Influence of thyroid-stimulating hormone level on the lipid profile, arterial stiffness, and central blood pressure in case of subclinical hypothyroidism
Abstract. Subclinical thyroid dysfunction is a risk factor for cardiovascular disease. The effect of a subclinical increase in thyroid-stimulating hormone (TSH) levels on blood pressure (BP) and arterial stiffness remians under investigation.A.S. Gusev-Shcherbakov, E.A. Troitskaya, Zh.D. Kobalava
The aim: to study central BP and arterial stiffness in patients with different TSH levels.
Material and methods. The main study group included 100 individuals with subclinical hypothyroidism: 50 patients with moderately elevated TSH level (Me 5.9 [4.27; 6.73] μIU/ml (hereinafter referred to as the “low TSH group”) and 50 with its significantly elevated level (Me 7.9 [5.25; 9.8] μIU/ml (hereinafter referred to as the “high TSH group”). The control group consisted of 100 apparently healthy individuals with normal TSH level (Me 2.61 [1.71; 3.10] μIU/ml). All participants underwent 24-hour BP monitoring with parallel measurement of peripheral and central blood pressure and assessment of arterial stiffness.
Results. Among patients in the high TSH group, the median values of peripheral and central clinical and 24-hour systolic BP (SBP) were significantly higher than in the control group: 119 vs. 115 mmHg and 111 vs. 106 mmHg, respectively, for clinical SBP; 120 vs. 112 mmHg and 114 vs. 109 mmHg for 24-hour SBP; 126 vs. 118 mmHg and 119 vs. 114 mmHg for daytime SBP; 109 vs. 102 mmHg and 103 vs. 100 mmHg for nighttime SBP. In addition, participants with high TSH levels demonstrated significantly less favorable arterial stiffness parameters compared with controls (carotid–femoral pulse wave velocity: 8.2 vs. 7.8 m/s; reflected wave transit time: 103 vs. 114 ms; augmentation index: 14 vs. 8%); also they showed signs of developing a more unfavorable metabolic and inflammatory profile.
Conclusion. Elevated TSH level in case of subclinical hypothyroidism is associated with dyslipidemia, elevated blood pressure, and increased arterial stiffness. The severity of these changes increases proportionally to TSH level.
Keywords
subclinical hypothyroidism
subclinical elevation of thyroid-stimulating hormone
central blood pressure
arterial stiffness
24-hour blood pressure monitoring
lipid profile
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About the Authors
Alexander S. Gusev-Shcherbakov, MD, postgraduate student of the Department of internal medicine with a course in cardiology and functional diagnostics named after Academician V.S. Moiseyev of the Institute of Clinical Medicine, Medical Institute of RUDN University; general practitioner, functional diagnostics physician at Academician G.M. Savelyeva City Clinical Hospital No. 31, Moscow, Russian Federation.E-mail: gusev-shcherbakov@yandex.ru
ORCID: https://orcid.org/0000-0003-4717-2160. eLibrary SPIN: 7273-5386
Elena A. Troitskaya, MD, PhD (Medicine), associate professor of the Department of internal medicine with a course in cardiology and functional diagnostics named after Academician V.S. Moiseyev of the Institute of Clinical Medicine, Medical Institute of RUDN University, Moscow, Russian Federation.
E-mail: trelen@yandex.ru,
ORCID: https://orcid.org/0000-0003-1756-7583. Scopus ID: 55673799900. eLibrary SPIN: 6097-9775
Zhanna D. Kobalava, MD, Dr. Sci. (Medicine), professor, corresponding member of RAS, head of the Department of internal medicine with a course in cardiology and functional diagnostics named after Academician V.S. Moiseyev, director of the Institute of Clinical Medicine, Medical Institute of RUDN University, Moscow, Russian Federation.
E-mail: zkobalava@mail.ru
ORCID: https://orcid.org/0000-0002-5873-1768. Scopus ID: 7004399203. eLibrary SPIN: 9828-5409
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