Increased carotid IMT in overweight and obese women affected by Hashimoto's thyroiditis: an adiposity and autoimmune linkage?
BACKGROUND
Hashimoto's thyroiditis is the most important cause of hypothyroidism. It is a systemic disease that can even affect the cardiovascular system, by accelerating the atherosclerotic process. Aim of this study was to examine whether autoimmune thyroiditis has an effect on the intima-media thickness of the common carotid artery (IMT-CCT), independently of the thyroid function and well-known cardiovascular risk factors. Hashimoto's thyroiditis is a systemic disease. The aim is to examine whether autoimmune thyroiditis and adiposity can effect carotid IMT independently of thyroid hormones and cardiovascular risk factors.


METHODS
A total of 104 obese women (BMI > or = 25.0 kg/m-2), with FT3 and FT4 serum levels in the normal range and TSH levels < 4.5 microU/ml, were investigated. None of these patients was taking any kind of drug influencing thyroid function. Measurements were made of the IMT-CCT, BMI, waist circumference, blood pressure levels, as well as fasting TSH, FT3, FT4, anti-thyroid antibodies, insulin, fasting glycemia, triglycerides, total and HDL-cholesterol serum concentrations.


RESULTS
Of the 104 women, 30 (28.8%) were affected by autoimmune thyroiditis. Significantly higher values of IMT-CCT (p < 0.05), TSH (p < 0.05), and triglycerides (p < 0.05) were obtained, and significantly lower values of FT4 (p < 0.05), in patients with Hashimoto's thyroiditis as compared to those with a normal thyroid function. When examining the whole group together, at multiple regression analysis Hashimoto's thyroiditis maintained a positive association with the IMT (p < 0.001), independently of age, hypertension, BMI, and the fasting serum levels of TSH, FT3, FT4, insulin, fasting glycemia, triglycerides, total and HDL-cholesterol levels.


CONCLUSIONS
The present study shows that Hashimoto's thyroiditis is associated to an increased IMT only in overweight and obese, independently of the thyroid function, BMI and cardiovascular risk factors. These results suggest that Hashimoto's thyroiditis is a marker of evolution of the atherosclerosis if combined to adiposity.
Department of Emergency and Organ Transplantation, University of Bari, Italy. ciccone@cardio.uniba.it
Marco M
MM
Ciccone
Giovanni
G
De Pergola
Maria T
MT
Porcelli
Pietro
P
Scicchitano
Pasquale
P
Caldarola
Massimo
M
Iacoviello
Guida
G
Pietro
Francesco
F
Giorgino
Stefano
S
Favale
D050154:Adiposity / Q000276:immunology; D000293:Adolescent; D000328:Adult; D000368:Aged; D015551:Autoimmunity; D015992:Body Mass Index; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D002340:Carotid Artery Diseases / Q000453:epidemiology* / Q000276:immunology / Q000473:pathology / Q000503:physiopathology; D005260:Female; D050031:Hashimoto Disease / Q000453:epidemiology* / Q000276:immunology / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007558:Italy; D008875:Middle Aged; D009765:Obesity; D012307:Risk Factors; D017539:Tunica Intima / Q000473:pathology*; D017540:Tunica Media / Q000473:pathology*; D014463:Ultrasonography