J Korean Soc Menopause.  2012 Dec;18(3):193-198.

The Association between Subclinical Hypothyroidism and Cardiovascular Risk Factors in Post-menopausal Women

• Kwon OS
• Kim JH
• Cho SH
• Park HM
• Sung EJ

Abstract

OBJECTIVES
The relationship between subclinical hypothyroidism and cardiovascular disease has not yet been clearly defined. This study will investigate whether or not there is a difference in the prevalence of subclinical hypothyroidism in menopausal women with respect to cardiovascular risk factors, and will furthermore analyze the relationship between cardiovascular diseases and subclinical hypothyroidism, in order to establish a foundation for subclinical hypothyroidism research.
METHODS
The study subjects consisted of 713 post-menopausal women, who visited the hospital for a health check-up in 2006-2010. They were divided into a subclinical hypothyroidism group and a normal group. This study analyzed the difference in blood pressure, serum lipid, body mass index (BMI) and blood glucose level between the two groups. The data was analyzed using a two-sample t-test.
RESULTS
The prevalence of subclinical hypothyroidism for menopausal women was 6.7%. The results showed no significant differences between the normal and subclinical hypothyroidism patient groups, in regards to blood pressure, BMI, and blood glucose levels (P > 0.05). However the triglyceride of serum lipid was significantly higher in the subclinical hypothyroidism group (P = 0.003).
CONCLUSION
It has been confirmed that the triglyceride of the subclinical hypothyroidism group was higher than that of the normal group, and so serum lipid maintenance and caution towards cardiovascular disease is necessary for the subclinical hypothyroidism group.

Keyword

Cardiovascular diseases; Hypothyroidism; Middle aged; Postmenopause; Triglycerides

MeSH Terms

Blood Glucose
Blood Pressure
Body Mass Index
Cardiovascular Diseases
Female
Humans
Hypothyroidism
Middle Aged
Postmenopause
Prevalence
Risk Factors
Triglycerides
Blood Glucose
Triglycerides

Reference

1. Cooper DS. Clinical practice. Subclinical hypothyroidism. N Engl J Med. 2001. 345:260–265.

2. Chung JH, Kim BJ, Choi YH, Shin MH, Kim SH, Min YK, et al. Prevalence of thyrotoxicosis and hypothyroidism in the subjects for health check-up. J Korean Soc Endocrinol. 1999. 14:301–313.

3. Hak AE, Pols HA, Visser TJ, Drexhage HA, Hofman A, Witteman JC. Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam Study. Ann Intern Med. 2000. 132:270–278.

4. Rodondi N, den Elzen WP, Bauer DC, Cappola AR, Razvi S, Walsh JP, et al. Subclinical hypothyroidism and the risk of coronary heart disease and mortality. JAMA. 2010. 304:1365–1374.

5. Dean JW, Fowler PB. Exaggerated responsiveness to thyrotrophin releasing hormone: a risk factor in women with coronary artery disease. Br Med J (Clin Res Ed). 1985. 290:1555–1561.

6. Vanderpump MP, Tunbridge WM, French JM, Appleton D, Bates D, Clark F, et al. The development of ischemic heart disease in relation to autoimmune thyroid disease in a 20-year follow-up study of an English community. Thyroid. 1996. 6:155–160.

7. Miura S, Iitaka M, Suzuki S, Fukasawa N, Kitahama S, Kawakami Y, et al. Decrease in serum levels of thyroid hormone in patients with coronary heart disease. Endocr J. 1996. 43:657–663.

8. Expert Panel on Detection Evaluation and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 2001. 285:2486–2497.

9. Choi JK, Kim JS, Hwang CH, Kim DH, Hwang SW, Cho B, et al. Subclinical hypothyroidism and coronary risk factors in women above 55 years. J Korean Acad Fam Med. 2002. 23:96–103.

10. Bemben DA, Winn P, Hamm RM, Morgan L, Davis A, Barton E. Thyroid disease in the elderly. Part 1. Prevalence of undiagnosed hypothyroidism. J Fam Pract. 1994. 38:577–582.

11. Tunbridge WM, Evered DC, Hall R, Appleton D, Brewis M, Clark F, et al. The spectrum of thyroid disease in a community: the Whickham survey. Clin Endocrinol (Oxf). 1977. 7:481–493.

12. Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado thyroid disease prevalence study. Arch Intern Med. 2000. 160:526–534.

13. Park KS, Oh KJ, Kang DJ, Park KC, Kim MJ, Lee YJ. Plasma lipid concentrations and blood pressure in women with subclinical hypothyroidism. J Korean Acad Fam Med. 2003. 24:1110–1116.

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

15. Jorde R. "Subclinical" thyroid disease. Tidsskr Nor Laegeforen. 2002. 122:938–940.

16. Vanhaelst L, Neve P, Chailly P, Bastenie PA. Coronary-artery disease in hypothyroidism. Observations in clinical myxoedema. Lancet. 1967. 2:800–802.

17. Elder J, McLelland A, O'Reilly DS, Packard CJ, Series JJ, Shepherd J. The relationship between serum cholesterol and serum thyrotropin, thyroxine and tri-iodothyronine concentrations in suspected hypothyroidism. Ann Clin Biochem. 1990. 27(Pt 2):110–113.

18. 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.

19. Caron P, Calazel C, Parra HJ, Hoff M, Louvet JP. Decreased HDL cholesterol in subclinical hypothyroidism: the effect of L-thyroxine therapy. Clin Endocrinol (Oxf). 1990. 33:519–523.

20. Parle JV, Franklyn JA, Cross KW, Jones SR, Sheppard MC. Circulating lipids and minor abnormalities of thyroid function. Clin Endocrinol (Oxf). 1992. 37:411–414.

21. Hollander M, Hak AE, Koudstaal PJ, Bots ML, Grobbee DE, Hofman A, et al. Comparison between measures of atherosclerosis and risk of stroke: the Rotterdam Study. Stroke. 2003. 34:2367–2372.

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

23. Chu JW, Crapo LM. The treatment of subclinical hypothyroidism is seldom necessary. J Clin Endocrinol Metab. 2001. 86:4591–4599.

24. Biondi B, Cooper DS. The clinical significance of subclinical thyroid dysfunction. Endocr Rev. 2008. 29:76–131.

25. Vanderpump MP, Tunbridge WM, French JM, Appleton D, Bates D, Clark F, et al. The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham Survey. Clin Endocrinol (Oxf). 1995. 43:55–68.

26. Danese MD, Ladenson PW, Meinert CL, Powe NR. Clinical review 115: effect of thyroxine therapy on serum lipoproteins in patients with mild thyroid failure: a quantitative review of the literature. J Clin Endocrinol Metab. 2000. 85:2993–3001.

27. Lee SR, Cho SB, Jeong KA. Serum lipid profiles and thyroid function tests in elderly women. J Korean Soc Menopause. 2009. 15:186–192.

28. Jo YS, Chung HS, Lim SO, Kim JH. The influence of thyroid function on the prevalence of osteoporosis in Korean women in a local community. J Korean Soc Menopause. 2009. 15:16–23.