Assessment of carotid intima-media thickness in hypothyroidism and the effect of thyroid replacement therapy

Background: Carotid artery intima-media thickness (CAIMT) measurement in hypothyroidism will help assess the progression of atherosclerosis and timely intervention may prevent vascular complications.Methods: This study included 30 clinical hypothyroid (CH), 30 subclinical hypothyroid (SCH) and 30 euthyroid. As per procedure, informed consent was taken from the patients in prescribed formats before their participation in the study. Patients were divided into 3 groups of CHs, SCH and Controls after obtaining the thyroid function test values. CAIMT on the right side was measured in the three groups for comparison. Other parameters included age, sex, height, weight, body mass index (BMI), total cholesterol and triglycerides. After 4 months of levothyroxine therapy, CAIMT, total cholesterol and triglycerides were reassessed.Results: The CAIMT was increased in CH and SCH group when compared to euthyroid individuals. The mean CAIMT in CH group was 0.60�009cm, in SCH group it was 0.055�010 cm and in controls it was 0.047�006 cm. After 4 months of levothyroxine therapy, there was no change observed in the mean CAIMT values.Conclusions: CAIMT levels were increased in CH and SCH group when compared to euthyroid group. There was no regression of CAIMT after 4 months of levothyroxine therapy

Relationship between the intima-media thickness of carotid artery and the accumulated radiation dose and its threshold value in intervention workers / 中国职业医学

OBJECTIVE: To analyze the relationship of the intima-media thickness( IMT) of carotid artery and accumulated radiation dose in intervention workers,and to evaluate the threshold dose leading to the abnormal IMT. METHODS: By cluster random sampling,155 intervention workers were selected as intervention group and 620 workers from the radiology departments were selected as control group. All workers came from 27 hospitals in Shandong Province. The workers in these two groups were given radiological occupational health check-up. Their accumulated dose of radiation was collected and IMT was measured by ultrasound. Multiple linear regression analysis was used to analyze the dose-effect between the IMT and the accumulated dose. RESULTS: In the intervention group,IMT was( 0. 70 ± 0. 11) mm,the abnormal rate of IMT was 4. 5%( 7 /155). The IMT in the control group was( 0. 68 ± 0. 09) mm,and the abnormal rate of IMT was 3. 9%( 24 /620). The abnormal rate of IMT between the two groups had no statistical significance( P > 0. 05). The multiple linear regression equation was y = 0. 007 x_1+ 0. 001 x_2- 0. 098 x3+ 0. 223( y means IMT,mm; x_1 means age,x_2 means accumulated radiation dose,mSv; x3 means gender),and the threshold doses deduced in all ages corresponding to 1 mm of IMT showed that the threshold dose was higher with younger age,and the larger accumulated radiation dose was needed to cause the IMT abnormity in the female than in the male workers. CONCLUSION: The IMT is positively correlated with the accumulated radiation dose in radiation workers,and the threshold dose of abnormal IMT could be estimated by the linear regression equation.

Correlation Between Distribution of TCM Constitutional Types and Carotid Artery Intima-media Thickness in Patients with Subclinical Hypothyroidism / 中国中医药信息杂志

Objective To discuss the correlation between the distribution of TCM constitutional types and carotid artery intima-media thickness (CIMT) in patients with subclinical hypothyroidism;To select the biased constitution type with high risk factors for atherosclerosis;To provide theoretical basis for preventing this disease from the perspective of TCM physique. Methods Totally 120 patients with subclinical hypothyroidism and 50 cases of normal healthy subjects were selected. TCM constitutional types of two groups were distinguished by KY3H TCM physique recognition software. CIMT was determined, and the correlation between the distribution of TCM constitutional types and CIMT in patients with subclinical hypothyroidism was analyzed. Results In 120 cases of subclinical hypothyroidism, there were 3 cases of gentleness type (2.50%), 30 cases of qi-depression type (25.00%), 28 cases of qi-deficiency type (23.33%), 25 cases of yang-deficiency type (20.83%), 13 cases of phlegm-damp type (10.84%), 9 cases of yin-deficiency type (7.50%), 6 cases of blood stasis type (5.00%), 5 cases of dampness heat type (4.17%), 1 case of particular type (0.83%). The main TCM constitutional types of subclinical hypothyroidism were qi-depression type, qi-deficiency type, yang-deficiency type and phlegm-damp type. The morbidity of atherosclerosis in patients with qi-depression type and qi-deficiency type were higher than other constitutional types. Conclusion The main TCM constitutional types of subclinical hypothyroidism were qi-depression type, qi-deficiency type, yang-deficiency type and phlegm-damp type.

Influence of blood pressure level on carotid intima-media thickness and plaque in elderly patients with coronary heart disease / 重庆医学

Objective To investigate the influence of blood pressure level on carotid intima‐media thickness (CIM T ) and plaque in elderly patients with coronary heart disease(CHD) .Methods 100 elderly CHD patients with hypertension admitted in our hospital from Jan .to Dec .2012 was collected .an epidemiological investigation was applied ,and blood pressure was measured .carotid CIMT and plaque were determined by colored Doppler ultrasound .multivariate linear regression model or Logistic regression model was used to analyze the effect of blood pressure on CIMT and plaque .Results A total of 100 subjects were enrolled .CIMT and plaque prevalence were (0 .7 ± 0 .1)mm ,45 .8% in 48 males and (0 .7 ± 0 .1)mm ,34 .6% in 52 females .the difference was statisti‐cally significant(χ2 =5 .609 ,P=0 .018) .multiple regression models showed that ,after adjusting relevant factors ,CIMT increased 0 .001 14 mm with SBP 1 mm Hg increase and CIMT increased 0 .001 18 mm with pulse pressure 1 mm Hg increase in males .Lo‐gistic regression model showed that the risk of plaque number >1 was higher in grade Ⅲhypertension compared to grade 1 hyper‐tension(OR= 2 .115 ,95% CI= 1 .128~ 3 .966 ,P= 0 .020) .Conclusion Elderly CHD patients with hypertension ,especially in males ,carotid CIMT increase while systolic BP and high pulse are high ,which cause the high risk of carotid artery plaque;hyperten‐sion is a independent risk factor for atherosclerosis in elderly CHD patients .

Association of carotid artery intima-media thickness and blood pressure variation in patients with hypertension / 中国综合临床

Objective To investigate the relationship of carotid artery intima-media thickness(IMT) and blood pressure variation in patients with prehypertension. Methods Three hundred and ninety-two patients were selected as our subjects. Artery IMT was measured by Doppler ultrasonography. All patients were divided into carotid artery IMT group( n = 204 ),not carotid artery IMT group( n = 188 ) based on carotid IMT. Meanwhile,all patients were monitored by ambulatory blood pressure. Results (1)The indices of 24 h mean systolic blood pressure,systolic blood pressure variability and diastolic blood pressure variability in patients of carotid artery IMT group were(136. 85 ± 9. 67)mmHg,(4. 13 ± 0. 67)% ,(2. 97 ± 0. 45)% respectively, higher than those of Not carotid artery IMT group((121. 92 ± 6. 54)mmHg,(2. 64 ± 0. 86)% ,(2. 06 ± 0. 36)% ;t = 21. 08,5. 97,3. 32;P < 0. 05).(2)The rate of the carotid artery thickness increased with systolic blood pressure variability increasing( P = 0. 001). There were no significant correlations between rate of the carotid artery thickness and diastolic blood pressure variability,24 h mean diastolic blood pressure(P = 0. 435, 0. 126). The IMT thickening rate was higher when the average systolic blood pressure was greater(P = 0. 013). (3)Regression analysis indicated that carotid artery IMT was positively related with systolic blood pressure variability,high-sensitivity C-reactive protein,24 h mean systolic blood pressure,2-hour postprandial blood glouse. Conclusion Carotid artery IMT is independently associated with variation of blood pressure,especially with systolic blood pressure variability in prehypertension patients.

The study on microalbuminuria and the thickness of carotid artery intima-media in patients with subclinical hypothyroidism / 中国基层医药

Objective To observe the level of urinary microalbumin(MAU) and carotid artery intima-media thickness(CIMT) in patients with subclinical hypothyroidism,and to explore the relationship between subclinical hypothyroidism and MAU,arteriosclerosis.Methods 70 patients with subclinical hypothyroidism were randomly divided into the two groups according to the level of CIMT.33 patients were selected as the arteriosclerosis group and 37 patients were selected as the non-arteriosclerosis group,and 30 healthy people were selected as the control group.The levels of FT3,FT4,TSH,blood fat,MAU,CIMT observed.Results Compared with the healthy controls,the levels of TC,TG,LDL-C,CIMT were significantly higher in the arteriosclerosis group (P =0.008,0.007,0.009,0.006),the level of HDL-C was significantly lower in the arteriosclerosis group(P =0.006).The levels of TC,TG,LDL-C,CIMT were significantly higher in the non-arteriosclerosis group (P =0.042,0.037,0.008,0.035),the level of HDL-C was significantly lower in the non-arteriosclerosis group(P =0.038).The levels of TC,TG,LDL-C,CIMT in arteriosclerosis group were significantly higher than those in the non-arteriosclerosis group (P =0.032,0.041,0.039,0.007).The level of HDL-C in the arteriosclerosis group was significantly lower than the non-arteriosclerosis group(P =0.044).The level of MAU had no significant difference among the three groups(P =0.052,0.087,0.092).TSH had no relationship with MAU (r =0.195,P ＞ 0.05),TSH had positive correlation with CIMT(r =0.578,P ＜ 0.01).Conclusion The patients with subclinical hypothyroidism have lipid metabolism disorder and CIMT incrassation,which can increase the risk of arteriosclerosis.

Early Detection of Atherosclerosis in Primary School Children.

Purpose: The aim of this study was to determine the correlations of age, sex, anthropometric measurements, pulse rate, blood pressure, and family history of cardiovascular disease with early atherosclerosis in children. Methods: Between December 2011 and January 2012 we included 112 children of primary school »Osnovna šola Bojana Ilicha Maribor«, whose parents consented and signed the inform consensus. We made a questionnaire about cardiovascular diseases in child's family. We measured blood pressure, pulse rate, body height, weight, waist circumference. We performed ultrasound measurement of carotid artery intima-media thickness (IMT). The data were processed using the SPSS statistical program. Results: Body mass index (BMI) (r=0.246; p<0.009), waist circumference (r=0.198; p<0.036) systolic (r=0.282; p<0.003) and diastolic blood pressure (r=0.282; p<0.003) were positively correlated with carotid artery IMT. In addition, those with family history of cardiovascular diseases had higher carotid artery IMT (p<0.0001) at baseline. A multivariable logistic regression analysis revealed that family history of cardiovascular disease was associated with carotid artery IMT (p<0.0001). Conclusion: Higher levels of BMI, waist circumference, and arterial blood pressure were correlated with higher carotid artery IMT in children. In addition, the presence of family history of cardiovascular disease was independently associated with carotid artery IMT in children.

Analysis on the relationship of type 2 diabetes patients with acute glucose fluctuations and carotid artery intima-media thickness of cerebral infarc-tion / 中国现代医生

Objective To investigate the relationship of T2DM with acute glucose fluctuations and IMT. Methods Forty-five cases of T2DM patients were selected from January 2013 to 2014 February in our hospital as T2DM group, 50 cases of T2DM patients with acute cerebral infarction were selected in our hospital on the same period with T2DM group as DMCI group,the carotid artery IMT of two groups were measured, the patients in the DMCI group were divided into IMT thickening group(n=29), IMT normal group(n=21), the data of every groups were compared and the correlation of IMT with other indicators were analyzed. Results ①SBP, DBP, LDL-C, TC, TG, HbA1C, IMT, MAGE of DMCI group were higher than T2DM group, the difference was significant(P<0.05). ②SBP, LDL-C, IMT, MAGE IMT of IMT thickening group was significantly higher than IMT normal group, the difference was significant (P <0.05). ③MAGE, LDL-C, SBP were the influence factors for IMT (P<0.05). Conclusion Patients with high blood sugar stable and effi-cient glucose lowering blood sugar fluctuations can reduce the risk of atherosclerosis, reduce the incidence of diabetic complications.

Relationship between resting heart rate and carotid artery structure in young hypertensive patients / 中华流行病学杂志

Objective To investigate the relationship between resting heart rate (RHR)and carotid artery structure in young hypertensive patients.Methods A total of 663 primary hypertensive patients aged between 18 and 45 (38.01 ± 5.78) were chosen from the First Affiliated Hospital of Xinjiang Medical University from January,2009 to January,2012.Patients under this study were divided into three groups according to their RHRs:group A (RHR＜70 bpm,n=163),group B(70 bpm≤RHR＜80 bpm,n=268),group C (RHR≥80 bpm,n=232).Data on bilateral carotid artery intima-media thickness,common carotid artery diameter were detected by carotid ultra-sonography.Indexes of carotid artery were analyzed by both variance and bi-variate correlation analysis.Results 1)Differences in the blood pressure among three groups showed statistical significance (P＜0.01),with diastolic pressure in group A higher than in group B (P＜0.05),while both systolic and diastolic pressure in group C higher than in group B (P＜0.01).2)In group A,the right carotid artery diameter was higher than in group C(P＜0.05) and the left carotid artery diameter higher than in group B(P＜ 0.05) with the left carotid artery diameter higher than in group C (P＜0.05).3) Significant positive correlations were found between RHR and blood pressure (r =0.112,0.118) and negative correlation between RHR and left carotid artery diameter (r=-0.89).However,correlation between RHR and right carotid artery diameter was not significant (r=-0.075,P=0.068).Conclusion When blood pressure had an increase,we found that the carotid artery diameter was decreasing along with the increasing RHR among the young hypertensive patients.

Risk Factors for the Progression of Intima-Media Thickness of Carotid Arteries: A 2-Year Follow-Up Study in Patients with Newly Diagnosed Type 2 Diabetes

BACKGROUND: Intima-media thickness (IMT) of the carotid arteries is known to have a positive correlation with the risk of cardiovascular disease. This study was designed to identify risk factors affecting the progression of carotid IMT in patients with type 2 diabetes mellitus (T2DM). METHODS: Patients with newly diagnosed T2DM with carotid IMT measurements were enrolled, and their clinical data and carotid IMT results at baseline and 2 years later were compared. RESULTS: Of the 171 patients, 67.2% of males and 50.8% of females had abnormal baseline IMT of the left common carotid artery. At baseline, systolic blood pressure, body mass index and smoking in male participants, and fasting plasma glucose and glycated hemoglobin levels in females were significantly higher in patients with abnormal IMT than in those with normal IMT. Low density lipoprotein cholesterol (LDL-C) levels in males and high density lipoprotein cholesterol (HDL-C) levels in females at the 2-year follow-up were significantly different between the nonprogression and the progression groups. Reduction of the United Kingdom Prospective Diabetes Study (UKPDS) 10-year coronary heart disease (CHD) risk score after 2 years was generally higher in the nonprogression group than the progression group. CONCLUSION: LDL-C levels in males and HDL-C levels in females at the 2-year follow-up were significantly different between participants with and without progression of carotid IMT. Furthermore, a reduction in the UKPDS 10-year CHD risk score appeared to delay the advancement of atherosclerosis. Therefore, the importance of establishing the therapeutic goal of lipid profiles should be emphasized to prevent the progression of carotid IMT in newly diagnosed T2DM patients.

Risk Factors for the Progression of Intima-Media Thickness of Carotid Arteries: A 2-Year Follow-Up Study in Patients with Newly Diagnosed Type 2 Diabetes

BACKGROUND: Intima-media thickness (IMT) of the carotid arteries is known to have a positive correlation with the risk of cardiovascular disease. This study was designed to identify risk factors affecting the progression of carotid IMT in patients with type 2 diabetes mellitus (T2DM). METHODS: Patients with newly diagnosed T2DM with carotid IMT measurements were enrolled, and their clinical data and carotid IMT results at baseline and 2 years later were compared. RESULTS: Of the 171 patients, 67.2% of males and 50.8% of females had abnormal baseline IMT of the left common carotid artery. At baseline, systolic blood pressure, body mass index and smoking in male participants, and fasting plasma glucose and glycated hemoglobin levels in females were significantly higher in patients with abnormal IMT than in those with normal IMT. Low density lipoprotein cholesterol (LDL-C) levels in males and high density lipoprotein cholesterol (HDL-C) levels in females at the 2-year follow-up were significantly different between the nonprogression and the progression groups. Reduction of the United Kingdom Prospective Diabetes Study (UKPDS) 10-year coronary heart disease (CHD) risk score after 2 years was generally higher in the nonprogression group than the progression group. CONCLUSION: LDL-C levels in males and HDL-C levels in females at the 2-year follow-up were significantly different between participants with and without progression of carotid IMT. Furthermore, a reduction in the UKPDS 10-year CHD risk score appeared to delay the advancement of atherosclerosis. Therefore, the importance of establishing the therapeutic goal of lipid profiles should be emphasized to prevent the progression of carotid IMT in newly diagnosed T2DM patients.

Clinical Factors Associated with Carotid Plaque and Intima-Medial Thickness in HIV-Infected Patients

PURPOSE: HIV-infected patients are at increased risk for cardiovascular disease, which may be mediated in part by inflammation. This study aimed to evaluate the risk factors of carotid plaque, and clinical factors associated with carotid atherosclerosis measured by carotid intima-medial thickness (cIMT) in HIV patients. MATERIALS AND METHODS: Clinical and cardiometabolic factors as well as cIMT were prospectively measured in 145 HIV-infected participants who had received combined antiretroviral therapy for > or =6 months. The mean value of the bilateral average cIMT level was used as Mean-IMT in the analysis, and the greatest value among the measured cIMT levels was used as Max-IMT. RESULTS: Among 145 patients, 34 (23.4%) had carotid plaque. Multivariate logistic regression analysis revealed three independent risk factors of carotid plaque: old age [odds ratio (OR) 6.16, 95% confidence interval (CI) 1.09-34.88; p=0.040], hypertension (OR 12.62, 95% CI 1.72-92.49; p=0.013) and higher low-density lipoprotein cholesterol (LDL-C) (OR 1.08, 95% CI 1.01-1.16; p=0.039). Levels of estimated glomerular filtration rate were inversely associated with Mean-IMT (r=-0.379, p<0.001) and Max-IMT (r=-0.389, p<0.001). Stepwise multivariate regression analyses revealed that age, total cholesterol and fasting glucose were positively correlated with cIMT, independent of other risk factors. CONCLUSION: The presence of hypertension, old age and a higher level of LDL-C were independent risk factors of carotid plaque among HIV-infected subjects.

Correlation of free fatty acids with carotid artery intima-media thickness in patients with type 2 diabetes / 中华全科医师杂志

Seventy patients with type 2 diabetes (T2DM),23 subjects with impaired glucose tolerance (IGT) and 35 individuals with normal glucose tolerance (NGT) were recruited in the study.Fasting free fatty acids (fFFA) and postprandial free fatty acids (2 hFFA) after oral glucose tolerance test (OGTT) were measured; homeostasis model assessment of insulin resistance (HOMA-IR),area under the curve of free fatty acids (AUCFFA) were calculated.The carotid artery intima-media thickness (IMT) was assessed by color ultrasonography.HOMA-IR,fFFA,2 hFFA,AUCFFA and IMT in T2DM group were 3.3 ±3.2,(0.55 ± 0.20) mmol/L,(0.28 ±0.18)mmol/L,(0.83 ±0.34)mmol · L-1 · h-1 and (0.12±0.05) cm,which were significantly higher than those in NGT group,respectively [1.9 ± 1.3,(0.41 ±0.15) mmol/L,(0.12 ± 0.10) mmol/L,(0.53 ± 0.20) mmol · L-1 · h 1 and (0.09 ± 0.03) cm,all P ＜0.05].Both HOMA-IR and IMT were positively correlated with fFFA,2 hFFA and AUCFFA (all P ＜ 0.05).The results indicate that the levels of fasting and postprantial free fatty acid were related with insulin resistance and atherosclerosis of carotid artery.

Effect of Danzhi Jiangtang Capsule Combined with Atorvastatin on Intima-media Thickness in Diabetes Patients without Hypertension / 世界科学技术-中医药现代化

This study was aimed to observe the curative effect and safety of Danzhi Jiangtang Capsule ( DJC ) combined with atorvastatin on carotid artery intima-media thickness (IMT) in diabetes patients without hyper-tension . A total of 196 diabetes patients without hypertension with incrassate carotid artery IMT were randomly divided into the control group ( 98 cases ) and the treatment group ( 98 cases ) . The conventional diabetes thera-py was given to both groups . The atorvastatin of 20 mg/night was given to the control group . And the atorvas-tatin 20 mg/night added with DJC 9 . 0 g/night were given to the treatment group . The treatment course was 12 months . Carotid artery IMT , carotid atherosclerotic plaque area , FPG , FIns , HOMA-IR , HbA1c , blood lipids , hepatorenal function and etc . were examined before and after the treatment respectively . The results showed that there was a significant positive correlation between carotid artery IMT and FIns , HOMA-IR , HbAlc , LDL-C . After 12-month treatment , the total effectiveness is 85 . 87% in the treatment group . And there was significant difference compared with the control group ( P < 0 . 05 ) . The levels of FPG , FIns , HOMA-IR , HbAlc of the treatment group had no difference compared with the control group . Compared with the control group, TC and LDL-C of the treatment group was obviously decreased (P < 0.05). And HDL-C was significantly increased ( P < 0 . 05 ) . The carotid artery IMT of the treatment group decreased from ( 0 . 11 ±0 . 01 ) cm to ( 0 . 08 ± 0 . 01 ) cm . And compared with the control group , there was statistical significance ( P <0 . 05 ) . The carotid atherosclerotic plaque area of 58 cases in the treatment group decreased from ( 0 . 37 ±0.56) cm2 to (0.21 ± 0.25) cm2. However, there was no statistical significance compared to the control group. There were 5 adverse events in the control group and 9 adverse events in the treatment group . And there was no difference between two groups. It was concluded that DJC combined with atorvastatin can regulate lipid metabolism and reduce carotid artery IMT .

Increased Carotid Intima-Media Thickness is Associated with Progression of Diabetic Nephropathy in Patients with Type 2 Diabetes

BACKGROUND: Cardiovascular risk is higher among people with diabetic nephropathy than among those with normal renal function. Carotid intima-media thickness (IMT) is an independent predictor of cardiovascular mortality in type 2 diabetic patients. However, the relationship between carotid IMT and diabetic nephropathy is not well known. The aim of our study was to elucidate whether carotid IMT is associated with progression of diabetic nephropathy in type 2 diabetic patients. METHODS: We recruited a total of 354 type 2 diabetic patients with diabetic nephropathy. Renal function was evaluated by serum creatinine levels, estimated glomerular filtration rate (eGFR), and urinary albumin/creatinine ratio (ACR). Carotid IMT was assessed using B-mode ultrasound by measuring generally used parameters. Baseline-to-study end changes in eGFR were calculated, and the yearly change of eGFR (mL/min/yr) was computed. RESULTS: Age, diabetes duration, ACR, and eGFR were significantly correlated with mean or maximal carotid IMT; however, lipid profiles, HbA1c, and blood pressure were not correlated. The mean yearly eGFR change was -4.9 +/- 5.3 mL/min/yr. The yearly eGFR change was negatively correlated with mean and maximal carotid IMT. After adjusting for age and diabetes duration, the mean IMT is an independent predictor of yearly eGFR change. CONCLUSION: Carotid IMT may be a predictor of diabetic nephropathy progression in patients with type 2 diabetes.

Association between Carotid Artery Intima-Media Thickness and Stroke Risk Factors in Ischemic Stroke / 대한뇌졸중학회지

BACKGROUND: Common carotid artery intima-media thickness (IMT) is an accepted sonographic marker of early atherosclerosis, and increased IMT represents a risk of ischemic stroke. The purpose of this study was to evaluate the correlation between common carotid artery IMT and stroke risk factors in patients with ischemic stroke. METHODS: Subjects were 381 patients with acute ischemic stroke. High resolution B-mode ultrasonography was performed to measure IMT at common carotid artery. Multivariate regression analysis was performed to determine the independent factors related to common carotid artery IMT. RESULTS: The variables that strongly predicted an increase in the common carotid artery IMT were age (P <0.001) and diabetes mellitus (P <0.001). CONCLUSION: Increased common carotid artery IMT is independently associated with age and diabetes mellitus in patients with ischemic stroke.

Effects of thyroxine replacement on endothelial function and carotid artery intima-media thickness in female patients with mild subclinical hypothyroidism

BACKGROUND: Previous studies have suggested an association between subclinical hypothyroidism and coronary artery disease that could be related to changes in serum lipids or endothelial dysfunction. METHODS: Thirty-two female subclinical hypothyroidism patients were randomly assigned to 12 months of L-thyroxine replacement or no treatment. Endothelial function was measured by the flow-mediated vasodilatation of the brachial artery, as well as mean carotid artery intima-media thickness, and lipid profiles were studied at baseline and after 12 months of follow-up. RESULTS: The mean ( ± SD) serum thyroid-stimulating hormone levels in the L-thyroxine replacement and control groups were 6.09±1.32 and 6.27 ± 1.39 μUI/ml, respectively. No relationship between carotid artery intima-media thickness or brachial flow-mediated vasodilatation and free T4 and serum thyroid-stimulating hormone was found. The median L-T4 dose was 44.23 ± 18.13 μg/day. After 12 months, there was a significant decrease in the flow-mediated vasodilatation in the subclinical hypothyroidism control group (before: 17.33 ± 7.88 to after: 13.1 ±4.75 percent, p =0.03), but there were no significant differences in flow-mediated vasodilatation in the L-thyroxine treated group (before: 16.81 ± 7.0 to after: 18.52 ± 7.44 percent, p = 0.39). We did not find any significant change in mean carotid intimamedia thickness after 12 months of L-thyroxine treatment. CONCLUSION: Replacement therapy prevents a decline in flow-mediated vasodilatation with continuation of the subclinical hypothyroidism state. Large prospective multicenter placebo-controlled trials are necessaryto investigate endothelial physiology further in subclinical hypothyroidism patients and to define the role of L-thyroxine therapy in improving endothelial function in these patients.

Normal flow-mediated vasodilatation of the brachial artery and carotid artery intima-media thickness in subclinical hypothyroidism

Subclinical hypothyroidism (SHT) is a disease for which exact therapeutic approaches have not yet been established. Previous studies have suggested an association between SHT and coronary heart disease. Whether this association is related to SHT-induced changes in serum lipid levels or to endothelial dysfunction is unclear. The aim of this study was to determine endothelial function measured by the flow-mediated vasodilatation of the brachial artery and the carotid artery intima-media thickness (IMT) in a group of women with SHT compared with euthyroid subjects. Triglycerides, total cholesterol, HDL-C, LDL-C, apoprotein A (apo A), apo B, and lipoprotein(a) were also determined. Twenty-one patients with SHT (mean age: 42.4 ± 10.8 years and mean thyroid-stimulating hormone (TSH) levels: 8.2 ± 2.7 µIU/mL) and 21 euthyroid controls matched for body mass index, age and atherosclerotic risk factors (mean age: 44.2 ± 8.5 years and mean TSH levels: 1.4 ± 0.6 µIU/mL) participated in the study. Lipid parameters (except HDL-C and apo A, which were lower) and IMT values were higher in the common carotid and carotid bifurcation of SHT patients with positive serum thyroid peroxidase antibodies (TPO-Ab) (0.62 ± 0.2 and 0.62 ± 0.16 mm for the common carotid and carotid bifurcation, respectively) when compared with the negative TPO-Ab group (0.55 ± 0.24 and 0.58 ± 0.13 mm, for common carotid and carotid bifurcation, respectively). The difference was not statistically significant. We conclude that minimal thyroid dysfunction had no adverse effects on endothelial function in the population studied. Further investigation is warranted to assess whether subclinical hypothyroidism, with and without TPO-Ab-positive serology, has any effect on endothelial function.

Study of the change of large arterial compliance and carotid artery intima-media thickness in patients with metabolic syndrome / 中国医师进修杂志

Objective To investigate the changes of compliance in large arteries and carotid artery intima-media thickness(IMT)in patients with metabolic syndrome.Methods There were 64 patients with metabolic syndrome and 56 age-matched control subjects.Their carotid-femoral pulse wave velocities(C-FPWV)were measured by the Complior SP and their carotid artery IMT were detected by B-mode ultrasound.At the same time their height,weight,waist circumstance,hip girth,blood pressure,blood glucose,blood lipid,BMI and waist to hip ratio(WHR)were measured.Results Compared with the control,the patients with metabolic syndrome had higher C-FPWV(P

Effects of nocturnal hypoxemia on carotid artery atherosclerosis and plagues in patients with acute coronary syndrome / 上海第二医科大学学报

0.05).In group Ⅱand Ⅲ,the carotid artery IMT was thicker and the amount of plagues were larger than those in group Ⅰ(P