ArticleCureus2025
Rethinking Normal Thyroid-Stimulating Hormone (TSH): Stroke Risk and Metabolic Implications in High-Risk Cardiovascular Patients.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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5 authors.
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Abstract
Objective This study aimed to evaluate whether variations in normal-range thyroid-stimulating hormone (TSH) levels affect cardiovascular outcomes in patients at high cardiovascular (CV) risk. Methods A cross-sectional study was conducted involving 463 middle-aged euthyroid patients (354 women, 109 men) under treatment for hypertension and dyslipidemia (TSH range: 0.5-5.2 mIU/L). Patients were grouped by TSH tertiles: lower (0.5-1.3 mIU/L), middle (>1.3-2.16 mIU/L), and upper (>2.16-5.2 mIU/L). For statistical analysis, we compared individuals with TSH ≤2.16 mIU/L (n=310) versus those with TSH >2.16 mIU/L (n=153). Results Anthropometric and laboratory parameters were comparable between groups, except for higher triglycerides (Tg) (151.9 ±74.9 vs. 136.0 ±72.7 mg/dL) and Tg-to-high-density lipoprotein (HDL) ratio (3.17 ±2.05 vs. 2.92 ±2.07) in those with upper-normal TSH (p<0.05). Positive correlations emerged between TSH and BMI (r=0.099, p=0.033) as well as between TSH and the Tg-to-HDL ratio (r=0.149, p=0.001). Interestingly, stroke prevalence was higher in patients whose TSH levels were in the lower-normal range (6.1% vs. 2.0%, p=0.047). Multivariate regression, adjusting for age, sex, BMI, and Tg-to-HDL ratio, showed that patients with lower-normal TSH were five times more likely to experience stroke (odds ratio (OR): 5.08; 95% confidence interval (CI): 1.15-22.25; p=0.031). Conclusions Within normal TSH ranges, lower-normal TSH levels were associated with a higher risk of stroke, while upper-normal TSH was linked to higher Tg levels and insulin resistance markers. These findings underscore the importance of carefully evaluating TSH levels in high-risk patients. Further prospective studies are needed to confirm these results and elucidate underlying mechanisms.
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