The Relation of Thyroid Function with Cardiovascular Risk Factors and Disorders
Final Report Abstract
Before the second application phase it was under debate whether mild forms of thyroid dysfunction or serum TSH levels within the reference range are associated with hypertension and mortality. With our studies we added evidence that thyroid function tests are weakly associated with arterial blood pressure and cardiovascular mortality. While subclinical hyperthyroidism was associated with cardiovascular mortality, there was no association between subclinical hyperthyroidism and arterial blood pressure. In contrast, we demonstrated a significant association between subclinical hypothyroidism and arterial blood pressure in large populations of children and adults. However, this association was only present in cross-sectional but not in longitudinal analyses. Thus, our results argue for an only short-term effect of thyroid hormone levels on arterial blood pressure. Besides hypertension we demonstrated that thyroid function is also associated with other cardiovascular risk factors such as obesity, dyslipidemia, atherosclerosis, and hepatic steatosis. Regarding obesity we showed a modulating effect of smoking on the association between thyroid function tests and BMI. Hypothyroidism may lead to an increase of the BMI in smoking adolescents, whereas this is not the case in nonsmoking adolescents. Regarding atherosclerosis we demonstrated a relationship between hypothyroidism and oxidized LDL, which is involved in the pathogenesis of atherosclerosis. Regarding diabetes, we demonstrated an inhibitory effect of metformin on prevalent and incident goiter. Regarding hepatic steatosis we showed that thyroxine but not TSH or triiodothyronine is associated with hepatic steatosis. The fact that only thyroxine was associated with hepatic steatosis needs further evaluation. Hypothetically, novel classes of thyroid hormones such as thyronamines might play an important role in that context. Thus, we aim to specify effects of thyronamines on cardiovascular diseases and risk factors in the future.
Publications
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2011 Are serum TSH levels associated with oxidized low-density lipoprotein? Results from the Study of Health in Pomerania. Clinical endocrinology 76:526-532
Ittermann T, Baumeister SE, Volzke H, Wasner C, Schminke U, Wallaschofski H, Nauck M, Ludemann J
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2011 Serum thyroid-stimulating hormone levels are associated with blood pressure in children and adolescents. The Journal of clinical endocrinology and metabolism 97:828-834
Ittermann T, Thamm M, Wallaschofski H, Rettig R, Volzke H
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2011 Serum thyrotropin levels and blood pressure response to exercise in a population-based study. Thyroid 21:829-835
Lorbeer R, Dorr M, Ittermann T, Koch B, Ewert R, Rettig R, Nauck M, Felix SB, Wallaschofski H, Volzke H
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2012 Inverse association between serum free thyroxine levels and hepatic steatosis: results from the Study of Health in Pomerania. Thyroid 22:568-574
Ittermann T, Haring R, Wallaschofski H, Baumeister SE, Nauck M, Dorr M, Lerch M, Meyer zu Schwabedissen HE, Rosskopf D, Volzke H
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2012 Subclinical hyperthyroidism and the risk of coronary heart disease and mortality. Archives of internal medicine 172:799-809
Collet TH, Gussekloo J, Bauer DC, den Elzen WP, Cappola AR, Balmer P, Iervasi G, Asvold BO, Sgarbi JA, Volzke H, Gencer B, Maciel RM, Molinaro S, Bremner A, Luben RN, Maisonneuve P, Cornuz J, Newman AB, Khaw KT, Westendorp RG, Franklyn JA, Vittinghoff E, Walsh JP, Rodondi N
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2013 Relationship of Smoking and/or Passive Exposure to Tobacco Smoke on the Association Between Serum Thyrotropin and Body Mass Index in Large Groups of Adolescents and Children. Thyroid 23:262-268
Ittermann T, Thamm M, Schipf S, John U, Rettig R, Volzke H
