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. 2024 Feb 29:17:1013-1024.
doi: 10.2147/DMSO.S454023. eCollection 2024.

Impaired Sensitivity to Thyroid Hormone and Risk of Carotid Plaque Development in a Chinese Health Check-Up Population: A Large Sample Cross-Sectional Study

Jiangling Wang #  1   2 , Lijuan Yang #  3 , Wei Liu  1 , Chaogang Wei  1 , Junkang Shen  1
Affiliations

Impaired Sensitivity to Thyroid Hormone and Risk of Carotid Plaque Development in a Chinese Health Check-Up Population: A Large Sample Cross-Sectional Study

Jiangling Wang et al. Diabetes Metab Syndr Obes. .

Abstract

Objective: Previous research on the correlation between thyroid function and carotid plaque has revealed conflicting results, possibly attributable to the sensitivity of thyroid hormone indices. In this study, we aimed to analyze the association between thyroid hormone sensitivity indices and the risk of carotid plaque development in a Chinese health check-up population.

Methods: A total of 19,388 health check-up subjects were included in this study (mean age: 50.78±10.17 years). Central sensitivity to thyroid hormone was evaluated using the thyroid feedback quantile-based index (TFQI), the Chinese-referenced parametric TFQI (PTFQI), the TSH index (TSHI), and the thyrotropin thyroxine resistance index (TT4RI), while peripheral sensitivity to thyroid hormone was assessed by free triiodothyronine/free thyroxine (FT3/FT4) ratio. Multivariable logistic regression analyses were performed to detect the association between thyroid hormone sensitivity indices and carotid plaque risk, and subgroup analysis was also conducted to explore this association stratified by sex, age, obesity, and the status of smoking, drinking, diabetes, hypertension and dyslipidemia.

Results: Among the 19,388 participants, 3753 (19.4%) had carotid plaque. In multivariable adjustment models, the risk of carotid plaque was positively associated with TSHI (odds ratio [OR]: 1.23; 95% confidence interval [CI]: 1.18~1.28), TT4RI (OR: 1.28; 95% CI: 1.23~1.33), TFQI (OR: 1.06; 95% CI: 1.02~1.10), and PTFQI (OR: 1.11; 95% CI: 1.07~1.16), respectively. Conversely, the risk of carotid plaque was negatively correlated with FT3/FT4 (OR: 0.94; 95% CI: 0.90~0.98). In stratified analyses, all thyroid hormone sensitivity indices significantly increased the risk of carotid plaque especially in females, subjects<65 years, non-obese individuals, and those without current smoking, drinking, diabetes, hypertension and dyslipidemia.

Conclusion: In Chinese health check-up populations, a considerable connection between reduced sensitivity to thyroid hormones and carotid plaque has been observed, especially in females, those younger than 65 years, non-obese individuals, and those without any current smoking, drinking, diabetes, hypertension, or dyslipidemia.

Keywords: Chinese population; carotid plaque; euthyroid; resistance to thyroid hormone; thyroid hormone sensitivity.

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Conflict of interest statement

The authors declare no potential competing interests in this work.

Figures

Figure 1
Figure 1
Flowchart of the study population.
Figure 2
Figure 2
Carotid plaque incidence based on quartiles of thyroid hormones sensitivity indexes by gender and age. *P for trend<0.05; **P for trend<0.01; ***P for trend<0.001; ns, no significance.
Figure 3
Figure 3
Subgroup analysis of logistic regression analysis for the association between thyroid hormone sensitivity indices and the risk of carotid plaque (forest maps). The two ends of the segments represent 95% confidence intervals, the short vertical black line in the middle represents the adjusted OR value, and when the long dashed line representing OR equal to 1 does not intersect the segments, it represents the P-value less than 0.05.
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