The association of thyroid function with carotid artery plaque burden and strokes in a population-based sample from a previously iodine-deficient area

Background: Thyroid dysfunction is associated with detrimental cardiovascular effects. We analyzed whether thyroid status is related to carotid artery plaques and prevalent strokes. Design, patients and measurements: Data from 2128 subjects (1157 men and 971 women) aged >= 45 years without thyroid diseases participating in the Study of Health in Pomerania were analyzed. The presence of carotid plaques was assessed by B-mode ultrasound and prevalent stroke was assessed by interview. The sample was divided according to the reference range of serum TSH levels into decreased (< 0.25 mIU/l). normal (0.25-2.12 mIU/l). and elevated (> 2.12 mIU/l). Logistic regression models Were adjusted for common confounders including age, sex, BMI, hypertension, diabetes mellitus. smoking, School education. plasma fibrinogen and serum cholesterol levels, and statins. Results: The prevalence of carotid plaques at any site was higher in Subjects with decreased serum TSH levels (81.7'%) compared with normal serum TSH levels (70.2%) and elevated serum TSH levels (65.6%: P < 0.001). Fully adjusted logistic regression models revealed increased odds for carotid plaques (odds ratio (OR) 1.67: 95%, confidence interval (CI).1.11-2.51; P < 0.05) as well its tor prevalent strokes (OR 1.98: 95% CI 1.05-3.73: P < 0.05) in subjects with decreased serum TSH levels, while there was no association between elevated serum TSH levels and carotid plaques or stroke respectively. Conclusions: Thyroid function was associated with the presence of carotid artery plaques and prevalent strokes in this population-based sample. Periodical screening and early treatment of atherosclerotic risk factors should be performed in subjects with decreased serum TSH levels.