Study On The Relationship Between Thyroid Hormone Levels,Vascular Risk Factors And Leukoencephalopathy

Objective:To explore the relationship between serum TSH,FT3,FT4 levels and leukoencephalopathy and its severity,and to provide theoretical basis for the prevention and treatment of leukoencephalopathy.Methods:Clinical data of patients admitted to the Department of Neurology of Liaoning Provincial People’s Hospital from October 2019 to December 2020 who underwent complete head MRI were retrospectively collected..Clinical data were collected,including general information and vascular risk factors,previous stroke history,and related laboratory tests.The serum levels of TSH,FT3 and FT4 were determined by chemiluminescence immunoassay.According to the presence or absence of WMLs(White matter lesions)lesions,the patients were divided into WMLs group and WMl-free group.Head MRI was used to evaluate WMLs lesions.periventricular white matter hyperintensities were evaluated according to Fezakas scale.PVWMH)and deep white matter hyperintensities(DWMH)lesions(WMLs),the comprehensive severity is divided into: mild(1-2 points),moderate(3-4points),severe(5-6 points).SPSS 23.0 statistical software was used for statistical processing,Logistic regression was used to analyze the correlation between TSH,FT3,FT4 and WMLs and their severity,and Spearman correlation coefficient was used for correlation analysis.Results:A total of 137 patients were participated in this study,aged from 35 to91 years old,including 66 males(48.2%)and 71 females(51.8%).A total of 137 patients were divided into the WMLs group(83 cases,60.6%)and the non-Wmls group(54 cases,39.4%).According to the severity of WMLs,there were 34 cases in the mild group,29 cases in the moderate group,and 20 cases in the severe group.The results showed that the age,proportion of hypertension history,previous ischemic stroke history,and higher levels of plasma triglyceride,apolipoprotein,Hcy and TNF-α in the WMLs group were higher than those in the non-WMLs group in the normal range(P<0.05);Multivariate Logistic regression analysis showed that: Age(OR=0.889,95%CI:0.835-0.945,P=0.031)and thyroid stimulating hormone(OR=1.068,95%CI:1.002-1.139,P=0.000)were the independent risk factors for WMLs.Analysis of factors influencing the severity of white matter lesions showed that The age,proportion of stroke history,and higher thyroid stimulating hormone level within the normal range in the severe group were higher than those in the mild-to-moderate group(P < 0.05).Multivariate Logistic regression analysis showed that age,stroke history,and higher thyroid stimulating hormone level within the normal range were independent risk factors for white matter lesionsConclusions:Age and TSH are independent risk factors for leukoencephalopathy,and serum FT3 is protective factor for leukoencephalopathy.In patients with leukoencephalopathy,TSH,age,and history of ischemic stroke were positively correlated with the severity of leukoencephalopathy.