Muhammad Aziz1,2, Yugandhar Kandimalla3, Archana Machavarapu3, Anshul Saxena1, Sankalp Das4, Adnan Younus1, Michelle Nguyen3, Rehan Malik1, Dixitha Anugula5, Muhammad A Latif1, Choudhry Humayun1, Idrees M Khan1, Ali Adus1, Aisha Rasool1, Emir Veledar1,6, Khurram Nasir1,7,8,9,6. 1. Center for Healthcare Advancement & Outcomes, Baptist Health South Florida. 2. Benedictine University, Department of Public Health. 3. Ocala Regional Medical Center. 4. Baptist Health South Florida, Wellness Advantage. 5. Department of Internal Medicine, Creighton University Medical Center. 6. Florida International University, Department of Epidemiology, Robert Stempel College of Public Health. 7. Director High Risk Cardiovascular Disease Clinic, Baptist Health South Florida. 8. Florida International University, Department of Medicine, Herbert Wertheim College of Medicine. 9. Johns Hopkins University, Johns Hopkins Ciccarone Center for Prevention of Heart Disease.
Abstract
AIM: Research shows that subclinical hypothyroidism (SCH) is related to an increased carotid intima-media thickness (CIMT), a surrogate marker of subclinical cardiovascular disease (CVD). It is controversial whether or not SCH should be treated to reduce CVD morbidity and mortality. This meta-analysis aimed to determine whether SCH is associated with an increase in CIMT as compared to Euthyroidism (EU) and whether thyroxin (T4) treatment in SCH can reverse the change in CIMT. METHODS: Two independent reviewers conducted an extensive database research up to December 2016. A total of 12 clinical trials discussed the effect of Thyroxin on CIMT values at pre- and post-treatment in subjects with SCH. RESULTS: CIMT was significantly higher among SCH (n=280) as compared to EU controls (n=263) at baseline; the pooled weighted mean difference (WMD) of CIMT was 0.44 mm [95% confidence interval (CI) 0.14, 0.74], p=0.004; I2=65%. After treatment with thyroxin in subjects with SCH (n=314), there was a statistically significant decrease in CIMT from pre- to post-treatment; the pooled WMD of CIMT decrease was [WMD －0.32; 95% CI (－0.47, －0.16), p=＜0.0001; I2=2%], and it was no longer different from EU controls [WMD 0.13 mm; 95% CI (－0.04, 0.30); p=0.14; I2=27%]. The total cholesterol (TC), triglycerides (TG), and low-density lipoprotein (LDL) were higher in SCH as compared to EU controls and decreased significantly after treatment with thyroxin. CONCLUSION: This meta-analysis shows that thyroxin therapy in subjects with SCH significantly decreases CIMT and improves lipid profile, modifiable CVD risk factors. Thyroid hormone replacement in subjects with SCH may play a role in slowing down or preventing the progression of atherosclerosis.
AIM: Research shows that subclinical hypothyroidism (SCH) is related to an increased carotid intima-media thickness (CIMT), a surrogate marker of subclinical cardiovascular disease (CVD). It is controversial whether or not SCH should be treated to reduce CVD morbidity and mortality. This meta-analysis aimed to determine whether SCH is associated with an increase in CIMT as compared to Euthyroidism (EU) and whether thyroxin (T4) treatment in SCH can reverse the change in CIMT. METHODS: Two independent reviewers conducted an extensive database research up to December 2016. A total of 12 clinical trials discussed the effect of Thyroxin on CIMT values at pre- and post-treatment in subjects with SCH. RESULTS:CIMT was significantly higher among SCH (n=280) as compared to EU controls (n=263) at baseline; the pooled weighted mean difference (WMD) of CIMT was 0.44 mm [95% confidence interval (CI) 0.14, 0.74], p=0.004; I2=65%. After treatment with thyroxin in subjects with SCH (n=314), there was a statistically significant decrease in CIMT from pre- to post-treatment; the pooled WMD of CIMT decrease was [WMD －0.32; 95% CI (－0.47, －0.16), p=＜0.0001; I2=2%], and it was no longer different from EU controls [WMD 0.13 mm; 95% CI (－0.04, 0.30); p=0.14; I2=27%]. The total cholesterol (TC), triglycerides (TG), and low-density lipoprotein (LDL) were higher in SCH as compared to EU controls and decreased significantly after treatment with thyroxin. CONCLUSION: This meta-analysis shows that thyroxin therapy in subjects with SCH significantly decreases CIMT and improves lipid profile, modifiable CVD risk factors. Thyroid hormone replacement in subjects with SCH may play a role in slowing down or preventing the progression of atherosclerosis.
Authors: John P Walsh; Alexandra P Bremner; Max K Bulsara; Peter O'Leary; Peter J Leedman; Peter Feddema; Valdo Michelangeli Journal: Arch Intern Med Date: 2005-11-28
Authors: C Meier; J J Staub; C B Roth; M Guglielmetti; M Kunz; A R Miserez; J Drewe; P Huber; R Herzog; B Müller Journal: J Clin Endocrinol Metab Date: 2001-10 Impact factor: 5.958