Clinical Interventions in Aging (Aug 2022)

Association of Elevated Thyroid Stimulating Hormone with Atherosclerotic Cardiovascular Disease and Its Mortality in Elderly Community-Dwelling Chinese

  • Wang Y,
  • Liu C,
  • Liu L,
  • Chen X,
  • Wei L,
  • Liu J,
  • Peng S,
  • Pi J,
  • Zhang Q,
  • Tomlinson B,
  • Chan P,
  • Zhang L,
  • Fan H,
  • Zheng L,
  • Liu Z,
  • Zhang Y

Journal volume & issue
Vol. Volume 17
pp. 1139 – 1150

Abstract

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YingLu Wang,1,* Chang Liu,1,* Liping Liu,1,* Xiaoli Chen,1 Lu Wei,1 Jie Liu,1 Sheng Peng,2 Jingjiang Pi,3 Qi Zhang,3 Brian Tomlinson,4 Paul Chan,5 Lin Zhang,1 Huimin Fan,1 Liang Zheng,1 Zhongmin Liu,1 Yuzhen Zhang1 1Key Laboratory of Arrhythmias of the Ministry of Education of China, Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China; 2Department of Emergency Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China; 3Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China; 4Faculty of Medicine, Macau University of Science and Technology, Macau, People’s Republic of China; 5Division of Cardiology, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, Republic of China*These authors contributed equally to this workCorrespondence: Yuzhen Zhang; Zhongmin Liu, Key Laboratory of Arrhythmias of the Ministry of Education of China, Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China, Tel +86 21-61569673, Email [email protected]; [email protected]: With increase of population aging, the prevalence of atherosclerotic cardiovascular disease (ASCVD) and elevated serum thyroid stimulating hormone (TSH) in elderly is increasing. High TSH level was reported to be associated with ASCVD and CVD mortality; however, few are studied in Chinese population, especially in the elderly. This study aimed to investigate the prevalence of elevated serum TSH and ASCVD in an elderly population of Chinese community and to explore the association between high serum TSH and ASCVD or CVD mortality.Patients and Methods: We conducted a study involving 3814 adults who were at least 60 years of age. Questionnaires, physical examinations, and laboratory blood samples were collected in 2014, and a 78-months follow-up for cardiovascular and all-cause mortality was performed till December of 2020. Logistics regression was used to analyze the association between TSH and ASCVD. We used Cox models to assess the hazard ratios (HRs) for all-cause and CVD mortality across changes in serum TSH.Results: In this study, the prevalence of the elevated serum TSH was 19.8%, and significantly higher in women than in men (24.5% vs 13.9%, p < 0.001). The prevalence of ASCVD was 21.7%. In logistics regression models, elevated TSH was associated with ASCVD after adjusting for the risk factors of ASCVD in people over the age of 70 years (adjusted OR 1.054, P = 0.014). After a follow-up of 6.5 years, total 441 (11.6%) all-cause death and 174 (4.6%) death of CVD were observed. In Cox regression model, no significant correlation was found between TSH and all-cause mortality or CVD mortality in the elderly population.Conclusion: In the elderly population, there is high prevalence of elevated serum TSH and ASCVD. Elevated TSH seemed to be not associated with risk of all-cause or CVD mortality.Keywords: cardiovascular disease, thyroid stimulating hormone, mortality, community-dwelling elderly

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