Cardiovascular
Association of the adequacy of hypothyroidism treatment with the metabolic vulnerability index Vandrize Meneghini* Vandrize Meneghini Carolina Castro Porto Silva Janovsky William R. Tebar José Augusto Sgarbi Patrícia de Fatima dos Santos Teixeira Steven R. Jones Michael J. Blaha Peter P. Toth Paulo A. Lotufo Isabela M. Benseñor
Introduction: A novel mortality biomarker for cardiovascular risk, the Metabolic Vulnerability Index (MVX), has recently emerged but is still unexplored in the context of thyroid disorders. MVX integrates inflammation and malnutrition markers measured by metabolomics.
Objective: We investigated the association of the adequacy of hypothyroidism treatment with MVX scores in participants from the ELSA-Brasil study.
Methods: Cross-sectional study using baseline data of São Paulo Research Center (N=4666). Individuals with normal thyroid function and clinical and subclinical hypothyroidism were included. Thyroid function and adequacy of treatment were classified according to thyrotropin, free thyroxine levels, and levothyroxine use. GlycA and small high-density lipoprotein particles (7.4-8.7nm) are markers of inflammation, while branched-chain amino acids (valine, leucine, and isoleucine), and citrate are markers of malnutrition and were measured by NMR spectroscopy (LipoProfile® 4 test spectra, LabCorp). Sex-specific MVX scores were calculated and transformed in standard values. Generalized linear regression models were adjusted for sociodemographic and lifestyle factors, chronic diseases, cardiovascular history, and glomerular filtration rate.
Results: Participants were 51.5±9 years old, and 2,522 (54%) were female. The prevalence of euthyroidism and untreated, inadequately and adequately treated hypothyroidism were 82.7%, 10.0%, 2.8%, and 4.5%, respectively. Participants untreated (ꞵ:1.12 95%CI:1.02-1.23) and inadequately treated (ꞵ:1.41 95%CI:1.19-1.68) for hypothyroidism had higher MVX scores than the euthyroid group. After adjustment for potential confounders, participants with untreated hypothyroidism had higher MVX scores (ꞵ: 1.10 95%CI: 1.01-1.21), than the euthyroid participants.
Conclusion: The findings suggest that individuals inadequately treated and untreated for hypothyroidism present with a higher metabolic vulnerability and possibly higher cardiovascular risk.