Thyroid Antibody Status, Subclinical Hypothyroidism, and the Risk of Coronary Heart Disease: An Individual Participant Data Analysis

被引：55

作者：

Collet, Tinh-Hai ^{[1
,2
]}

Bauer, Douglas C. ^{[3
,4
]}

Cappola, Anne R. ^{[5
]}

Asvold, Bjorn O. ^{[6
,7
]}

Weiler, Stefan ^{[8
,9
]}

Vittinghoff, Eric ^{[3
]}

Gussekloo, Jacobijn ^{[10
]}

Bremner, Alexandra ^{[11
]}

den Elzen, Wendy P. J. ^{[10
]}

Maciel, Rui M. B. ^{[14
]}

Vanderpump, Mark P. J. ^{[15
]}

Cornuz, Jacques ^{[2
]}

Doerr, Marcus ^{[16
,19
]}

Wallaschofski, Henri ^{[17
,19
]}

Newman, Anne B. ^{[20
]}

Sgarbi, Jose A. ^{[14
,21
]}

Razvi, Salman ^{[22
]}

Voelzke, Henry ^{[18
]}

Walsh, John P. ^{[12
,13
]}

Aujesky, Drahomir ^{[8
]}

Rodondi, Nicolas ^{[8
]}

机构：

[1] Univ Lausanne Hosp, Serv Endocrinol Diabet & Metab, CH-1011 Lausanne, Switzerland

[2] Univ Lausanne, Dept Ambulatory Care & Community Med, CH-1011 Lausanne, Switzerland

[3] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA

[4] Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA

[5] Univ Penn, Sch Med, Dept Med, Div Endocrinol Diabet & Metab, Philadelphia, PA 19104 USA

[6] Norwegian Univ Sci & Technol, Dept Publ Hlth, N-7491 Trondheim, Norway

[7] Univ Trondheim Hosp, St Olavs Hosp, Dept Endocrinol, N-7006 Trondheim, Norway

[8] Univ Bern, Inselspital, Dept Gen Internal Med, CH-3000 Bern, Switzerland

[9] Univ Zurich Hosp, Dept Clin Pharmacol & Toxicol, CH-8091 Zurich, Switzerland

[10] Leiden Univ, Med Ctr, Dept Publ Hlth & Primary Care, NL-2300 RC Leiden, Netherlands

[11] Univ Western Australia, Sch Populat Hlth, Crawley, WA 6009, Australia

[12] Univ Western Australia, Sch Med & Pharmacol, Crawley, WA 6009, Australia

[13] Sir Charles Gairdner Hosp, Dept Endocrinol & Diabet, Nedlands, WA 6009, Australia

[14] Univ Fed Sao Paulo, Dept Med, Div Endocrinol, BR-04023900 Sao Paulo, Brazil

[15] Royal Free Hosp, Dept Endocrinol, London NW3 2PF, England

[16] Univ Greifswald, Clin Internal Med B, D-17487 Greifswald, Germany

[17] Univ Greifswald, Inst Clin Chem & Lab Med, Univ Med Greifswald, D-17487 Greifswald, Germany

[18] Univ Greifswald, Inst Community Med, Study Hlth Pomerania Clin Epidemiol Res, D-17487 Greifswald, Germany

[19] DZHKGerman Ctr Cardiovasc Res, Partner Site Greifswald, Greifswald, Germany

[20] Univ Pittsburgh, Dept Epidemiol, Pittsburgh, PA 15260 USA

[21] Fac Med Marilia, Div Endocrinol, BR-17519030 Marilia, Brazil

[22] Gateshead Hlth Fdn Natl Hlth Serv Trust, Dept Endocrinol, Gateshead NE9 6SX, England

来源：

JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM | 2014年 / 99卷 / 09期

基金：

瑞士国家科学基金会; 巴西圣保罗研究基金会;

关键词：

20-YEAR FOLLOW-UP; CARDIOVASCULAR RISK; MYOCARDIAL-INFARCTION; DYSFUNCTION; MORTALITY; METAANALYSIS; THYROTROPIN; COMMUNITY; TESTS; WOMEN;

D O I：

10.1210/jc.2014-1250

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Context: Subclinical hypothyroidism has been associated with increased risk of coronary heart disease (CHD), particularly with thyrotropin levels of 10.0 mIU/L or greater. The measurement of thyroid antibodies helps predict the progression to overt hypothyroidism, but it is unclear whether thyroid autoimmunity independently affects CHD risk. Objective: The objective of the study was to compare the CHD risk of subclinical hypothyroidism with and without thyroid peroxidase antibodies (TPOAbs). Data Sources and Study Selection: A MEDLINE and EMBASE search from 1950 to 2011 was conducted for prospective cohorts, reporting baseline thyroid function, antibodies, and CHD outcomes. Data Extraction: Individual data of 38 274 participants from six cohorts for CHD mortality followed up for 460 333 person-years and 33 394 participants from four cohorts for CHD events. Data Synthesis: Among 38 274 adults (median age 55 y, 63% women), 1691 (4.4%) had subclinical hypothyroidism, of whom 775 (45.8%) had positive TPOAbs. During follow-up, 1436 participants died of CHD and 3285 had CHD events. Compared with euthyroid individuals, age-and gender-adjusted risks of CHD mortality in subclinical hypothyroidism were similar among individuals with and without TPOAbs [hazard ratio (HR) 1.15, 95% confidence interval (CI) 0.87-1.53 vs HR 1.26, CI 1.01-1.58, P for interaction = .62], as were risks of CHD events (HR 1.16, CI 0.87-1.56 vs HR 1.26, CI 1.02-1.56, P for interaction = .65). Risks of CHD mortality and events increased with higher thyrotropin, but within each stratum, risks did not differ by TPOAb status. Conclusions: CHD risk associated with subclinical hypothyroidism did not differ by TPOAb status, suggesting that biomarkers of thyroid autoimmunity do not add independent prognostic information for CHD outcomes.

引用

页码：3353 / 3362

页数：10

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