic disease. It is well-known that overt thyroid dysfunction is a cardiovascular risk factor. However, the influence of euthyroid status is unclear. The aim of this study was to evaluate the metabolic parameters and carotid intima-media thickness (CIMT) in euthyroid premenopausal women with AIT. Fourty-eight premenopausal women and 18 age-matched healthy controls attending the Endocrinology and Metabolism Clinic from 2008 to 2009 were enrolled to this cross-sectional study. Patients were divided into 2 groups according to TSH levels; patients in group 1 (n = 23) had TSH levels ≤ 2.5 μIU/mL and patients in group 2 had TSH levels > 2.5 μIU/mL (n = 25). All participants were evaluated by ultrasound for CIMT (mean of three segments in both carotid arteries) by the same experienced investigator. Fasting venous blood samples were collected to evaluate insulin resistance (HOMA-IR), TSH, FT4, plasma lipids, high-sensitive CRP (Hs-CRP), homocysteine, and fibrinogen. Carotid intima-media thickness was found to be significantly higher in patients than the controls (p < 0.001). However, there was no significant difference in average CIMT between group 1 and 2 (0.66 ± 0.08 vs 0.63 ± 0.09 mm). Anti-Tg levels were independently associated with CIMT in the patient group (p = 0.014). There were no significant correlations between serum TSH levels and BMI; waist circumference, serum lipids, and glucose levels. However, there was a positive significant correlation between TSH levels and blood pressure in the patients (for systolic blood pressure r = 0.466, p = 0.001, for diastolic blood pressure r = 0.372, p = 0.009). In the present study, it was shown that CIMT is increased in euthyroid premenopausal women with autoimmune thyroiditis compared to age-matched healthy controls.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. D.S. McLeod, D.S. Cooper The incidence and prevalence of thyroid autoimmunity. Endocrine. (2012). doi: 10.1007/s12020-012-9703-2

  2. M.L. Bots, P.J. Breslau, E. Briet et al., Cardiovascular determinants of carotid artery disease: the Rotterdam Elderly Study. Hypertension 19, 717–720 (1992)

    Article  PubMed  CAS  Google Scholar 

  3. H. Hashimoto, K. Kitagawa, H. Hougaku et al., C-reactive protein is an independent predictor of the rate of increase in early carotid atherosclerosis. Circulation 104, 63–67 (2001)

    Article  PubMed  CAS  Google Scholar 

  4. P.M. Ridker, C.H. Hennekens, J.E. Buring et al., C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N. Engl. J. Med. 342, 836–843 (2000)

    Article  PubMed  CAS  Google Scholar 

  5. R. Clarke, L.E. Daly, K. Robinson et al., Hyperhomocysteinemia: an independent risk factor for vascular disease. N. Engl. J. Med. 324, 1149–1155 (1991)

    Article  PubMed  CAS  Google Scholar 

  6. D.S. Wald, M. Law, J.K. Morris, Homocysteine and cardiovascular disease: evidence on causality from a meta-analysis. BMJ 325(7374), 1202 (2002)

    Article  PubMed  Google Scholar 

  7. C.J. Boushey, S.A. Beresford, G.S. Omenn et al., A quantitative assessment of plasma homocysteine as a risk factor for vascular disease. Probable benefits of increasing folic acid intakes. JAMA 274, 1049–1057 (1995)

    Article  PubMed  CAS  Google Scholar 

  8. B.J. Hoogwerf, F.Q. Nuttall, Long-term weight regulation in treated hyperthyroid and hypothyroid subjects. Am. J. Med. 76, 963–970 (1984)

    Article  PubMed  CAS  Google Scholar 

  9. N. Knudsen, P. Laurberg, L.B. Rasmussen, I. Bulow, H. Perrild, L. Ovesen, T. Jorgensen, Small differences in thyroid function may be important for body mass index and the occurrence of obesity in the population. J. Clin. Endocrinol. Metab. 90, 4019–4024 (2005)

    Article  PubMed  CAS  Google Scholar 

  10. M.A. Michalaki, A.G. Vagenakis, A.S. Leonardou, M.N. Argentou et al., Thyroid function in humans with morbid obesity. Thyroid. 16, 73–78 (2006)

    Article  PubMed  CAS  Google Scholar 

  11. N. Manji, K. Boelaert, M.C. Sheppard, R.L. Holder et al., Lack of association between TSH or free T4 and body mass index in euthyroid subjects. Clin. Endocrinol. 64, 125–128 (2006)

    Article  CAS  Google Scholar 

  12. H.S. Shon, E.D. Jung, S.H. Kin, J.H. Lee, Free T4 is negatively correlated with body mass index in euthyroid women. The Korean Journal of Internal Medicine. 23, 53–57 (2008)

    Article  PubMed  CAS  Google Scholar 

  13. G. Iacobellis, M.C. Ribaudo, A. Zappaterreno, C.V. Iannucci et al., Relationship of thyroid function with body mass index, leptin, insulin sensitivity and adiponectin in euhtyroid obese women. Clin. Endocrinol. 62, 487–491 (2005)

    Article  CAS  Google Scholar 

  14. A. Nyrnes, R. Jorde, J. Sundsfjord, Serum TSH is positively associated with BMI. Int J Obes. 30, 100–105 (2006)

    Article  CAS  Google Scholar 

  15. A. Roos, S.J. Bakker, T.P. Links, R.O. Gans et al., Thyroid function is associated with components components of the metabolic syndrome in euthyroid subjects. J. Clin. Endocrinol. Metab. 92, 491–496 (2007)

    Article  PubMed  CAS  Google Scholar 

  16. J.M. Fernandez-Real, A. Lopez-Bermejo, A. Castro et al., Thyroid function is intrinsically linked to insulin sensitivity and endothelium -dependent vasodilation in healthy euthyroid subjects. J. Clin. Endocrinol. Metab. 91, 3337–3343 (2006)

    Article  PubMed  CAS  Google Scholar 

  17. O. Gumieniak, T.S. Perlstein, P.N. Hopkins, N.J. Brown et al., Thyroid function and blood pressure homeostasis in euthyroid subjects. J. Clin. Endocrinol. Metab. 89, 3455–3461 (2004)

    Article  PubMed  CAS  Google Scholar 

  18. S. Ruhla, M.O. Weickert, A.M. Arafat, M. Osterhoff et al., A high normal TSH is associated with the metabolic syndrome. Clin Endocrinology. 72, 696–701 (2010)

    Article  CAS  Google Scholar 

  19. D.H. O’Leary, J.F. Polak, R.A. Kronmal, T.A. Manolio et al., Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults: cardiovascular health study collaborative research group. New England J Medicine. 340, 14–22 (1999)

    Article  Google Scholar 

  20. E. De Groot, G.K. Hovingh, A. Wiegman, P. Duriez et al., Measurement of arterial wall thickness as a surrogate marker for atherosclerosis. Circulation 109(23 Suppl.I), III33–III38 (2004)

    PubMed  Google Scholar 

  21. C. Lamotte, C. Iliescu, C. Libersa, F. Gottrand, Increased intima-media thickness of the carotid artery in childhood: a systematic review of observational studies. Eur. J. Pediatr. 170, 719–729 (2011)

    Article  PubMed  Google Scholar 

  22. M. Litwin, A. Niermirska, Intima-media thickness measurements in children with cardiovascular risk factors. Pediatr. Nephrol. 24, 707–719 (2009)

    Article  PubMed  Google Scholar 

  23. T. Nagasaki, M. Inaba, Y. Henmi, Y. Kumeda et al., Decrease in carotid intima-media thickness in hypothyroid patients after normalization of thyroid function. Clin. Endocrinol. 59, 607–612 (2003)

    Article  CAS  Google Scholar 

  24. F. Monzani, N. Caraccio, M. Kozakowa, A. Dardano et al., Effect of levothyroxine replacement on lipid profile and intima-media thickness in subclinical hypothyroidism: a double-blind, placebo controlled study. J. Clin. Endocrinol. Metab. 89, 2099–2106 (2004)

    Article  PubMed  CAS  Google Scholar 

  25. R.P.F. Dullaart, R. de Vries, C. Roozendaa, A.C. Muller Kobold et al., Carotid artery intima media thickness is inversely related to serum free thyroxine in euthyroid subjects. Clin. Endocrinol. 67, 668–673 (2007)

    Article  CAS  Google Scholar 

  26. M.M. Ciccone, G. De Pergola, M.T. Porcelli, P. Scicchitano et al., Increased carotid IMT in overweight and obese women affected by Hashimoto’s thyroiditis: an adiposity and autoimmune linkage? BMC Cardiovascular Disorders 10, 22 (2010)

    Article  PubMed  Google Scholar 

  27. G. Mazziotti, F. Sorvillo, C. Naclerio, A. Farzati, et al., Type-1 response in peripheral CD4+ and CD8+ T cells from patients with Hashimoto’s thyroiditis. Eur J Endocrinol. 148,383 (2003)

    Google Scholar 

  28. S. Taddei, N. Caraccio, A. Virdis, A. Dardano et al., Low-grade systemic inflammation causes endothelial dysfunction in patients with Hashimoto’s thyroiditis. J. Clin. Endocrinol. Metab. 91, 5076 (2006)

    Article  PubMed  CAS  Google Scholar 

  29. G. Tamer, M. Mert, I. Tamer, B. Mesci, D. Kilic, S. Arik, Effects of thyroid autoimmunity on abdominal obesity and hyperlipidaemia. Endokrynol Pol. 62, 421 (2011)

    PubMed  CAS  Google Scholar 

  30. H. Oflaz, R. Kurt, F. Sen, I. Onur et al., Coronary flow reserve after L-thyroxine therapy in Hashimoto’s thyroiditis patients with subclinical and overt hypothyroidism. Endocr. 32, 264 (2007)

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Oya Topaloglu.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 1465 kb)

Supplementary material 2 (DOCX 18 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Topaloglu, O., Gokay, F., Kucukler, K. et al. Is autoimmune thyroiditis a risk factor for early atherosclerosis in premenopausal women even if in euthyroid status?. Endocrine 44, 145–151 (2013). https://doi.org/10.1007/s12020-012-9842-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12020-012-9842-5

Keywords

Navigation