Association of thyroid stimulating hormone levels with subclinical carotid atherosclerosis in a Mediterranean female population

Objective To determine whether thyroid stimulating hormone (TSH) levels, an index of thyroid function, are associated with signs of carotid atherosclerosis. Participants and methods We examined 310 women from Southern Italy, aged 30–69 years, recruited for a prospective study, currently ongoing, on the etiology of cardiovascular disease and cancer in the female population (Progetto ATENA). All participants underwent cardiovascular risk factor assessment and high-resolution B-mode ultrasound to measure intima-media thickness (IMT) of carotid arteries. The occurrence and the number of atherosclerotic plaques (intima-media thickness>1.2 mm) were also evaluated. Results Women in the upper TSH decile (n=30; TSH>3.13 mU/l) had a significantly higher prevalence of diabetes mellitus and hypertriglyceridemia compared with women in the other TSH deciles. In a multivariate analysis, women in the upper TSH decile had a thicker carotid intima-media complex than those in the other deciles (0.92±0.02 vs. 0.86±0.01 mm; P=0.037) after adjustment for covariates. Furthermore, the number of carotid plaques was significantly associated with higher TSH levels (2.3±0.3 vs. 1.7±0.1; P=0.025). Conclusion In a cohort of women, higher TSH levels were associated with subclinical atherosclerotic changes of the carotid artery wall.