Dataset Information

Thyroid function and cardiovascular disease risk factors in euthyroid adults: a cross-sectional and longitudinal study.

ABSTRACT:

Objective and design

We explored the cross-sectional and longitudinal associations of thyroid function within the normal range with cardiovascular disease (CVD) risk factors and adiposity measures.

Patients and measurements

A total of 3483 (50·4% women) participants for the cross-sectional CVD study and 1630 (41·2% women) participants for the cross-sectional body composition substudy were drawn from the Framingham Third Generation Exam 1; 2912 participants (50·1% women) for the longitudinal CVD study and 713 participants (35·9% women) for the longitudinal body composition substudy were drawn from the Framingham Third Generation Exams 1-2. Thyroid function was assessed by thyrotropin [thyroid-stimulating hormone (TSH)] and free thyroxine (fT4) concentrations within the reference range at Exam 1. The associations between thyroid function and CVD risk factors were modelled via multivariable-adjusted regression models. Multivariable adjustment included age, sex, current smoking, postmenopausal status and BMI.

Results

Cross-sectionally, higher TSH concentration was associated with increased odds of hypertriglyceridaemia [odds ratio (OR)=1·10], and higher BMI (β = 0·19 kg/m² ), total cholesterol (β = 0·05 mmol/l), triglycerides (β = 0·0006 mmol/l) and subcutaneous adipose tissue (SAT) volume (β = 38·8 cm³ ) (all P < 0·05). Cross-sectionally, fT4 was inversely associated with metabolic and adiposity-related CVD risk factors, including obesity (OR = 1·17), hypertriglyceridaemia (OR = 1·09), BMI (β = 0·42 kg/m² ), total cholesterol (β = 0·05 mmol/l), triglycerides (β = 0·0002 mmol/l), visceral adipose tissue (VAT) volume (β = -20·7 cm³ ) and attenuation (0·17 HU) and VAT/SAT ratio (β = -0·01) (all P < 0·05). However, during 6·1 years of follow-up, baseline TSH and fT4 levels were not longitudinally associated with CVD risk factors and adiposity measures.

Conclusions

Thyroid function within the normal range is cross-sectionally, but not longitudinally, associated with CVD risk factors and adiposity measures.

SUBMITTER: Lee JJ

PROVIDER: S-EPMC5589187 | biostudies-literature | 2016 Dec

REPOSITORIES: biostudies-literature

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Publications

Thyroid function and cardiovascular disease risk factors in euthyroid adults: a cross-sectional and longitudinal study.

Lee Jane J JJ Pedley Alison A Marqusee Ellen E Sutherland Patrice P Hoffmann Udo U Massaro Joseph M JM Fox Caroline S CS

Clinical endocrinology 20160714 6

<h4>Objective and design</h4>We explored the cross-sectional and longitudinal associations of thyroid function within the normal range with cardiovascular disease (CVD) risk factors and adiposity measures.<h4>Patients and measurements</h4>A total of 3483 (50·4% women) participants for the cross-sectional CVD study and 1630 (41·2% women) participants for the cross-sectional body composition substudy were drawn from the Framingham Third Generation Exam 1; 2912 participants (50·1% women) for the lo ...[more]

PMID: 27256825

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Project description:BackgroundThyroid hormones are important modulators of cardiovascular function. Both hypothyroidism and hyperthyroidism are known to contribute to an increased cardiovascular risk. It remains uncertain whether thyroid hormones level within the euthyroid range are associated with cardiometabolic risk. We aimed to evaluate the association between thyroid function levels within the euthyroid range and cardiovascular risk in a population-based cohort.MethodsEight hundred thirty-five subjects aged ≥45 years from the EPIPorto population-based cohort were included. We excluded participants with TSH, free T4 (FT4), or free T3 (FT3) outside of the reference range, or with previous cardiovascular or thyroid disease. The associations between thyroid function, cardiovascular risk factors and the 10-year estimated risk of cardiovascular events (using SCORE2 and SCORE2-OP) were evaluated in linear and logistic regression models, crudely and adjusting for age, sex, BMI, diabetes, and smoking.ResultsThe mean age of the participants was 61.5 (SD 10.5) years and 38.9% were men. Eleven percent of the participants had diabetes, 47.8% had dyslipidemia, and 54.8% had hypertension. The mean body mass index (BMI) was 27.4 (SD 4.6) kg/m2, and the median (percentile25-75) 10-year risk of cardiovascular events was 5.46% (2.92, 10.11). Participants with higher BMI, larger waist circumference and higher hs-CRP had higher levels of FT3 and FT3/FT4 ratio. Lower FT3/FT4 ratio and higher FT4 levels were associated with higher prevalence of diabetes and more adverse lipid profile. Higher TSH, lower FT3 and lower FT3/FT4 ratio were associated with lower eGFR. Lower FT3, lower FT3/FT4 ratio and higher FT4 were associated with an increased 10-year risk of cardiovascular events.ConclusionsIn a population-based study, variations of thyroid function within the euthyroid range were associated with cardiovascular risk factors. On one hand, individuals with higher BMI, larger waist circumference and higher hs-CRP had higher levels of FT3 and FT3/FT4 ratio. On the other hand, a decreased conversion of T4 to T3 (lower FT3, lower FT3/FT4 ratio and/or higher FT4) was associated with a higher prevalence of diabetes, a more adverse lipid profile, a lower eGFR and an increased 10-year risk of cardiovascular events.

Project description:ObjectivesTo estimate prevalence and clustering of cardiovascular risk factors (CRFs), and investigate the association between relevant characteristics and CRF clustering among adults in eastern China.DesignCommunity-based cross-sectional study.SettingData were collected by interview survey, physical measurements and laboratory examinations from the 2011 Nanjing Chronic Disease and Risk Factor Surveillance.ParticipantsA representative sample of 41 072 residents aged ≥18 years volunteered to participate in the survey, with a response rate of 91.3%. We excluded 1232 subjects due to missing data or having a history of cardiovascular diseases; a total of 39 840 participants were included in the analysis.Outcome measuresPrevalence and clustering of five major CRFs including hypertension, diabetes, dyslipidaemia, overweight or obesity and current smoking.ResultsOf 39 840 participants (mean age 47.9±16.2 years), 17 964 (45.1%) were men and 21 876 (54.9%) were women. The weighted prevalence of CRFs ranged between 6.2% for diabetes and 35.6% for overweight or obesity. The proportion of CRFs tended to be higher in men, the elderly, participants who lost a life partner, or lived in rural areas, or had lower level of education and total annual income. Overall, 30.1% and 35.2% of participants had one and at least two CRFs, respectively. Multivariate logistic regression revealed that men, older age, loss of a life partner, lower level of socioeconomic status, rural areas, insufficient physical activity or unhealthy diets were positively associated with CVD risk factor clustering, compared with their counterparts.ConclusionsHigh regional prevalence of hypertension, dyslipidaemia, overweight or obesity and their clustering are present in Nanjing. The Nanjing government should develop effective public health policies at the regional level especially for high-risk groups, such as enhancing the public's health awareness, organising health promotion programmes, implementing smoke-free law, producing healthy nutrient foods, providing free or low-cost public sports and fitness facilities.

Project description:ObjectiveTo assess the prevalence, magnitude and factors associated with the number of major modifiable cardiovascular disease (CVD) risk factors.DesignCommunity-based cross-sectional study.SettingGeneral population in urban and rural Wolaita, southern Ethiopia.ParticipantsA total of 2483 adults aged 25-64 years were selected using the three-stage random sampling.Outcome measuresPrevalence of major modifiable CVD risk factors, co-occurrences and the number of modifiable CVD risk factors.ResultsThe major modifiable CVD risk factors documented in the Wolaita area were smoking with a weighted prevalence of 0.8%, hypercholesterolaemia 5.0%, hypertriglyceridaemia 15.5%, low high-density lipoprotein cholesterol (HDL-C) 31.3%, high systolic blood pressure 22.2%, high diastolic blood pressure 22.4%, physical inactivity 44.1%, obesity 2.8% and hyperglycaemia 3.7%. The numbers of participants having ≥1, ≥2 and ≥3 major modifiable CVD risk factors in the study area were 2013, 1201 and 576 with a weighted prevalence of 75.8%, 42.3% and 19.4%, respectively. In general, there were 28 different combinations of major modifiable CVD risk factor co-occurrences. The combination of physical inactivity with low HDL-C was found in 19.7% of the study participants, followed by physical inactivity with hypertension of 17.8%. Urban residence, male gender, sugar-sweetened food consumption and older age had a positive association with the number of major modifiable CVD risk factors, while being a farmer had a negative association.ConclusionsThe prevalence and magnitude of major modifiable CVD risk factors in the study area were high. The components of the most prevalent combinations of major modifiable CVD risk factors should be targeted. Therefore, public health measures against major modifiable CVD risk factors such as promotion of physical exercise and reduction of sugar-sweetened food consumption have to be taken, targeting the vulnerable groups such as urban residents and older age.

Dataset Information

Thyroid function and cardiovascular disease risk factors in euthyroid adults: a cross-sectional and longitudinal study.

Objective and design

Patients and measurements

Results

Conclusions

Publications

Thyroid function and cardiovascular disease risk factors in euthyroid adults: a cross-sectional and longitudinal study.

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