Key result
Subclinical hyperthyroidism (crude SDNN β -0.070; 95% CI -0.014 to -0.009) and hypothyroidism were not significantly associated with heart rate variability after multivariate adjustment.
Why the study?
Is subclinical thyroid dysfunction associated with changes in heart rate variability in apparently healthy adults?
Cross-Sectional (n=9,270)
Is subclinical thyroid dysfunction associated with changes in heart rate variability in apparently healthy adults?
Subclinical thyroid dysfunction does not appear to be independently associated with altered heart rate variability in apparently healthy adults after adjusting for sociodemographic and cardiovascular risk factors.
Answers are grounded in this paper and cite their sources.
No independent HRV link after adjustment in healthy adults; leaves open effects in comorbid or higher-risk populations.
The association between subclinical thyroid dysfunctions and autonomic modulation changes has been described by many studies with conflicting results. We aimed to analyze the association between subclinical hyperthyroidism (SCHyper), subclinical hypothyroidism (SCHypo), and heart rate variability (HRV) using the baseline from ELSA-Brasil. SCHyper and SCHypo were classified by use of medication to treat thyroid disorders, thyrotropin levels respectively above and under the reference range, and normal free thyroxine levels. For HRV, the participants underwent 10 min in supine position and the R-R intervals of the final 5 min were selected for analysis. We first used linear regression models to report crude data and then, multivariate adjustment for sociodemographic (age, sex, and race) and cardiovascular risk factors (hypertension, dyslipidemia, diabetes, smoking, body mass index, use of alcohol, and leisure physical activity) using the euthyroid group as reference. From 9270 subjects (median age, 50; interquartile range: 44-56), 8623 (93.0%) were classified as euthyroid, 136 (1.5%) as SCHyper, and 511 (5.5%) as SCHypo. Compared to euthyroid subjects, SCHyper participants presented significantly higher heart rate (68.8 vs 66.5 for euthyroidism, P=0.007) and shorter R-R intervals (871.4 vs 901.6, P=0.007). Although SCHyper was associated with lower standard deviation of NN interval (SDNN) (β: -0.070; 95% confidence interval (95%CI): -0.014 to -0.009) and low-frequency (LF) (β: -0.242, 95%CI: -0.426 to -0.058) compared to the euthyroid group, these differences lost significance after multivariate adjustment for confounders. No significant differences were found for HRV in SCHypo. No association was found between HRV and SCHyper or SCHypo compared to euthyroid subjects in this sample of apparently healthy subjects.
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Miranda et al. (2018) conducted a cross-sectional in Subclinical thyroid disorders (n=9,270). Subclinical hyperthyroidism and subclinical hypothyroidism vs. Euthyroid subjects was evaluated on Heart rate variability (SDNN) (β -0.070, 95% CI -0.014 to -0.009, p=not significant). Subclinical hyperthyroidism (crude SDNN β -0.070; 95% CI -0.014 to -0.009) and hypothyroidism were not significantly associated with heart rate variability after multivariate adjustment.
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