Document Detail


Effects of L-thyroxine replacement therapy on carotid intima-media thickness in patients with primary hypothyroidism.
MedLine Citation:
PMID:  19085705     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In hypothyroid patients, the risk for cardiovascular disease is higher and ultrasonography (US) demonstrates that the carotid intima-media thickness (CIMT) is significantly increased. We hypothesized that L-thyroxine replacement therapy might be able to reverse the process associated with increase in CIMT in patients with primary hypothyroidism. PATIENTS: In this study, a total of 43 females with primary hypothyroidism and 21 euthyroid females as control group were included. In hypothyroid patients, CIMT was measured using US and the measurement was repeated 6 months after euthyroidism was achieved with L-thyroxine replacement therapy. Biochemically, lipid profile, high sensitivity C-reactive protein (hs-CRP), plasminogen activator inhibitory-1 (PAI-1) and fibrinogen levels were measured. RESULTS: It was found that in hypothyroid patients the value of CIMT was significantly higher than those in control group (0.534+/-0.08 mm vs. 0.443+/-0.05 mm, respectively; p<0.001). However, the value of CIMT decreased significantly in all but two patients after euthyroidism was achieved with L-thyroxine replacement therapy (0.534+/-0.08 mm and 0.465+/-0.06 mm, respectively; p<0.001). Moreover, there was a positive correlation between the CIMT value and all other parameters except patient age, including total cholesterol (r=0.437, p=0.003), low density lipoprotein (LDL) cholesterol (r=0.415, p=0.006), total cholesterol/high density lipoprotein (HDL) cholesterol ratio (r=0.391, p=0.01) basal levels. CONCLUSION: This report demonstrates that in patients with primary hypothyroidism, in addition to values of total cholesterol, LDL cholesterol, and total cholesterol/HDL cholesterol ratio, the CIMT value was higher compared to healthy controls. Importantly, the value of CIMT, as well as the levels of lipid parameters, decreased to normal level after L-thyroxine replacement therapy. Furthermore, significant correlations were detected between the changes of CIMT and the changes of total cholesterol and LDL cholesterol respectively. Thus, it is suggested that an increased CIMT value may be an objective sign of accelerated atherosclerosis in patients with primary hypothroidism.
Authors:
E Cakal; A T Turgut; B Demirbas; M Ozkaya; B Cakal; R Serter; Y Aral
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-09-30
Journal Detail:
Title:  Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association     Volume:  117     ISSN:  1439-3646     ISO Abbreviation:  Exp. Clin. Endocrinol. Diabetes     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-10     Completed Date:  2009-08-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9505926     Medline TA:  Exp Clin Endocrinol Diabetes     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  294-300     Citation Subset:  IM    
Affiliation:
Department of Endocrinology and Metabolism, Ankara Training and Research Hospital, Ankara, Turkey. ermancakal@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Atherosclerosis / blood,  chemically induced*,  drug therapy,  pathology*
Carotid Arteries / pathology*
Cholesterol, HDL / blood
Cholesterol, LDL / blood
Female
Hormone Replacement Therapy*
Humans
Hypothyroidism / blood,  drug therapy*,  pathology*
Prospective Studies
Thyroxine / adverse effects*,  therapeutic use
Tunica Intima / pathology*
Chemical
Reg. No./Substance:
0/Cholesterol, HDL; 0/Cholesterol, LDL; 7488-70-2/Thyroxine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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