Document Detail

Effects of long-term L-thyroxine treatment on endothelial function and arterial distensibility in young adults with congenital hypothyroidism.
MedLine Citation:
PMID:  19903797     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Patients with congenital hypothyroidism (CH) display subclinical abnormalities of the cardiovascular system that are related to unphysiological fluctuations of TSH levels and occur despite careful replacement therapy. DESIGN: The aim of the present case-control study was to evaluate the effects of long-term levothyroxine (l-T(4)) replacement therapy on the vascular district in CH patients by assessing endothelial function with flow-mediated dilation (FMD) and brachial artery distensibility with the measurement of the coefficient of distensibility (DC). METHODS: Thirty-two young adults with CH aged 18.9+/-0.2 years and 32 age- and sex-matched controls underwent brachial Doppler ultrasound examination to measure FMD and DC at the time of the study. Hypothyroidism was diagnosed by neonatal screening, and l-T(4) treatment was initiated within the first month of life. RESULTS: Compared to healthy controls, CH patients had significantly reduced brachial artery reactivity with lower FMD values (8.9+/-5.7 vs 14.1+/-5.1% P=0.003) and decreased vascular distensibility (24.6+/-1.6 vs 27.3+/-3 kPa(-1)x10(-3), P<0.0002). Linear regression analysis revealed that both total and pubertal mean TSH and number of episodes of undertreatment were independent determinants of FMD and DC. Pubertal mean TSH was the best predictor of both FMD and DC (r=0.81 and r=0.87 respectively, P<0.001). CONCLUSIONS: Young adults with CH treated with long-term l-T(4) replacement therapy may have significant impairment of both FMD and DC. Our data suggest that high TSH levels, inadequately corrected by l-T(4) replacement therapy in CH patients especially during puberty, can exert significant effects on the elastic and functional vessel properties.
Ugo Oliviero; Antonio Cittadini; Giorgio Bosso; Manuela Cerbone; Antonio Valvano; Donatella Capalbo; Valentina Apuzzi; Fabrizia Calabrese; Teresa Lettiero; Mariacarolina Salerno
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-11-10
Journal Detail:
Title:  European journal of endocrinology / European Federation of Endocrine Societies     Volume:  162     ISSN:  1479-683X     ISO Abbreviation:  Eur. J. Endocrinol.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-25     Completed Date:  2010-02-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423848     Medline TA:  Eur J Endocrinol     Country:  England    
Other Details:
Languages:  eng     Pagination:  289-94     Citation Subset:  IM    
Department of Clinical Medicine, University Federico II, 80131 Naples, Italy.
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MeSH Terms
Atherosclerosis / epidemiology*
Brachial Artery / drug effects,  physiology,  ultrasonography
Case-Control Studies
Congenital Hypothyroidism / drug therapy*,  epidemiology*
Endothelium, Vascular / drug effects*
Linear Models
Longitudinal Studies
Puberty / physiology
Risk Factors
Thyroxine / administration & dosage*
Ultrasonography, Doppler
Vasodilation / drug effects
Young Adult
Reg. No./Substance:

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

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