Eur J Endocrinol
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DOI: 10.1530/EJE-08-0140
European Journal of Endocrinology, Vol 159, Issue 2, 145-152
Copyright © 2008 by European Society of Endocrinology
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CLINICAL STUDIES

The association of thyroid function with carotid artery plaque burden and strokes in a population-based sample from a previously iodine-deficient area

Marcus Dörr1, Klaus Empen1, Daniel M Robinson1, Henri Wallaschofski2, Stephan B Felix1 and Henry Völzke3

Departments of1 Cardiology, Angiology and Pulmonology2 Gastroenterology, Endocrinology and Nutrition3 Institute for Community Medicine, Ernst-Moritz-Arndt-University, 17475 Greifswald, Germany

(Correspondence should be addressed to M Dörr who is now at Department of Internal Medicine B, Ernst Moritz Arndt University, Friedrich Loeffler Str. 23 a, D-17475 Greifswald, Germany; Email: mdoerr{at}uni-greifswald.de)

Background: Thyroid dysfunction is associated with detrimental cardiovascular effects. We analyzed whether thyroid status is related to carotid artery plaques and prevalent strokes.

Design, patients and measurements: Data from 2128 subjects (1157 men and 971 women) aged ≥45 years without thyroid diseases participating in the Study of Health in Pomerania were analyzed. The presence of carotid plaques was assessed by B-mode ultrasound and prevalent stroke was assessed by interview. The sample was divided according to the reference range of serum TSH levels into decreased (<0.25 mIU/l), normal (0.25–2.12 mIU/l), and elevated (>2.12 mIU/l). Logistic regression models were adjusted for common confounders including age, sex, BMI, hypertension, diabetes mellitus, smoking, school education, plasma fibrinogen and serum cholesterol levels, and statins.

Results: The prevalence of carotid plaques at any site was higher in subjects with decreased serum TSH levels (81.7%) compared with normal serum TSH levels (70.2%) and elevated serum TSH levels (65.6%; P<0.001). Fully adjusted logistic regression models revealed increased odds for carotid plaques (odds ratio (OR) 1.67; 95% confidence interval (CI) 1.11–2.51; P<0.05) as well as for prevalent strokes (OR 1.98; 95% CI 1.05–3.73; P<0.05) in subjects with decreased serum TSH levels, while there was no association between elevated serum TSH levels and carotid plaques or stroke respectively.

Conclusions: Thyroid function was associated with the presence of carotid artery plaques and prevalent strokes in this population-based sample. Periodical screening and early treatment of atherosclerotic risk factors should be performed in subjects with decreased serum TSH levels.




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B. Biondi
Should we treat all subjects with subclinical thyroid disease the same way?
Eur. J. Endocrinol., September 1, 2008; 159(3): 343 - 345.
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