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Horm Metab Res 2015; 47(08): 577-580
DOI: 10.1055/s-0034-1398491
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Pulsatility Index in Carotid Arteries is Increased in Levothyroxine-Treated Hashimoto Disease

M. Owecki   *
1   Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznań, Poland
,
N. Sawicka-Gutaj   *
1   Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznań, Poland
,
M. K. Owecki
2   Department of Neurology, Poznan University of Medical Sciences, Poznań, Poland
,
W. Ambrosius
2   Department of Neurology, Poznan University of Medical Sciences, Poznań, Poland
,
J. Dorszewska
2   Department of Neurology, Poznan University of Medical Sciences, Poznań, Poland
,
A. Oczkowska
2   Department of Neurology, Poznan University of Medical Sciences, Poznań, Poland
,
M. Michalak
3   Department of Informatics and Statistics, Poznan University of Medical Sciences, Poznań, Poland
,
J. Fischbach
1   Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznań, Poland
,
W. Kozubski
2   Department of Neurology, Poznan University of Medical Sciences, Poznań, Poland
,
M. Ruchała
1   Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznań, Poland
› Author Affiliations
Further Information

Publication History

received 28 August 2014

accepted 11 December 2014

Publication Date:
11 February 2015 (online)

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Abstract

The aim of this case-control study was to evaluate carotid hemodynamic variables and traditional cardiovascular risk factors in women with Hashimoto thyroiditis (HT). The study group consisted of 31 females with HT on levothyroxine (L-T4) and 26 euthyroid women with HT without L-T4 matched for age and body mass index (BMI) as controls. Carotid intima-media thickness (CIMT), carotid extra-media thickness (CEMT), and pulsatility indexes in common carotid artery (PI CCA) and in internal carotid artery (PI ICA) were measured. BMI, waist circumference, lipid profile, fasting glucose and insulin levels, and parameters of thyroid function [TSH, free thyroxine (FT4) and antithyroperoxidase antibodies (TPOAbs)] were assessed. The study and the control groups did not differ in age, BMI, waist circumference, lipid profile, fasting glucose, and insulin levels. Results are expressed as median (IQR). Treated HT group had higher FT4 levels than nontreated [17.13 (5.11) pmol/l vs. 14.7 (2.27) pmol/l; p=0.0011] and similar TSH [1.64 (2.08) IU/ml vs. 2.07 (3.14) IU/ml; p=0.5915]. PI CCA and PI ICA were higher in the study group than in controls (p=0.0224 and p=0.0477, respectively). The difference remained statistically significant for PI ICA and PI CCA after adjustment for other variables (coefficient=0.09487; standard error=0.04438; p=0.037 and coefficient=0.1786; standard error=0.0870; p=0.0449, respectively). CIMT and CEMT were similar in both groups (p=0.8746 and p=0.0712, respectively). Women with HT on L-T4 replacement therapy have increased PI in common and internal carotid arteries than nontreated euthyroid HT patients. Therefore, it seems that hypothyroidism, but not autoimmune thyroiditis per se, influences arterial stiffness.

Key words

autoimmune thyroiditis - Hashimoto disease - vascular stiffness - cardiovascular disease

* These authors contributed equally to this work.


 

  • References

  • 1 Fruchart JC, Nierman MC, Stroes ESG, Kastelein JJP, Duriez P. New risk factors for atherosclerosis and patient risk assessment. Circulation 2004; 109 (Suppl. 01) III-15
    PubMedSearch in Google Scholar
  • 2 Murad MH, Hazem A, Coto-Yglesias F, Dzyubak S, Gupta S, Bancos I, Lane MA, Erwin PJ, Berglund L, Elraiyah T, Montori VM. The association of hypertriglyceridemia with cardiovascular events and pancreatitis: a systematic review and meta-analysis. BMC Endocr Disord 2012; 12: 2
    CrossrefPubMedSearch in Google Scholar
  • 3 Ertek S, Cicero AF. Hyperthyroidism and cardiovascular complications: a narrative review on the basis of pathophysiology. Arch Med Sci 2013; 9: 944-952
    PubMedSearch in Google Scholar
  • 4 Kamiński G, Makowski K, Michałkiewicz D, Kowal J, Ruchała M, Szczepanek E, Gielerak G. The influence of subclinical hyperthyroidism on blood pressure, heart rate variability, and prevalence of arrhythmias. Thyroid 2012; 22: 454-460
    CrossrefPubMedSearch in Google Scholar
  • 5 Biondi B, Klein I. Hypothyroidism as a risk factor for cardiovascular disease. Endocrine 2004; 24: 1-13
    CrossrefPubMedSearch in Google Scholar
  • 6 Erdogan E, Akkaya M, Bacaksiz A, Tasal A, Ilhan M, Kul S, Asoglu E, Turfan M, Sonmez O, Tasan E. Electrocardiographic and echocardiographic evidence of myocardial impairment inpatients with overt hypothyroidism. Ann Endocrinol (Paris) 2013; 74: 477-482
    CrossrefPubMedSearch in Google Scholar
  • 7 Cappola AR, Ladenson PW. Hypothyroidism and atherosclerosis. J Clin Endocrinol Metab 2003; 88: 2438-2444
    CrossrefPubMedSearch in Google Scholar
  • 8 McLeod D. Autoimmune thyroid disease: a novel risk factor for atherosclerosis?. Endocrine 2013; 44: 8-10
    CrossrefPubMedSearch in Google Scholar
  • 9 Tamer G, Mert M, Tamer I, Mesci B, Kilic D, Arik S. Effects of thyroid autoimmunity on abdominal obesity and hyperlipideamia. Endokrynol Pol 2011; 62: 421-428
    PubMedSearch in Google Scholar
  • 10 Nyirenda MJ, Clark DN, Finlayson AR, Read J, Elders A, Bain M, Fox KA, Toft AD. Thyroid disease and increased cardiovascular risk. Thyroid 2005; 15: 718-724
    CrossrefPubMedSearch in Google Scholar
  • 11 Kvetny J, Heldgaard PE, Bladbjerg EM, Gram J. Subclinical hypothyroidism is associated with a low-grade inflammation, increased triglyceride levels and predicts cardiovascular disease in males below 50 years. Clin Endocrinol (Oxf) 2004; 61: 232-238
    CrossrefPubMedSearch in Google Scholar
  • 12 Tadde S, Caraccio N, Virdis A, Dardano A, Versari D, Ghiadoni L, Ferrannini E, Salvetti A, Monzani F. Low-grade systemic inflammation causes endothelial dysfunction in patients with Hashimoto’s thyroiditis. J Clin Endocrinol Metab 2006; 91: 5076-5082
    CrossrefPubMedSearch in Google Scholar
  • 13 Perk J, De Backer G, Gohlke H, Graham I, Reiner Ž, Verschuren M, Albus Ch, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvänne M, Scholte Op Reimer W, Vrints Ch, Wood D, Zamorano JL, Zannad F, Cooney MT, Bax J, Baumgartner H, Ceconi C, Dean V, Deaton Ch, Fagard R, Funck-Brentano Ch, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Ž, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vahanian A, Windecker S, Aboyans V, Ezquerra EA, Baigent C, Brotons C, Burell G, Ceriello A, De Sutter J, Deckers J, Del Prato S, Diener H-Ch, Fitzsimons D, Fras Z, Hambrecht R, Jankowski P, Keil U, Kirby M, Larsen ML, Mancia G, Manolis AJ, McMurray J, Pająk A, Parkhomenko A, Rallidis L, Rigo F, Rocha E, Ruilope LM, van der Velde E, Vanuzzo D, Viigimaa M, Volpe M, Wiklund O, Wolper Ch. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) The fifth joint task force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts) developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2012; 33: 1635-1701
    CrossrefPubMedSearch in Google Scholar
  • 14 Touboul PJ, Hennerici MG, Meairs S, Adams H, Amarenco P, Bornstein N, Csiba L, Desvarieux M, Ebrahim S, Hernandez Hernandez R, Jaff M, Kownator S, Naqvi T, Prati P, Rundek T, Sitzer M, Schminke U, Tardif JC, Taylor A, Vicaut E, Woo KS. Mannheim carotid intima-media thickness and plaque consensus (2004–2006–2011). An update on behalf of the advisory board of the 3rd, 4th and 5th watching the risk symposia, at the 13th, 15th and 20th European Stroke Conferences, Mannheim, Germany, 2004, Brussels, Belgium, 2006, and Hamburg, Germany, 2011. Cerebrovasc Dis 2012; 34: 290-296
    CrossrefPubMedSearch in Google Scholar
  • 15 Skilton MR, Sérusclat A, Sethu AH, Brun S, Bernard S, Balkau B, Moulin P, Bonnet F. Noninvasive measurement of carotid extra-media thickness: associations with cardiovascular risk factors and intima-media thickness. JACC Cardiovasc Imaging 2009; 2: 176-182
    CrossrefPubMedSearch in Google Scholar
  • 16 Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D, Pannier B, Vlachopoulos C, Wilkinson I, Struijker-Boudier H. European Network for Non-invasive Investigation of Large Arteries; Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J 2006; 27: 2588-2605
    CrossrefPubMedSearch in Google Scholar
  • 17 Stamatelopoulos KS, Kyrkou K, Chrysochoou E, Karga H, Chatzidou S, Georgiopoulos G, Georgiou S, Xiromeritis K, Papamichael CM, Alevizaki M. Arterial stiffness but not intima-media thickness is increased in euthyroid patients with Hashimoto’s thyroiditis: The effect of menopausal status. Thyroid 2009; 19: 857-862
    CrossrefPubMedSearch in Google Scholar
  • 18 Ciccone MM, De Pergola G, Porcelli MT, Scicchitano P, Caldarola P, Iacoviello M, Pietro G, Giorgino F, Favale S. Increased carotid IMT in overweight and obese women affected by Hashimoto’s thyroiditis: an adiposity and autoimmune linkage?. BMC Cardiovasc Disord 2010; 10: 22
    CrossrefPubMedSearch in Google Scholar
  • 19 Dagre AG, Lekakis JP, Papaioannou TG, Papamichael CM, Koutras DA, Stamatelopoulos SF, Alevizaki M. Arterial stiffness is increased in subjects with hypothyroidism. Int J Cardiol 2005; 103: 1-6
    CrossrefPubMedSearch in Google Scholar
  • 20 Tian L, Gao C, Liu J, Zhang X. Increased carotid arterial stiffness in subclinical hypothyroidism. Eur J Int Med 2010; 21: 560-563
    CrossrefPubMedSearch in Google Scholar
  • 21 Takamura N, Akilzhanova A, Hayashida N, Kadota K, Yamasaki H, Usa T, Nakazato M, Maeda T, Ozono Y, Aoyagi K. Thyroid function is associated with carotid intima-media thickness in euthyroid subjects. Atherosclerosis 2009; 204: e77-e81
    CrossrefPubMedSearch in Google Scholar
  • 22 Dullaart RP, de Vries R, Roozendaal C, Kobold AC, Sluiter WJ. Carotid artery intima media thickness is inversely related to serum free thyroxine level in euthyroid subjects. Clin Endocrinol (Oxf) 2007; 67: 668-673
    CrossrefPubMedSearch in Google Scholar
  • 23 Asvold B, Bjoro T, Nilsen TI, Gunnell D, Vatten LJ. Thyrotropin levels and risk of fatal coronary heart disease. Arch Intern Med 2008; 168: 855-860
    CrossrefPubMedSearch in Google Scholar
  • 24 Roos A, Bakker SJ, Links TP, Gans RO, Wolffenbuttel BH. Thyroid function is associated with components of metabolic syndrome in euthyroid subjects. J Clin Endocrinol Metab 2007; 92: 491-496
    CrossrefPubMedSearch in Google Scholar
  • 25 Tinh-Hai C, Bauer DC, Cappola AR, Åsvold BO, Weiler S, Vittinghoff E, Gussekloo J, Bremner A, den Elzen WPJ, Maciel RM, Vanderpump MPJ, Cornuz J, Dörr M, Wallaschofski H, Newman AB, Sgarbi JA, Razvi S, Völzke H, Walsh JP, Aujesky D, Rodondi N. Thyroid antibody status, subclinical hypothyroidism, and the risk of coronary heart disease: an individual participant data analysis. J Clin Endocrinol Metab 2014; 99: 3353-3362
    CrossrefPubMedSearch in Google Scholar
  • 26 Owecki M, Dorszewska J, Sawicka-Gutaj N, Oczkowska A, Owecki MK, Michalak M, Fischbach J, Kozubski W, Ruchała M. Serum homocysteine levels are decreased in levothyroxine-treated women with autoimmune thyroiditis. BMC Endocr Disord 2014; 14: 18
    CrossrefPubMedSearch in Google Scholar
  • 27 Anagnostis P, Karras SN, Gotsis E, Gouni-Berthold I. Thyroid dysfunction and arterial stiffness. Does the restoration of thyroid function tests offer any benefit?. Open Hypertens J 2013; 5: 87-93
    PubMedSearch in Google Scholar