Korean J Fam Pract 2019; 9(1): 36-43  https://doi.org/10.21215/kjfp.2019.9.1.36
Association of Subclinical Hypothyroidism with Cardiovascular Risk Factors and Coronary Artery Calcium Score
Sung-Kyoung Cho, Hyun-Min Koh*, Jin-Sook Moon
Department of Family Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
Hyun-Min Koh, Tel: +82-55-233-5199, Fax: +82-55-233-5189, E-mail: sunkhm@naver.com, ORCID: http://orcid.org/0000-0002-3499-6198
Received: April 2, 2018; Revised: July 11, 2018; Accepted: October 31, 2018; Published online: February 20, 2019.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Few studies have investigated the association between subclinical hypothyroidism (SCH) and coronary artery calcification (CAC). This study investigated this association in patients who visited a health promotion center.
Methods: This study included patients who visited the Health Promotion Center at a University Hospital between January 2014 and December 2015. Serum thyroid stimulating hormone (TSH) level, free thyroxine level, and the CAC score (CACS) were measured in all patients. Patients were classified into euthyroid and SCH groups. An independent t-test and chi-squared test were performed to analyze the general characteristics. Patients were further classified into three groups based on serum TSH levels (serum TSH level <4.0, 4.0–10, and >10 μIU/mL), and the one-way analysis of variance test was performed to assess the clinical differences among three groups. Partial correlation coefficients were calculated to assess the correlation between serum TSH levels and cardiovascular risk factors. Patients with CACS=0 were classified into the non-calcification group, and those with CACS >0 were classified into the calcification group. The odds ratios of SCH to CAC were analyzed using logistic regression analysis.
Results: Serum TSH levels were significantly associated with body mass index, waist circumference, high-density lipoprotein cholesterol, and triglyceride levels. The risk of obesity, diabetes, and high triglyceride levels (>150 mg/dL) was significantly higher in the SCH group. Moreover, the SCH group with TSH levels >10 μIU/mL showed a significant risk of CAC (odds ratio, 3.18; 95% confidence interval, 1.10–9.21).
Conclusion: SCH with TSH levels >10 μIU/mL is independently associated with the CACS.
Keywords: Hypothyroidism; Thyrotropin; Coronary Artery Calcium Score; Cardiovascular Disease; Atherosclerosis
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