Resumo

PEREIRA, Teresa Alves et al. Subclinical hypothyroidism, autoimmune thyroiditis and cardiovascular risk factor. Arq Med [online]. 2015, vol.29, n.3, pp.69-73. ISSN 2183-2447.

Background: There is increasing evidence that subclinical hypothyroidism is related with an increased cardiovascular risk. The objective was to evaluate the relationship between autoimmune thyroiditis, subclinical hypothyroidism and cardiovascular risk factors. Methods: We recorded thyroid function tests, anti-TPO and antithyroglobulin antibodies, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, apolipoproteinA1, apolipoproteinB, lipoprotein(a), homocysteine, high sensitivity CRP, folic acid, vitamin B12, HOMA-IR, HOMA-β, QUICKI, HISI, WBISI, IGI in 185 subjects with autoimmune thyroiditis and in euthyroid state and in 69 subjects with autoimmune thyroiditis and subclinical hypothyroidism. Statistical analysis was performed with Mann-Whitney test, logistic regression and Spearman correlations. The results were adjusted for age and body mass index. Statistical significance was considered for a bilateral value of p<0.05. Results: 94% of subjects were female. The median age was significantly higher in the euthyroid group. Patients with higher levels of total cholesterol (OR=1.01; p=0.03), CRP (OR=1.68; p=0.04) or anti-thyroglobulin antibodies (OR=1.00; p=0.02) had an increased likelihood of having subclinical hypothyroidism. In the total group of patients, we observed positive correlations between TSH, CRP and HOMA-IR, between free T3 and HDL-cholesterol and between free T4 and IGI. TSH levels correlated negatively with QUICKI, HISI and WBISI. In the group with subclinical hypothyroidism, we found negative correlations between free T3 and homocysteine and between free T4 and anti-TPO antibodies. Conclusions: The interrelations between thyroid function, lipid profile, CRP and insulin-resistance demonstrate an increased cardiovascular risk in subclinical hypothyroidism due to autoimmune thyroiditis.

Palavras-chave : hypothyroidism; autoimmune thyroiditis; risk factors; cardiovascular diseases.

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