scholarly journals Effect of Thyroxin Treatment on Carotid Intima–Media Thickness (CIMT) Reduction in Patients with Subclinical Hypothyroidism (SCH): a Meta-Analysis of Clinical Trials

2017 ◽  
Vol 24 (7) ◽  
pp. 643-659 ◽  
Author(s):  
Muhammad Aziz ◽  
Yugandhar Kandimalla ◽  
Archana Machavarapu ◽  
Anshul Saxena ◽  
Sankalp Das ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Subclinical Hypothyroidism ◽  
Meta Analysis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Media Thickness

Abstract 111: Effect of Thyroxin Treatment on Carotid Intima Media Thickness (CIMT) Reduction in Patients With Subclinical Hypothyroidism (SCH)-A Meta-Analysis of Randomized Clinical Trials

2017 ◽  
Vol 37 (suppl_1) ◽  
Author(s):  
Yugandhar Kandimalla ◽  
Muhammad Aziz ◽  
Archana Machavarapu ◽  
Rehan Malik ◽  
Adnan Younus ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Subclinical Hypothyroidism ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Hormone Replacement ◽  
Surrogate Marker ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Post Treatment ◽  
Media Thickness

Background: Research shows that subclinical hypothyroidism (SCH) is related to increased carotid intima media thickness (CIMT), a surrogate marker of stroke and subclinical cardiovascular disease (CVD). It is controversial whether SCH should be treated or not to reduce risk of stroke and CVD morbidity and mortality. The aim of this meta-analysis was to determine whether SCH is associated with an increase in CIMT as compared to Euthyroidism (EU) and whether thyroxin therapy in SCH can reverse the change in CIMT. Methods: Two independent reviewers did an extensive database search up to December 2016. Total of 12 randomized clinical trials discussed effect of thyroxin treatment on CIMT values at pre-and-post treatment in SCH subjects. Results: CIMT was significantly higher among SCH (n=280) as compared to EU controls (n=263) at baseline, pooled standardized mean difference (SMD) of CIMT was 0.44 mm [95%CI 0.14, 0.74], SE=0.15; p=0.004 with heterogeneity I 2 = 65%. After treatment with thyroxin in SCH subjects (n=314), there was a statistically significant decrease in CIMT from pre-to-post treatment, pooled SMD of CIMT decrease was [SMD -0.32; 95%CI (-0.47, -0.16), SE=0.08; p<0.0001, with heterogeneity I 2 = 2%], and was no longer different from EU controls [SMD 0.13 mm; 95% CI (-0.04, 0.30); p= 0.14; I 2 = 27%]. The total cholesterol, triglycerides, and low density lipoprotein were higher in SCH as compared to EU controls and decreased significantly after treatment with thyroxin. Conclusion: This meta-analysis shows that thyroxin therapy in SCH subjects significantly decreases CIMT and improves lipid profile, modifiable risk factors for stroke and CVD. Thyroid hormone replacement in SCH subjects might have a role in slowing down or preventing progression of atherosclerosis.

scholarly journals Effect of levothyroxine on the progression of carotid intima-media thickness in subclinical hypothyroidism patients: a meta-analysis

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e016053 ◽  
Author(s):  
Tong Zhao ◽  
Baomin Chen ◽  
Yingying Zhou ◽  
Xinyi Wang ◽  
Yuanyuan Zhang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Subclinical Hypothyroidism ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Media Thickness

BackgroundSubclinical hypothyroidism (SCH) has been associated with increased carotid intima-media thickness (C-IMT) in recent studies, but the effects of levothyroxine (L-T4) therapy on C-IMT in SCH patients are still controversial.AimTo evaluate the effect of L-T4 therapy on endothelial function as determined by C-IMT in patients with SCH.MethodsBeforeJuly 2016, we searched the PubMed, Embase, Cochrane Library and Google Scholar databases, selecting published randomised controlled trials (RCTs) and self-controlled trials for the meta-analysis.ResultsThree RCTs with 117 patients were considered appropriate for the meta-analysis. The results of the meta-analysis indicated that L-T4 significantly decreased the development of C-IMT (weighted mean difference (WMD) −0.05 mm, 95% CI −0.08 to –0.01 mm; p=0.025). We also analysed nine studies (self-controlled trials) with 247 patients and extracted the IMT of SCH patients before and after L-T4 treatment. After L-T4 therapy, the pooled estimate of the WMD of decreased C-IMT was −0.04 mm (95% CI −0.07 to –0.02 mm; p=0.05). Subgroup analysis showed that L-T4 therapy was associated with a decrease in C-IMT among patients of mixed genders (WMD −0.03 mm, 95% CI −0.06 to –0.01 mm; p=0.145). L-T4 therapy was associated with a decrease in C-IMT among female patients (WMD −0.07 mm, 95% CI −0.14 to –0.01; p=0.186). Longer treatment (>6 months) also resulted in a significant decrease in C-IMT (WMD −0.05 mm, 95% CI −0.08 to –0.02; p=0.335).ConclusionThis meta-analysis indicates that L-T4 treatment of SCH patients can reduce C-IMT, possibly as a result of the reduction of total cholesterol, triglyceride, low density lipoprotein, systolic blood pressure, diastolic blood pressure, lipoprotein(a), and flow-mediated dilatation. Decreased C-IMT was observed in SCH patients after long-term (>6 months) L-T4 treatment. RCTs with larger samples are needed to verify these observations.

Carotid intima-media thickness in patients with subclinical hypothyroidism: A meta-analysis

2013 ◽  
Vol 227 (1) ◽  
pp. 18-25 ◽  
Author(s):  
Ning Gao ◽  
Wei Zhang ◽  
Yu-zhen Zhang ◽  
Qing Yang ◽  
Shao-hua Chen
Keyword(s):  
Subclinical Hypothyroidism ◽  
Meta Analysis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Media Thickness

Serum Vitamin D Level and Carotid Intima-Media Thickness: A Systematic Review and Meta-Analysis of Observational Studies and Randomized Control Trials

2020 ◽  
Vol 52 (05) ◽  
pp. 305-315
Author(s):  
Nasim Säidifard ◽  
Hadith Tangestani ◽  
Kurosh Djafarian ◽  
Sakineh Shab-Bidar
Keyword(s):  
Vitamin D ◽  
Observational Studies ◽  
Meta Analysis ◽  
Serum Vitamin ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Vitamin D Supplementation ◽  
Inverse Association ◽  
Serum Vitamin D ◽  
Media Thickness

AbstractIt is reported that vitamin D deficiency is associated with carotid intima-media thickness (CIMT). In addition, several randomized clinical trials (RCTs) have studied the influence of vitamin D supplement on CIMT. However, results are inconclusive. This review aimed to systematically explore the potential link of the serum vitamin D level with CIMT pooling together observational studies and RCTs. PubMed and Scopus were searched for studies published until February 13, 2018. The Fisher’s z (SE) correlation coefficient, odds ratio (OR), and mean (SD) of changes in CIMT from baseline were used to perform meta-analysis in observational studies and RCTs, respectively. To pool data, both a fixed-effects model and a random-effects model (in case of heterogeneity) were used. Heterogeneity was assessed using Cochran’s Q and I2 tests. Nineteen observational studies and 3 RCTs met inclusion criteria. The pooled correlation coefficients of 17 observational studies showed [(Fisher’s z=− 0.41, 95% CI: –0.63 to –0.19, p<0.001), I2=96.9%, p < 0.001] a significant inverse association between serum vitamin D and risk of CIMT. Pooling three risk estimates of three studies [(OR = 1.69, 95% CI: 0.74 to 3.86, p=0.209); I2=085.1%, p<0.001)] indicated no significant association between serum vitamin D status and risk of CIMT. Combining data of RCTs showed vitamin D supplementation significantly reduced CIMT [(MD: –0.034, 95% CI: –0.62 to –0.05, p=0.012), I2=16.6%, p = 0.301]. Our findings show that serum vitamin D is inversely associated with CIMT and vitamin D supplementation may reduce CMIT.

The effect of HIV infection, antiretroviral therapy on carotid intima-media thickness: A systematic review and meta-analysis

Life Sciences ◽  
2019 ◽  
Vol 235 ◽  
pp. 116851 ◽  
Author(s):  
Titus F. Msoka ◽  
Gary P. Van Guilder ◽  
Marceline van Furth ◽  
Yvo Smulders ◽  
Sebastian J. Meek ◽  
...  
Keyword(s):  
Systematic Review ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Meta Analysis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Media Thickness
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