Effects of restoration of the euthyroid state on epicardial adipose tissue and carotid intima media thickness in subclin
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ORIGINAL ARTICLE
Effects of restoration of the euthyroid state on epicardial adipose tissue and carotid intima media thickness in subclinical hypothyroid patients ¨ zben • Ahmet Toprak • Dilek Yazıcı • Beste O ¨ zlem Tarc¸ın • • Dilek Yavuz Hasan Aydın • O • Og˘uzhan Deyneli Sema Akalın
Received: 11 March 2014 / Accepted: 24 July 2014 / Published online: 10 August 2014 Ó Springer Science+Business Media New York 2014
Abstract Epicardial adipose tissue (EAT) thickness is a novel cardiovascular risk indicator, whereas carotid intima media thickness (CIMT) is a known marker of subclinical atherosclerosis. The aim of this study was to measure EAT thickness and CIMT in subclinical hypothyroid (SCH) patients and to determine the effect of restoration of the euthyroid state on these variables. The study included 43 patients with SCH (mean age: 35.2 ± 10.7 years; F–M ratio: 42:1) and 30 healthy controls (mean age: 34.5 ± 8.2 years; F–M ratio: 25:5). EAT thickness and CIMT were measured via conventional echocardiography and ultrasonography. Among the patients, 23 were followed up with L-thyroxine replacement until restoration of the euthyroid state and re-evaluated 6 months after baseline. Basal EAT thickness was higher in the SCH patients than in the controls (3.2 ± 0.7 vs. 2.3 ± 0.3 mm—
D. Yazıcı (&) D. Yavuz O. Deyneli S. Akalın Section of Endocrinology and Metabolism, Marmara University Medical School, ˙Iskele Sok. Hu¨seyin Ayaz Apt. No:22/8 Caddebostan/Istanbul, Istanbul, Turkey e-mail: [email protected] ¨ zben B. O Department of Cardiology, Marmara University Medical School, Istanbul, Turkey A. Toprak Division of Cardiovascular Diseases, University of Missouri, Columbia, MO, USA H. Aydın Section of Endocrinology and Metabolism, Yeditepe University Medical School, Istanbul, Turkey ¨ . Tarc¸ın O Section of Endocrinology and Metabolism, Baskent University Medical School, Istanbul, Turkey
p \ 0.0001), whereas CIMT was similar in both groups (0.50 ± 0.09 vs. 0.48 ± 0.04 mm). EAT thickness was correlated with CIMT in the patient group (r = 0.39, p = 0.01), but this correlation was not evident based on multivariate analysis when corrected for age and body mass index (r2 = 0.47 and p = 0.0001 for the model). In the follow-up patient subgroup, both EAT thickness and CIMT decreased significantly following L-thyroxine treatment, when normal TSH levels were attained (3.4 ± 0.7 vs. 2.3 ± 0.5 mm—p = 0.007 and 0.51 ± 0.09 vs. 0.46 ± 0.07 mm—p = 0.01, respectively). EAT thickness was greater in the SCH patients than in controls, whereas CIMT was similar in both groups. Restoration of the euthyroid state with L-thyroxine treatment was associated with significant decreases in EAT thickness and CIMT in the group of patients that received L-thyroxine treatment and, as such, might reduce the cardiovascular risk associated with SCH. Keywords Epicardial adipose tissue thickness Carotid intima media thickness Subclinical hypothyroidism
Introduction Subclinical hypothyroidism (SCH) is associated with an increased risk of card
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