Impact of subclinical hypothyroidism complicating hyperuricemia on carotid atherosclerosis
Objective To explore the impact of subclinical hypothyroidism (SCH) complicating hyperu-ricemia (HUA) on carotid atherosclerosis,and to provide reference for the clinical management of the patients with SCH complicating HUA.Methods A retrospective analysis was conducted on the clinical data of 387 in-patients with carotid atherosclerosis in the Department of General Medicine of the Affiliated Hospital of Qing-dao University from January 1,2016,to December 31,2022.The patients were divided into the SCH complica-ting HUA group (n=170),SCH group (n=108),and HUA group (n=109) according to clinical diagnosis results,and into the low risk group (n=137),medium risk group (n=116),high risk group (n=66),and ex-tremely high risk group (n=68) for carotid atherosclerosis according to the carotid ultrasound results.The clinical data were compared among the groups,and the multivariable ordered logistic regression model was used to analyze the influencing factors of carotid atherosclerosis risk degree.Results There were statistically significant differences in gender,BMI,smoking history,drinking history,blood uric acid,thyroid-stimulating hormone (TSH),free triiodothyronine (FT3),free thyroxine (FT4) levels and composition of carotid athero-sclerosis risk degree among the SCH complicating HUA group,SCH group and HUA group (P<0.05).The other indicators had no statistical difference (P>0.05).The age,history of hypertension,history of stroke,blood uric acid,TSH and FT3 levels had statistical differences among the low,medium,high and extremely high risk groups for carotid atherosclerosis (P<0.05).Further pairwise comparison between groups showed that the TSH level in the carotid atherosclerosis low risk group was significantly lower than that in the high and ex-tremely high risk group (P<0.001).The multivariable ordered logistic regression analysis results showed that in-crease of blood uric acid (OR=1.003,95％CI:1.001-1.005,P=0.001),TSH (OR=1.231,95％CI:1.128-1.343,P<0.001) and fasting plasma glucose levels (OR=1.447,95％CI:1.109-1.889,P=0.007),and age in-crease (OR=1.039,95％CI:1.020-1.058,P<0.001) were associated with the increase of carotid atherosclerosis risk.Low-density lipoprotein cholesterol (LDL-C) and total cholesterol showed collinearity,and logistic regression a-nalysis results after principal component analysis transformation showed that the elevated LDL-C level increased the risk of carotid atherosclerosis (OR=1.104,95％CI:1.001-1.218,P<0.001).Conclusion SCH complicating HUA could promote the occurrence of carotid atherosclerosis.TSH,blood uric acid,fasting plasma glucose,LDL-C and age are the independent influencing factors for carotid atherosclerosis risk in patients with SCH complicating HUA.
万方数据
维普
