Impairment of endothelium‐dependent arterial dilation in Hashimoto's thyroiditis patients with euthyroidism

Summary Objective  Recent studies have shown that immune responses contribute to atherosclerosis, and endothelial dysfunction is an important early event in atherogenesis. The aim of this study was to investigate the alteration of endothelial function in Hashimoto's thyroiditis (HT) patients with euthyroidism. Methods  Study subjects included 28 female HT patients with euthyroidism, 23 female HT patients with hypothyroidism, and 22 healthy women. High-resolution ultrasound was used to measure brachial artery diameter at rest, after reactive hyperaemia and after sublingual glyceryltrinitrate (GTN). Results  Flow-mediated arterial dilation in HT patients with euthyroidism was significantly lower (3·88%) than in controls (4·98%, P = 0·000) and higher than in HT patients with hypothyroidism (3·26%, P   0·05). On multiple regression analysis, anti-thyroid peroxidase antibody (TPO-Ab), TSH, free T3, low density lipoprotein cholesterol (LDL-C) and lipoprotein (a) [Lp(a)] were found to be significant factors associated with endothelium-dependent arterial dilation. Conclusion  Endothelial dysfunction exists in HT patients with euthyroidism. Autoimmune reactivity and an elevated Lp(a) level might be responsible for the endothelial dysfunction.