The Correlation Between TSH Level Of Subclinical Hypothyroidism And Coronary Artery Lesions

Objective:This study investigated the correlation between subclinical hypothyroid ism(SCH)and the degree of coronary artery lesions,and discussed the predictive val ue of thyroid stimulating hormone(TSH)for the extent of coronary artery lesions in coronary atherosclerosis heart disease(CHD)patients.Methods:340 cases with coronary angiography,and diagnosed coronary heart dis ease,and thyroid function was tested,who have accepted hospitalization treatment in t he department of cardiology of Soochow university affiliated to the first hospital fr om January2013 to June2013,were divided into two groups:euthyroid group(n=298)and SCH group(n=42),according to the levels of TSH and free thyroid hormones(FT4).According to lesion vessel numbers of coronary heart disease,these cases were di vided into three groups:1: single vessel lesion;2.two vessel lesions;3:multiple vessel lesions.According to Gensini scores of coronary heart disease,these cases were divi ded into three groups:A: 1≤scores≤20;B: 20<scores≤40;C: scores>40.Statistics on general information of all subjects.Compared the level of blood lipid including total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high-density lipoprotei n cholesterol(HDL-C),triglyceride(TG),lipoprotein a(LP(a))in euthyroid groupwi th SCH group,and the level of TSH in the different groups,according to the degree of coronary artery lesions.Analyzed the relationship between subclinical hypothyroid ism and coronary artery lesions.Results:1.The level of blood lipid including TC,LDL-C in SCH group(4.09±1.17mmol/L,2.53±0.83mmol/L)was higher than in euthyroid group(3.66±0.87mmol/L,2.27±0.73mmol/L)(P<0.05).2.The level of TSH and LDL-C in multiple vessel le sions group(3.67(1.87,8.04)m IU/L,2.79±0.68mmol/L)and two vessel lesions group(2.19(1.28,5.30)m IU/L,2.38±0.67mmol/L)were higher than in single vessel lesions grou p(1.77(1.00,2.85)m IU/L,2.09±0.72mmol/L)(P<0.01).The level of TSH and LDL-C in multiple vessel lesions group(3.67(1.87,8.04)m IU/L,2.79±0.68mmol/L)was higher than in two vessel lesions group(2.19(1.28,5.30)m IU/L,2.38±0.67mmol/L)(P<0.01),The results of correlation analysis between TSH and lesion vessel numbers: RS=0.316,P?0.001.3.The differences in TC,LDL-C,TSH and LP(a)of different Gensini g roups were statistically significant.The level of TC,LDL-C,LP(a),TSH and in gro up C(5.25±0.87mmol/L、3.32±0.63mmol/L、214.10±108.74mmol/L、12.02±5.45 m IU/L)were higher than group A(3.29±0.61mmol/L,1.88±0.49mmol/L,122.32±39.96 mmo l/L,5.41±1.23 m IU/L)and group B(4.22±1.15mmol/L,2.78±0.61mmol/L,131.04±94.84mmol/L,8.61±1.51 m IU/L)(P<0.05),and the level of TC,LDL-C,LP(a),TSH in grou p B(4.22±1.15mmol/L,2.78±0.61mmol/L,131.04±94.84mmol/L,8.61±1.51 m IU/L)w ere higher than group A(3.29±0.61mmol/L,1.88±0.49mmol/L,122.32±39.96mmol/L,5.41±1.23 m IU/L)(P<0.05),The results of correlation analysis between TSH and Ge nsini scores: RS=0.568,P?0.001.4.Analyses were achieved by orderly Logistic regre ssion analysis,showed that SCH was an independent risk factor for CHD with multi ple vessel lesions(OR=1.08,95%CI(1.04,1.13),P?0.001).Conclusion:There was a positive correlation between serum thyrotropin level an d the severity of coronary artery disease in patients with coronary heart disease.SC H was an independent risk factor for CHD with multiple vessel lesions.