Association between sensitivity to thyroid hormones and dyslipidemia in patients with coronary heart disease

Endocrine. 2023 Mar;79(3):459-468. doi: 10.1007/s12020-022-03254-x. Epub 2022 Nov 24.

Abstract

Background: Thyroid hormones affect lipid metabolism via central and peripheral regulation. However, there have been few studies on the association between thyroid hormone sensitivity and dyslipidemia. We aimed to investigate the association between thyroid hormone sensitivity and dyslipidemia in patients with coronary heart disease (CHD).

Methods: A total of 31,678 patients with CHD were included in this large multicenter retrospective study. Central thyroid hormone sensitivity was evaluated using the thyroid feedback quantile-based index (TFQI), parametric thyroid feedback quantile-based index (PTFQI), thyroid-stimulating hormone index (TSHI), and thyrotropin thyroxine resistance index (TT4RI); peripheral thyroid hormone sensitivity was assessed by the ratio of free triiodothyronine (FT3)/free thyroxine (FT4). Logistic regression analysis was used to analyze the association between thyroid hormone sensitivity and dyslipidemia.

Results: Among 31,678 participants, 21,648 (68.34%) had dyslipidemia. In the multi-adjusted models, the risk of dyslipidemia was positively correlated with TFQI (odds ratio [OR]: 1.04; 95% confidence interval [CI]: 1.03-1.05), PTFQI (OR: 1.09; 95% CI: 1.06-1.12), TSHI (OR: 1.08; 95% CI: 1.06-1.11), and TT4RI (OR: 1.08; 95% CI: 1.05-1.11). Conversely, the risk of dyslipidemia was negatively correlated with FT3/FT4 (OR: 0.94; 95% CI: 0.92-0.97). In stratified analyses, the association between thyroid hormone sensitivity and dyslipidemia was statistically significant for different sexes, glucose levels, and blood pressure states.

Conclusion: There is a significant association between sensitivity to thyroid hormones and dyslipidemia, regardless of sex, glucose level, or blood pressure. Graphical abstract.

Keywords: Coronary heart disease; Dyslipidemia; Elevated blood glucose; Hypertension; Resistance to thyroid hormones; Thyroid hormone sensitivity.

Publication types

  • Multicenter Study
  • Comment

MeSH terms

  • Coronary Disease*
  • Dyslipidemias*
  • Glucose
  • Humans
  • Retrospective Studies
  • Thyroid Hormone Resistance Syndrome*
  • Thyroid Hormones
  • Thyrotropin
  • Thyroxine
  • Triiodothyronine

Substances

  • Thyroxine
  • Thyroid Hormones
  • Triiodothyronine
  • Thyrotropin
  • Glucose

Supplementary concepts

  • Hypothyroidism, Congenital, Nongoitrous, 3