Are thyroid peroxidase antibodies associated with cardiovascular disease risk in patients with subclinical hypothyroidism?
OBJECTIVE
Conflicting evidence has been reported about whether subclinical hypothyroidism (SCH) is associated with hyperlipidemia or cardiovascular disease. Thyroid peroxidase antibodies (TPOAb) are more common in persons with SCH. The purpose of this study was to evaluate whether the presence of (TPOAb) in people with SCH is associated with markers of cardiovascular disease.


METHODS
Cross-sectional study using multivariate regression.


METHODS
Adults over age 40 who, in the National Health and Nutrition Examination Survey (NHANES) III, met the criteria for SCH (n = 188).


METHODS
Participants were stratified into TPOAb-negative (n = 82) and TPOAb-positive (n = 106) groups. Markers of cardiovascular disease risk were compared between the TPOAb-negative and TPOAb-positive groups. Multivariate regression models were performed to adjust for potential confounders.


RESULTS
In bivariate analyses, individuals with and without TPOAb had similar levels of triglycerides, high-density lipoprotein, low-density lipoprotein, total cholesterol and C-reactive protein. Homocysteine levels were higher in the patients without antibodies (P = 0.01). After adjusting for, age, gender, smoking, hypertension, diabetes and use of a lipid-lowering medication, however, no statistically significant relationships were found between the presence of TPOAb and any of the cardiovascular risk markers.


CONCLUSIONS
The presence of thyroid peroxidase antibodies does not appear to correlate with cardiovascular disease risk in patients with subclinical hypothyroidism. This study does not support the measurement of TPOAb antibodies in SCH as a strategy for guiding treatment or assessment of cardiovascular disease risk.
Wells
Brian J
BJ
Department of Family Medicine at the Cleveland Clinic Foundation, Strongsville, Ohio, USA.
Hueston
William J
WJ
D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000276:immunology*; D002784:Cholesterol / Q000097:blood; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000097:blood*; D007453:Iodide Peroxidase / Q000276:immunology; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D013954:Thyroglobulin / Q000032:analysis; D013960:Thyroid Function Tests; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D014280:Triglycerides / Q000097:blood
D001323:Autoantibodies; D015415:Biomarkers; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D014280:Triglycerides; C056626:thyroid microsomal antibodies; D013972:Thyrotropin; D002097:C-Reactive Protein; D013954:Thyroglobulin; D002784:Cholesterol; D007453:Iodide Peroxidase; D013974:Thyroxine