Non-invasive markers of cardiovascular risk in patients with subclinical hypothyroidism: A systematic review and meta-analysis of 27 case control studies

作者：Yao, Kecheng; Zhao, Tianming; Zeng, Linghai; Yang, Jianming; Liu, Yanqun; He, Qian; Zou, Xiulan^*

来源：Scientific Reports, 2018, 8(1): 4579.

DOI：10.1038/s41598-018-22897-3

• INTIMA-MEDIA THICKNESS
• EPICARDIAL ADIPOSE-TISSUE
• CORONARY-HEART-DISEASE
• PULSE-WAVE VELOCITY
• DEPENDENT ARTERIAL DILATION
• ALL-CAUSE MORTALITY
• LEVOTHYROXINE REPLACEMENT
• MYOCARDIAL-INFARCTION
• ENDOTHELIAL FUNCTION
• THYROXINE TREATMENT

It has been reported that subclinical hypothyroidism (SCH) is closely related to subclinical atherosclerosis. According to the impact of SCH on noninvasive markers of cardiovascular risk, we fulfilled a meta-analysis of included studies to provide an integrated overview. We searched electronic databases and included all relevant studies involving SCH and epicardial adipose tissue (EAT), carotid intima-media thickness (CIMT), pulse wave velocity (PWV), flow-mediated dilation (FMD) and glyceryl trinitrate-induced dilation (GNT-induced dilation). The result was calculated in a meta-analysis to assess the impact of SCH on these markers. A total of 27 studies were entered in the final analysis. Compared with euthyroid subjects, SCH patients exhibited a significantly increased CIMT (SMD: 0.369 mm; 95%CI: 0.038, 0.700; P = 0.029) and EAT (SMD: 1.167 mm; 95%CI: 0.869, 1.466; P = 0.000) and increased PWV (SMD: 3.574 m/s; 95%CI: 0.935, 6.213, P = 0.008). We also found significantly lower FMD (SMD: -1.525%, 95%CI: -2.156, -0.894, P = 0.000) and lower GNT-induced dilation (SMD: -0.384%, 95% CI: -0.625, -0.142, P = 0.002). Sensitivity analysis and subgroup analysis confirmed the above results. Our meta-analysis confirmed a significant association of SCH and cardiovascular risk with arterial wall thickening and stiffening and endothelial dysfunction. These findings will help to establish detailed cardiovascular prevention strategies for SCH patients.

• 出版日期2018-3-15
• 单位三峡大学