ERIQUE JOSE PEIXOTO DE MIRANDA

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SCPACEX-62, Hospital Universitário
LIM/20 - Laboratório de Terapêutica Experimental, Hospital das Clínicas, Faculdade de Medicina

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Autor e Coautores FMUSP-HC Normalizados: ALESSANDRA CARVALHO GOULART ×

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  • conferenceObject
    The Relationship Between Thyroid-Stimulating Hormone Levels and Lipoprotein Subfractions in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
    (2018) PEIXOTO-MIRANDA, Erique J.; GOULART, Alessandra C.; BITTENCOURT, Marcio S.; BLAHA, Michael; JONES, Steven; SANTOS, Itamar S.; TOTH, Peter; KULKARNI, Krishnaji; LOTUFO, Paulo A.; BENSENOR, Isabela M.
  • article 27 Citação(ões) na Scopus
    Thyrotropin Levels, Insulin Resistance, and Metabolic Syndrome: A Cross-Sectional Analysis in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
    (2015) BENSENOR, Isabela M.; GOULART, Alessandra Carvalho; MOLINA, Maria del Carmen B.; MIRANDA, Erique Jose Peixoto de; SANTOS, Itamar S.; LOTUFO, Paulo A.
    Background: Previous studies have described an association with thyrotropin (TSH) levels, insulin resistance, and metabolic syndrome. We performed a cross-sectional analysis to investigate the relationship between TSH levels, insulin resistance, and metabolic syndrome using baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods: Diabetics and individuals using medications that interfere in thyroid function were excluded, leaving 10,935 participants (54.3% women) for current analyses. Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) values above the 75th percentile was considered as indicative of presence of insulin resistance. Logistic regression models were built using HOMA-IR and metabolic syndrome as the dependent variable, and quintiles of TSH as the independent variable (first quintile as reference). Odds ratios (OR) were presented with multivariate adjustment for socioeconomic/cardiovascular risk factors for insulin resistance, and adjustment only for socioeconomic factors and smoking for metabolic syndrome. Results: Age, body mass index, waist measurement, fasting glucose and fasting and post load insulin and HOMA-IR increased according to TSH quintiles. Subjects in the fifth TSH quintile presented an OR of association with insulin resistance of 1.86 [95% confidence interval (95% CI) 1.26-2.75], regardless of gender. For the metabolic syndrome, subjects in the fifth quintile presented an OR of 1.21 (95% CI 1.01-1.45) and remained positive only for men (OR 1.37; 95% CI 1.07-1.76). Restricting the analysis to quintiles of TSH in the normal range did not change the results. Conclusions: In this cross-sectional evaluation, high TSH quintiles were associated to insulin resistance/metabolic syndrome.
  • article 12 Citação(ões) na Scopus
    Lack of Association Between Subclinical Hypothyroidism and Carotid-Femoral Pulse Wave Velocity in a Cross-Sectional Analysis of the ELSA-Brasil
    (2017) MIRANDA, Erique Jose F. Peixoto de; BITTENCOURT, Marcio Sommer; GOULART, Alessandra Carvalho; SANTOS, Itamar Souza; MILL, Jose Geraldo; SCHMIDT, Maria Ines; LOTUFO, Paulo Andrade; BENSENOR, Isabela J. Martins
    BACKGROUND There is little available data on carotid-femoral pulse wave velocity (cf-PWV) in subjects with subclinical hypothyroidism (SCH). We aimed to analyze the association between SCH and cf-PWV using baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). METHODS We included subjects with normal thyroid function (thyrotropin (TSH): 0.4-4.0 mIU/l, and normal free thyroxine (FT4: 0.8-1.9ng/dl) and SCH (TSH > 4.0 mIU/l and normal FT4) evaluated for cf-PWV in a crosssectional analysis. We excluded individuals using medications that interfere in thyroid function, antihypertensives, or diuretics, and subjects with chronic kidney disease or previous cardiovascular disease. Generalized linear and logistic regression models evaluated cf-PWV as a dependent variable and SCH as an independent variable, adjusted for cardiovascular risk factors. RESULTS Of 8,341 subjects (52.3% women), 7,878 (94.4%) were euthyroid and 463 (5.6%) showed SCH. The median age was 50 years (interquartile range: 44-56). The groups differed by age, sex, body mass index, glomerular filtration rate, and C-reactive protein. SCH was not associated with cf-PWV in the full-adjusted linear model (beta = -0.039; P = 0.562) and with cf-PWV > 75th percentile in the full-adjusted logistic model (odds ratio = 0.94; 95% confidence interval = 0.72-1.22). CONCLUSION In a large sample, SCH was not associated with increased cf-PWV.
  • article 15 Citação(ões) na Scopus
    Thyrotropin levels are associated with chronic kidney disease among healthy subjects in cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
    (2017) MIRANDA, Erique Jose F. Peixoto de; BITTENCOURT, Marcio Sommer; GOULART, Alessandra C.; SANTOS, Itamar S.; TITAN, Silvia Maria de Oliveira; LADEIRA, Roberto Marini; BARRETO, Sandhi Maria; LOTUFO, Paulo A.; BENSENOR, Isabela Judith Martins
    Few studies have evaluated a possible relationship between thyrotropin levels and glomerular filtration rate (GFR) and albumin/creatinine ratio in euthyroid subjects. We aimed to analyze this association using baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Cross-sectionally, we included subjects with normal thyroid function and with subclinical hypothyroidism (SCH). We excluded individuals using medications that affect thyroid function. Linear and logistic regression models evaluated GFR estimated by Chronic Kidney Disease Epidemiology Collaboration (CKD-Epi) and albuminuria/creatinine ratio as dependent variables and thyrotropin quartiles in individuals with euthyroidism and SCH as independent variables, adjusted for demographical characteristics and diseases related to CKD. We included 13,193 subjects with a median age of 51 years [interquartile range, (IQR): 45-58], 6840 (51.8%) women, 12,416 (94.1%) euthyroid, and 777 (5.9%) with SCH. SCH subjects were characterized by higher age, triglycerides, frequency of white race, cardiovascular disease, CKD, and former smokers. In adjusted models, log-transformed TSH in euthyroid subjects was inversely and strongly associated with CKD (beta = -2.181, 95% CI -2.714 to -1.648), P < 0.0001 for glomerular filtration rate and 4.528 (1.190-7.865) for albuminuria/creatinine ratio. Multivariate logistic models for euthyroid subjects showed an OR of 1.45 (95% CI 1.15-1.83) for GFR and of 1.95 (95% CI 1.08-3.54) for albuminuria/creatinine ratio in the fourth quartile of TSH using the first as the reference. Thyrotropin levels are independently associated with CKD in euthyroid subjects.
  • article 29 Citação(ões) na Scopus
    Subclinical hypothyroidism is associated with higher carotid intima-media thickness in cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
    (2016) MIRANDA, E. J. F. Peixoto de; BITTENCOURT, M. S.; PEREIRA, A. C.; GOULART, A. C.; SANTOS, I. S.; LOTUFO, P. A.; BENSENOR, I. M.
    Background and aim: Although subclinical hypothyroidism (SCH) is associated with cardiovascular risk, there is scarce data about subclinical atherosclerosis in subjects with SCH. We aimed to analyze the association between SCH and carotid intima-media thickness (IMT) using baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods and Results: We included subjects with normal thyroid function (TSH: 0.4-4.0 mIU/l, and normal free thyroxine (FT4): 0.8-1.9 ng/dl) and SCH (TSH >= 4.0 mIU/l and normal FT4) evaluated for IMT in a cross-sectional analysis. We excluded individuals using medications that affect thyroid function and those with a history of cardiovascular disease. We performed logistic and linear regression models to evaluate the association with IMT (mean values and categorized at the 75th percentile) as a dependent variable and SCH as an independent variable, adjusted for other cardiovascular risk factors. From 8623 subjects (median age of 50 years; interquartile range: 44-57), 4624 (53.6%) were women, 8095 (93.9%) were euthyroid, and 528 (6.1%) had SCH. Groups varied in age, body mass index, Framingham risk score, Homeostasis Model Assessment for Insulin Resistance (HOMA-IR), C-reactive protein, as well as, IMT, that were all higher in SCH compared to euthyroid participants. SCH is associated with IMT as a continuous variable (beta = 0.010, P = 0.036) and IMT > 75th percentile: OR = 1.30 (95% CI = 1.06-1.59) in logistic models. Conclusion: Individuals with SCH presented higher IMT compared with euthyroid subjects, even after adjustment for potential confounders. IMT was independently associated with SCH in the baseline of the ELSA-Brasil study.