medigraphic.com
SPANISH

Revista Cubana de Medicina

ISSN 1561-302X (Print)
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2019, Number 2

<< Back Next >>

Rev cubana med 2019; 58 (2)

Primary hypothyroidism, insulin resistance, and subclinical carotid atherosclerosis

del Busto MA, Ramos RA, Pulido PYL, Pozo SM
Full text How to cite this article

Language: Spanish
References: 16
Page: 1-12
PDF size: 271.29 Kb.


Key words:

hypothyroidism, insulin resistance, carotid intima-media thickness.

ABSTRACT

Introduction: Hypothyroidism is considered a risk factor for cardiovascular disease due to its relationship with dyslipidemia, high blood pressure and ischemic heart disease. In Cuba, after diabetes, it ranks second in the prevalence of endocrine diseases.
Objective: To identify if there is a relationship between the presence of primary hypothyroidism and insulin resistance and subclinical carotid atherosclerosis.
Methods: An analytical, multicenter, cross-sectional study was carried out in 150 patients separated into two comparison groups: 1) primary hypothyroidism (n = 75) and 2) insulin resistance with no hypothyroidism (n = 75). They underwent laboratory and ultrasound procedures. The patients were treated at the endocrinology consultations from 10 de Octubre Clinical Surgical Hospital, Miguel Enríquez Hospital and the National Institute of Endocrinology.
Results: The hypothyroidism group showed mean values of body mass index, total cholesterol, thyroid-stimulating hormone and carotid intima-media thickness significantly higher compared to insulin-resistant drugs. HOMA-IR was significantly higher in the insulin resistance group. TSH value ≥ 4.20 μmol / L showed 95.5% sensitivity and 73.3% specificity in predicting GIMC increase. HOMA-IR ≥ 3.10 had 95.5% sensitivity and 73.1% specificity.
Conclusions: Hypothyroidism and insulin resistance are independent predictors of subclinical carotid atherosclerosis.


REFERENCES

  1. Parlá Sardiñas J. Hipotiroidismo. Rev Cubana Endocrinol. 2012;23:208-12.

  2. Pando Álvarez RM, Torres Aparcana HL, Arbañil Huamán H, Aliaga Herrera E. Aterosclerosis subclínica y perfil metabólico en mujeres asintomáticas de edad media, con TSH ≥ 2,5 uUI/mL. An Fac Med. 2012[acceso: 15/06/2019];73(2). Disponible en: http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S1025-55832012000200005

  3. Kilic I, Tanriverdi H, Fenkci S, Akin F, Uslu S, Kaftan A. Noninva-sive indicators of atherosclerosis in subclinical hypothyroidism. Indian J Endocrinol Metab. 2013;17:271-5.

  4. Calderín Bouza RO, Yanes Quesada MÁ, Yanes Quesada M, Jiménez Paneque R, Fernández-Britto Rodríguez JE, León Álvarez JL, et al. Propuesta de clasificación cubana para el estudio del síndrome de insulinorresistencia en pacientes dislipidémicos. Acta Médica de Cuba. 2017[acceso: 15/06/2019];18(2). Disponible en: https://www.medigraphic.com/pdfs/actamedica/acm-2017/acm172a.pdf

  5. Cabrera Rego JO, Gandarilla Sarmientos JC, del Busto Mesa A, Valiente Mustelier J. Grasa epicárdica y su asociación con el HOMA-IR y el grosor íntima-media carotideo. Rev Argent Cardiol. 2012; 80:223-30.

  6. Busto Mesa A, Cabrera Rego JO, Gandarilla JC, Valiente J. Insulinorresistencia y su asociación con aterosclerosis carotidea subclínica. Rev Cubana Cardiol Cir Cardiovasc. 2011;17(2):167-75.

  7. Busto Mesa A, Cabrera Rego JO, Carrero Fernández L, Hernández Roca CV, González Valdés JL, de la Rosa Pazos JE. Changes in arterial stiffness, carotid intima-media thickness, and epicardial fat after L-thyroxine replacement therapy in hypothyroidism. Endocrinol Nutr. 2015;62:270-6.

  8. Arranz C, González RM. Utilización de un método rápido para la separación de la hormona libre y unida en el radioinmunoensayo de insulina. Rev Cubana Invest Biomed. 1988;7:150-6.

  9. De Pedro S, Benozzi S, Becerra H, Bonacorsi SM, Jouffré G, Kriplianski, et al. Factores de riesgo cardiovascular en pacientes con hipotiroidismo subclínico. Rev Argent Endocrinol Metab. 2012;49(4).

  10. Takamura N, Akilzhanova A, Hayashida N, Kadota K, Yamasaki H, Usa T, et al. Thyroid function is associated with carotid intima-media thickness in euthyroid subjects. Atherosclerosis. 2013;204:77-81. http://www.raem.org.ar/numeros/2012-vol49/numero- 04/183-190-endo4-3_depedro.pdf

  11. Biondi B. Impact of hyperthyroidism on the cardiovascular and musculoskeletal systems and management of patients with subclinical Graves’ Disease. Chapter 23. In: Bahn RS. Grave’s Disease. Springer; New York. 2015. p. 133-46.

  12. Moura Souza A, Herrera JD, Leiva PL, Martin ML. Insulin resistance and changes in thyrotropin levels in patients with euthyroidism or subclinic thyroid dysfunction. Insulinorresistencia y nivel de TSH. Rev Argent Endocrinol. 2014[acceso: 15/06/2019];49(4). Disponible en: https://www.medigraphic.com/cgibin/ new/resumen.cgi?IDARTICULO=48545

  13. Sanyal D, Raychaudhuri M. Hypothyroidism and obesity: An intriguing link. Indian J Endocrinol Metab. 2016;20(4):554.

  14. Nagasaki T, Inaba M, Henmi Y, Kumeda Y, Ueda M, Tahara H, et al. Decrease in carotid intima media thickness in hypothyroid patients after normalization of thyroid function. Clin Endocrinol. 2003;59:607-12.

  15. Díaz M, Teixeira P, Soares D, Leite S, Salles E, Waisman M. Effects of thyroxine replacement on endothelial function and carotid artery intima-media thickness in female patients with mild subclinical hypothyroidism. Clinics. 2011;66:1321-7.

  16. Gao N, Zhang W, Zhang YZ, Yang Q, Chen SH. Carotid intima-media thickness in patients with subclinical hypothyroidism: a meta-analysis. Atherosclerosis. 2013;227:18-25.




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Rev cubana med. 2019;58