Emerging cardiovascular risk factors in subclinical hypothyroidism: Lack of change after restoration of euthyroidism

Subclinical hypothyroidism (SH) is a frequent condition that may be associated with increased cardiovascular risk. There is current interest in determining the effect, if any, of substitutive therapy with l-thyroxine (L-T4) on cardiovascular risk factors in SH and, particularly, on those associated...

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Published in:Metabolism, clinical and experimental clinical and experimental, 2004-11, Vol.53 (11), p.1512-1515
Main Authors: PEREZ, A, CUBERO, J. M, SUCUNZA, N, ORTEGA, E, ARCELUS, R, RODRIGUEZ-ESPINOSA, J, ORDONEZ-LLANOS, J, BLANCO-VACA, F
Format: Article
Language:English
Subjects:
Adult
Aged
Apolipoproteins B - blood
Atherosclerosis (general aspects, experimental research)
Biological and medical sciences
Biomarkers - blood
Blood and lymphatic vessels
C-Reactive Protein - metabolism
Cardiology. Vascular system
Cardiovascular Diseases - blood
Cardiovascular Diseases - etiology
Coronary heart disease
Endocrinopathies
Female
Heart
Homocysteine - blood
Humans
Hypothyroidism - blood
Hypothyroidism - complications
Lipoprotein(a) - blood
Male
Medical sciences
Middle Aged
Non tumoral diseases. Target tissue resistance. Benign neoplasms
Risk Factors
Thyroid. Thyroid axis (diseases)
Thyrotropin-Releasing Hormone - blood
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Summary:Subclinical hypothyroidism (SH) is a frequent condition that may be associated with increased cardiovascular risk. There is current interest in determining the effect, if any, of substitutive therapy with l-thyroxine (L-T4) on cardiovascular risk factors in SH and, particularly, on those associated with emerging cardiovacular risk, such as apolipoprotein (apo) B, lipoprotein (Lp) (a), total homocysteine (t-Hcy), and C-reactive protein (CRP). Thus, the aim of this study was to assess the impact of euthyroidism restoration on these emerging risk factors in SH. Forty-two patients diagnosed with SH were consecutively recruited before treatment. These patients were treated with L-T4 for 3 to 6 months with the dose necessary to restore euthyroidism. Lp(a), fasting and postmethionine (n = 28) t-Hcy, and CRP did not change with substitutive therapy, regardless of the respective baseline values, and the decrease in apo B paralleled that of low-density lipoprotein (LDL) cholesterol. Similarly, no treatment effect was observed on homocysteine or CRP in patients with thyrotropin-stimulating hormone (TSH) >10 mIU/L. Monitoring of emerging risk factors did not offer additional arguments for treating patients with SH and, thus, is not justified in their clinical management.
ISSN:0026-0495
1532-8600
DOI:10.1016/j.metabol.2004.05.016