Mazzeffi MA, Lin HM, Flynn BC, O'Connell TL, DeLaet DE, et al.
Vascular health and risk management. Date of publication 2010 Oct 21;volume 6():957-62.
1. Vasc Health Risk Manag. 2010 Oct 21;6:957-62. doi: 10.2147/VHRM.S13535.
Hypothyroidism and the risk of lower extremity arterial disease.
Mazzeffi MA(1), Lin HM, Flynn BC, O'Connell TL, DeLaet DE.
Author information:
(1)Department of Anesthesiology, Mount Sinai School of Medicine, New York, NY,
USA. michael.mazzeffi@mssm.edu
BACKGROUND: Although an independent association between hypothyroidism and
coronary artery disease has been demonstrated, few studies have examined the
association between hypothyroidism and peripheral arterial disease. In the
current study, we test the hypothesis that there is an independent association
between hypothyroidism and lower extremity arterial disease.
METHODS: We retrospectively compared the prevalence of hypothyroidism in patients
who had infra-inguinal arterial bypass surgery over a 6-year period with that of
a control group of surgical patients who had pure cardiac valve surgery during
the same time period. Both unadjusted and adjusted odds ratios were calculated to
estimate the association between hypothyroidism and lower extremity arterial
disease.
RESULTS: A total of 614 cases and 529 control subjects had surgery during the
study period. When comparing all subjects, there was no association between
hypothyroidism and lower extremity arterial disease (unadjusted odds ratio 0.88;
95% confidence intervals [CI]: 0.61-1.28). However, gender was found to be a
significant effect modifier (P < 0.001), and gender-stratified analyses were
subsequently performed. In men, there was a positive independent association
between hypothyroidism and lower extremity arterial disease (adjusted odds ratio
2.65; 95% CI: 1.19-5.89), whereas in women there was a negative independent
association (adjusted odds ratio 0.22; 95% CI: 0.11-0.46).
CONCLUSIONS: Gender is a significant effect modifier for the association between
hypothyroidism and lower extremity arterial disease. The association is positive
in men and negative in women. Future prospective studies that evaluate
hypothyroidism as a risk factor for peripheral arterial disease should consider
gender stratification in order to corroborate this finding.
DOI: 10.2147/VHRM.S13535
PMCID: PMC2964948
PMID: 21057580 [Indexed for MEDLINE]
