Emerging cardiovascular risk factors in subclinical hypothyroidism: lack of change after restoration of euthyroidism |
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Authors: | Pérez A Cubero J M Sucunza N Ortega E Arcelús R Rodriguez-Espinosa J Ordoñez-Llanos J Blanco-Vaca F |
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Affiliation: | Serveis d'Endocrinologia, Bioquímica i Institut de Recerca, Hospital Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 08025 Barcelona, Spain. |
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Abstract: | 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. |
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