Subclinical inflammation: The link between increased cardiovascular risk and subclinical hypothyroidism in postmenopausal women

Abstract

Introduction: Increased inflammatory markers correlate with progressive hypothyroidism. The link between subclinical hypothyroidism, subclinical inflammation and cardiovascular disease in postmenopausal women still remains unclear. Objective: To evaluate the association of subclinical hypothyroidism with inflammatory biomarkers and their impact on cardiovascular risk in postmenopausal women. Materials (subjects) and methods: Prospective clinical study included 140 postmenopausal women in the outpatient and diagnostic department of the Clinic for endocrinology in a tertiary university hospital. Sociodemographic and anthropometric data, thyroid hormonal status, inflammation markers (CRP, homocysteine, acidum uricum, IL-6, TNF-α) were obtained for all subjects. They were followed for 30 months and the incidence of cardiovascular disease was determined. Results: Subclinical hypothyroidism was associated with elevated CRP, acidum uricum, homocysteine, and TNF-α. The incidence of cardiovascular disease was significantly higher in postmenopausal women with subclinical hypothyroidism compared to euthyroid women (p<0.001). Subclinical hypothyroidism was associated with higher cardiovascular risk regardless of age and duration of postmenopause (p=0.0007). Conclusion:Subclinical hypothyroidism is associated with elevated CRP, homocysteine, acidum uricum and TNF-α, and increases cardiovascular risk in postmenopausal women.