Correlation between serum FT3/FT4 levels and carotid atherosclerosis in a physical examination population
10.3760/cma.j.cn115624-20250217-00130
- VernacularTitle:健康体检人群血清FT3/FT4水平与颈动脉硬化的相关性
- Author:
Ying GUO
1
;
Naisi ZHANG
1
;
Dongmei PEI
1
Author Information
1. 中国医科大学附属盛京医院健康管理科，沈阳110023
- Publication Type:Journal Article
- Keywords:
Physical examination;
Free triiodothyronine;
Free thyroxine;
Atherosclerosis;
Carotid ultrasound
- From:
Chinese Journal of Health Management
2025;19(7):493-499
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the correlation between the ratio of serum free triiodothyronine/free thyroxine (FT3/FT4) and carotid atherosclerosis in a population undergoing physical examination.Methods:This retrospective cross-sectional study consecutively enrolled 4 031 adult healthy examinees who underwent both carotid ultrasound and serum thyroid hormone level testing at the Health Management Center of Shengjing Hospital Affiliated to China Medical University from January 2017 to December 2023. The general information, anthropometric measurements, and related laboratory indicators were collected. Based on carotid ultrasound results, the participants were divided into carotid atherosclerosis group (2 382 cases) and non-carotid atherosclerosis group (1 649 cases). According to the median FT3/FT4 ratio (0.35), participants were further categorized into a high FT3/FT4 ratio group (1 998 cases) and a low FT3/FT4 ratio group (2 033 cases). Receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic value of serum FT3/FT4 levels for carotid atherosclerosis. Additionally, the carotid atherosclerosis group was subdivided into carotid intima-media thickness (CIMT) thickening group (1 006 cases) and plaque formation group (1 376 cases). Stepwise logistic regression analysis was used to assess the correlation between FT3/FT4 levels and different severity of carotid artery stiffness.Results:Among the 4 031 health examinees included in the study, the detection rate of carotid atherosclerosis was 59.09% (2 382/4 031). The FT3/FT4 ratio in the carotid atherosclerosis group was significantly lower than that in the non-carotid atherosclerosis group (0.34 vs 0.39, Z=-19.958, P<0.001). The incidence rate of carotid atherosclerosis in the high FT3/FT4 ratio group was significantly lower than that in the low FT3/FT4 ratio group (46.7% vs 71.3%, Z=251.797, P<0.001). Multivariate regression analysis revealed that the FT3/FT4 ratio was an independent protective factor for carotid atherosclerosis ( OR=0.493, 95% CI: 0.458-0.529), with a protective effect comparable to high-density lipoprotein cholesterol ( OR=0.659, 95% CI: 0.543-0.801), while fasting blood glucose ( OR=1.566) and low-density lipoprotein cholesterol ( OR=1.164) were risk factors. ROC curve analysis showed that the area under the curve (AUC) of the FT3/FT4 ratio for diagnosing carotid atherosclerosis was 0.685 (sensitivity 79.3%, specificity 50.2%, cutoff value 0.39). In the analysis of carotid atherosclerosis subtypes, the FT3/FT4 ratio in the plaque formation group (0.328) was significantly lower than that in the CIMT thickening group (0.360) and the non-stiffness group (0.391)(all P<0.001), and it exhibited a stronger protective effect against plaque formation ( OR=0.297, 95% CI: 0.256-0.344). Conclusion:The FT3/FT4 ratio shows a dose-response relationship with the severity of carotid artery sclerosis and can serve as an auxiliary screening indicator for individuals at high cardiovascular risk. To enhance diagnostic efficacy, it is recommended to integrate this measure with other metabolic indicators.
