Abstract
Background
There is little information about the association between thyrotropin (TSH) levels and coronary artery calcification (CAC).
Objective
Our aim was to analyze the association between TSH quintiles and subclinical atherosclerosis measured by CAC, using baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).
Design
Cross-sectional study.
Patients and Measurements
We excluded individuals using medications that affect thyroid function and who self-reported cardiovascular disease. We included euthyroid subjects, and individuals with subclinical hypothyroidism (SCHypo) and subclinical hyperthyroidism (SCHyper). Logistic regression models evaluated CAC >100 Agatston units as the dependent variable, and increasing quintiles of TSH as the independent variable, adjusted for demographic and cardiovascular risk factors.
Results
Our sample included 3,836 subjects, mean age 49 years (interquartile range 44–56); 1,999 (52.1%) were female, 3,551 (92.6%) were euthyroid, 239 (6.2%) had SCHypo and 46 (1.2%) had SCHyper. The frequency of women, whites, and never smokers as well as body mass index and insulin resistance increased according to quintiles. The 1st quintile for TSH (0–0.99mIU/l) was associated with CAC >100, using the 3rd quintile (1.39–1.85mIU/l) as reference (adjusted OR=1.57, 95% CI 1.05–2.35, P=0.027), but no association was shown for the 5th quintile (2.68–35.5mIU/l) compared to the 3rd. Restricting the analysis to euthyroid subjects did not change the results. For women, but not for men, we observed a U-shaped curve with 1st and 5th TSH quintiles associated with CAC>100.
Conclusion
Low and low-normal (1st quintile) TSH levels were associated with CAC >100 Agatston units in a sample with subclinical thyroid disorders and euthyroid subjects.
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