Effects of Hypothyroidism on Central and Peripheral Atherosclerosis in the Old Aged

Abstract

Objectives: Aging is associated with an increased incidence of thyroid function abnormalities. Thyroid hormones have been shown to affect vascular hemodynamics and arterial stiffness. Arterial stiffness appears to be an essential risk factor for cardiovascular disease. The long-term effect of hypothyroidism on the development of the peripheral arterial disease is not well understood. Pulse wave velocity (PWV) is a simple, non-invasive marker of atherosclerosis that measures arterial stiffness. Ankle brachial index (ABI) is a non-invasive technique commonly used to detect peripheral vascular diseases. A limited number of studies evaluated hypothyroidism as a risk factor for both peripheral arterial disease and arterial stiffness in the old aged. We aimed to investigate this relationship in older patients and then compared with their younger counterparts. Materials and Methods: A total of 22 patients ≥65 years of age and 23 younger patients with hypothyroidism and 23 gender-matched, and body mass index-matched old aged individuals with euthyroidism as controls were enrolled in this study. Old aged patients with hypothyroidism were defined as group I, old aged individuals with euthyroidism were defined as group II, and younger patients with hypothyroidism were defined as group III. PWV was measured between the carotid and femoral arteries. ABI was measured by a handheld Doppler. Results: PWV was similar (0.36) in older groups (groups I and II) and was lower (p < 0.001) in group III. ABI measurements (left and right) were similar in all groups (p > 0.05). More than half of the patients with hypothyroidism had subclinical hypothyroidism, and this condition was similar in all groups (p = 0.26). We also compared patients with hypothyroidism (group I plus III) with older controls with euthyroidism (group II). Median age was higher in group II than that in group I plus III (p < 0.001). PWV was higher in group II than that in group I plus III (p < 0.001). Hypertension was more common in group II than in group I plus III (p < 0.001). Conclusion: We did not find a relationship between hypothyroidism and atherosclerosis in old aged. PWV and hypertension were higher in older patients with hypothyroidism than in younger. Aging and hypertension increased PWV. Studies with larger series are needed to increase the reliability of these results.

Keywords

• Hypothyroidism
• Peripheral Arterial Disease
• PWV
• ABI
• Arterial Stiffness
• Old Aged

Ethical Statement

Ethics Committee Approval: This study is ethically approved by local ethics committee with number 15973. Informed Consent: All subjects provided informed consent before entering the study. Peer-review: Externally peer-reviewed. Authorship Contributions Concept: V.A., B.E.Ö., M.F.E., T.A., Design: V.A., B.E.Ö., M.F.E.,T.A., Data Collection or Processing: V.A., B.E.Ö., M.F.E., T.A., Analysis or Interpretation: V.A., B.E.Ö., M.F.E., T.A., LiteratureSearch: V.A., B.E.Ö., M.F.E., T.A., Writing: V.A., B.E.Ö., M.F.E., T.A. Conflict of Interest: No conflict of interest was declared by the authors. Financial Disclosure: The authors declared that this study received no financial support

Yaşlı Hastalarda Hipotiroidizmin Santral ve Periferik Arter Aterosklerozuna Etkileri

Abstract

Amaç: Yaşlanma, tiroid fonksiyon bozukluğu sıklığının artması ile ilişkilidir. Tiroid hormonlarının vasküler hemodinamiği ve arter sertliğini etkilediği gösterilmiştir. Arteriyel sertlik, kardiyovasküler hastalıklar için önemli bir risk faktörü olarak görünmektedir. Hipotiroidizmin periferik arter hastalığının gelişimi üzerindeki uzun vadeli etkisi iyi anlaşılmamıştır. Nabız dalga hızı (NDH), arteriyel sertliği ölçen basit, invazif olmayan bir ateroskleroz belirtecidir. Ayak bileği-brakiyal indeks (ABI) periferik vasküler hastalıkları tespit etmek için yaygın olarak kullanılan invaziv olmayan bir tekniktir. Sınırlı sayıda çalışma yaşlılarda hipotiroidizmi periferik arter hastalığı ve arter sertliği açısından bir risk faktörü olarak değerlendirmiştir. Bu çalışmada yaşlı hastalarda bu ilişkiyi araştırmayı ve daha sonra genç kontrollerle karşılaştırmayı amaçladık. Gereç ve Yöntem: Kırk Çalışmaya hipotiroidis olan 65 yaş üstü 22 hasta, 65 yaş altı 23 hasta ile cinsiyeti ve vücut kitle indeksi çalışma grubuyla benzer 65 yaş üstü 23 ötiroidik katılımcı alındı.yaşları 65, yaşları 23, hipotiroidizmi olan 23 genç Hipotiroidizmi olan yaşlı hastalar grup I, ötiroidisi olan yaşlılar grup II, hipotiroidizmi olan genç hastalar grup III olarak tanımlandı. Karotis ve femoral arterler arasında PWV ölçüldü. ABI el tipi bir Doppler ile ölçülmüştür. Bulgular: LDL düzeyleri hipotiroidizmli hastalarda daha yüksek saptandı. Nabız dalga hızı değerleri arasında yaşlı kontrol ve yaşlı hasta grubunda anlamlı fark saptanmadı. En düşük nabız dalga hızları genç hasta grubunda izlendi. Yaşlı gruplarla genç hasta grubu arasındaki fark anlamlıydı (p=0,001). ABI ölçümleri arasında gruplar arasında anlamlı fark saptanmadı (p>0,05). Grupların ABI değerleri periferik arter hastalığı için tanısal olmayan sınırlardaydı (>0,9). Sonuç: Yaşlı hipotiroidizmli hastalarda santral ve periferik ateroskleroz artışı izlenmedi.Bu konuda daha fazla sayıda kapsamlı çalışmalara ihtiyaç vardır.

Keywords

• Hipotiroidizm
• Periferik Arter Hastalığı
• PWV
• ABI
• Arteriyel Katılık
• İleri Yaş

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