Mìžnarodnij Endokrinologìčnij Žurnal (Nov 2019)

Features of the relationship between thyroid-stimulating hormone values and some markers of cardiovascular risk in subclinical hypothyroidism

  • N.V. Pasiechko,
  • Yu.V. Yevstratieva

DOI
https://doi.org/10.22141/2224-0721.15.8.2019.191687
Journal volume & issue
Vol. 15, no. 8
pp. 633 – 638

Abstract

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Background. Hypothyroidism, including subclinical one, is associated with an increased risk of chronic heart failure. According to the Cardiovascular Health Study, an increased level of thyroid­stimulating hormone (TSH) can be considered as a risk factor for heart failure. The purpose of the study was to investigate the relationship between TSH levels and the presence of cardiovascular disorders in female patients with subclinical hypothyroidism. Materials and me­thods. Twenty­six women of reproductive age (32 to 47 years old) with subclinical hypothyroidism (group 1) and 25 women without a history of thyroid dysfunction and cardiac pathology (group 2) were included in a cross­sectional study. In all patients, the presence of factors and markers of cardiovascular risk, early signs of myocardial damage were evaluated. To compare groups of patients with normal thyroid function and with subclinical hypothyroidism (groups 1 and 2), the receiver operating characteristic (ROC) analysis was used to identify the TSH levels associated with the highest likelihood of detecting abnormalities. Results. According to the ROC analysis, TSH level ≥ 4.67 mIU/l predicted the development of diastolic dysfunction of the left and/or right ventricle with sensitivity of 70.6 (49.8; 89.1) % and specificity of 69.3 (53.2; 80.6) % (area under the ROC curve (AUC) 0.672 (0.561; 0.787); p = 0.032). Similarly, TSH value of ≥ 4.8 mIU/l indicated the possibility of detecting segmental relaxation disorders with sensitivity of 61.9 (46.2; 77.7) % and specificity of 73.1 (42.9; 91.0) % (AUC 0.680 (0.543; 0.831); p = 0.042). Conclusions. Initial manifestations of cardiovascular disorders more often occur with TSH values in the range of 4.6–5.9 mIU/l. TSH level of more than 5.45 mIU/l can be considered as a predictor of the development of cardiovascular disorders associated with subclinical hypothyroidism.

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