Association between impaired sensitivity to thyroid hormones and ischemic stroke in euthyroid population with hypertension and sex difference in this association

Youyou Zhang; Ruirui Jia; Long Wang; Dong Chen; Hui Wang; Zhaoyang LI

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Association between impaired sensitivity to thyroid hormones and ischemic stroke in euthyroid population with hypertension and sex difference in this association

VernacularTitle:甲状腺激素敏感性指标对甲状腺功能正常高血压患者缺血性脑卒中患病风险的影响及性别差异研究
Author: Youyou ZHANG ¹ ; Ruirui JIA ¹ ; Long WANG ¹ ; Dong CHEN ² ; Hui WANG ¹ ; Zhaoyang LI ³
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1. Department of Geriatric Neurology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004
2. Department of Clinical Laboratory, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004
3. School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China
Publication Type:Journal Article
Keywords: hypertension; thyroid function; sensitivity to thyroid hormone; ischemic stroke; sex difference
From: Journal of Xi'an Jiaotong University(Medical Sciences) 2024;45(5):763-768
CountryChina
Language:Chinese
Abstract: 【Objective】 To investigate the associations between thyroid hormone sensitivity indices in euthyroid patients with hypertension and the risk of ischemic stroke, as well as gender difference in this association. 【Methods】 We selected 760 hypertensive patients admitted to the Geriatric Neurology Department and outpatient clinic in The Second Affiliated Hospital of Xi’an Jiaotong University between April 2021 and May 2022. We collected their basic characteristics, blood biochemical parameters, thyroid indices, and brain magnetic resonance imaging information. All the patients were divided into two groups based on the clinical manifestations and brain magnetic resonance imaging: hypertension combined with ischemic stroke (n=526) and control (n=234) groups. Independent sample t-tests or non-parametric tests were used to compare the differences in thyroid hormone sensitivity indicators between the two groups. Spearman correlation analysis was used to analyze the correlation between serum thyroid indices and ischemic stroke. Multivariate conditional Logistic regression analysis was made to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for thyroid indices and ischemic stroke. 【Results】 There were statistically significant differences between the two groups in terms of age, gender, TC, LDL-c, HDL-c, systolic blood pressure, FT3/FT4, TFQI, and PTFQI (all P<0.05). However, there was no statistically significant difference between the two groups in weight, smoking, drinking, history of diabetes, TG, FBG, diastolic blood pressure, TSHI, or TT4RI (all P>0.05). The results of Spearman correlation analysis showed a negative correlation between FT3/FT4 and ischemic stroke (P<0.05), but a positive correlation of TFQI and PTFQI with ischemic stroke (P<0.05) in euthyroid patients with hypertension. Logistic regression analysis showed that FT3/FT4 was significantly associated with ischemic stroke in euthyroid patients with hypertension (P=0.001), with OR (95% CI) of 0.001 (0.000, 0.058). After stratifying by gender, Logistic regression analysis found that FT3/FT4, TFQI, and PTFQI were associated with an increased risk of ischemic stroke in female patients, with OR (95% CI) of 0.000 (0.000, 0.001), 3.132 (1.415, 6.930), and 3.010 (1.406, 6.445), respectively. 【Conclusion】 Lower serum FT3/FT4 ratio is associated with an increased risk of ischemic stroke in euthyroid patients with hypertension, and the significant association of TFQI and PTFQI with the risk of ischemic stroke is found in females.