title: Low serum free thyroxine concentrations associate with increased arterial stiffness in euthyroid subjects: a population-based cross-sectional study.
abstract: Some studies suggest that even in euthyroid subjects, thyroid function may affect arteriosclerotic risk factors. We aimed to determine whether thyroid hormones or thyroid autoantibodies are associated with arterial stiffness in middle-aged and elderly Chinese subjects with euthyroidism. A cross-sectional, population-based study was conducted in Nanjing, China. A total of 812 euthyroid subjects (mean age [56.75 ± 8.34] years; 402 men) without vascular disease and major arteriosclerotic risk factors were included. Clinical factors, oral glucose tolerance test results, homeostasis model assessment for insulin resistance (HOMA-IR) results, and serum levels of lipids, free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), and thyroid autoantibodies were measured. Arterial stiffness was assessed using brachial-ankle pulse wave velocity (baPWV). In Pearson correlation analyses, baPWV correlated inversely with FT4 (r = -0.146, P < 0.001), but not with FT3 (r = 0.008, P = 0.816) or TSH (r = 0.055, P = 0.118). Subsequently, a multiple stepwise regression analysis revealed a significant and independent association of FT4 with baPWV in euthyroid subjects (β = -0.076, P = 0.005). After adjusting for potential cardiovascular risk factors, mean diastolic blood pressure (DBP), HOMA-IR, and baPWV levels decreased across increasing FT4 quartiles (DBP, P < 0.001; HOMA-IR, P < 0.001; baPWV, P = 0.003). No difference in baPWV was observed between the positive and the negative thyroid antibody groups (15.23 ± 3.30 m/s vs. 15.73 ± 3.05 m/s, P > 0.05). FT4 levels were inversely associated with arterial stiffness in euthyroid subjects. A prospective study is warranted to validate whether subjects with low-normal FT4 levels have a high incidence of cardiovascular disease.
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
authors.forename: Xuqin
authors.initials: X
authors.lastname: Zheng
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
authors.forename: Min
authors.initials: M
authors.lastname: Sun
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
authors.forename: Zhixiao
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Fu
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Shi
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
authors.forename: Mengdie
authors.initials: M
authors.lastname: Cao
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
authors.forename: Zhenxin
authors.initials: Z
authors.lastname: Zhu
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
authors.forename: Chuchen
authors.initials: C
authors.lastname: Meng
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Mao
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
authors.forename: Fan
authors.initials: F
authors.lastname: Yang
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Huang
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
authors.forename: Jingjing
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
authors.forename: Hongwen
authors.initials: H
authors.lastname: Zhou
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Duan
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
authors.forename: Wei
authors.initials: W
authors.lastname: He
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
authors.forename: Mei
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China. yangt@njmu.edu.cn.
authors.forename: Tao
authors.initials: T
authors.lastname: Yang
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D001323:Autoantibodies / Q000097:blood; D001324:Autoantigens / Q000276:immunology; D002318:Cardiovascular Diseases / Q000097:blood*; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007453:Iodide Peroxidase / Q000276:immunology; D033862:Iron-Binding Proteins / Q000276:immunology; D008297:Male; D008875:Middle Aged; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood*; D014284:Triiodothyronine / Q000097:blood; D059289:Vascular Stiffness / Q000502:physiology*
chemical_list: D001323:Autoantibodies; D001324:Autoantigens; D033862:Iron-Binding Proteins; C006606:anti-thyroglobulin; D014284:Triiodothyronine; D013972:Thyrotropin; C056658:TPO protein, human; D007453:Iodide Peroxidase; D013974:Thyroxine
keywords: Arterial stiffness; Brachial-ankle pulse wave velocity; Free thyroxine; Thyroid antibody; Thyroid hormones