Endothelial Dysfunction in Patients with Subclinical Hypothyroidism and the Effects of Treatment with Levothyroxine

Overview

Journal Adv Biomed Res

Specialty Biomedical Engineering

Date 2016 Apr 22

PMID 27099851

Citations 12

Authors

Nasmi Niknam

Noushin Khalili

Elham Khosravi

Mohsen Nourbakhsh

Affiliations

Soon will be listed here.

Abstract

Background: Subclinical hypothyroidism (SHT) may increase the risk of cardiovascular disease. We compared endothelial function between SHT patients and euthyroid individuals, and evaluated the effects of levothyroxine therapy on endothelial function in the patients.

Materials And Methods: In a quasi-experimental study, flow-mediated dilatation (FMD) and intima-media thickness (IMT) were assessed in SHT patients and healthy controls (n = 25 in each group). Patients then received levothyroxine (50 μg/day) for 2 months, and the FMD and IMT assessments were repeated.

Results: Patients and controls were similar in IMT (0.56 ± 0.09 vs. 0.58 ± 0.08 mm, P = 0.481), but FMD was lower in patients than in controls (4.95 ± 2.02 vs. 6.50 ± 2.57%, P = 0.011). A significant increase was observed in FMD (4.11 ± 2.37%, P = 0.001), but not in IMT (-0.004 ± 0.020 mm, P = 0.327), after levothyroxine therapy among the patients.

Conclusions: Patients with SHT have endothelial dysfunction which responds to levothyroxine therapy. Randomized placebo-controlled trials are needed to confirm these findings.

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References

Nagasaki T, Inaba M, Henmi Y, Kumeda Y, Ueda M, Tahara H . Change in von Willebrand factor and carotid intima-media thickness in hypothyroid patients with normal thyroid function after levothyroxine replacement therapy. Eur J Endocrinol. 2004; 150(2):125-31. DOI: 10.1530/eje.0.1500125. View

Walsh J, Bremner A, Bulsara M, OLeary P, Leedman P, Feddema P . Subclinical thyroid dysfunction as a risk factor for cardiovascular disease. Arch Intern Med. 2005; 165(21):2467-72. DOI: 10.1001/archinte.165.21.2467. View

Cikim A, Oflaz H, Ozbey N, Cikim K, Umman S, Meric M . Evaluation of endothelial function in subclinical hypothyroidism and subclinical hyperthyroidism. Thyroid. 2004; 14(8):605-9. DOI: 10.1089/1050725041692891. View

Klein I, Ojamaa K . Thyroid hormone and the cardiovascular system. N Engl J Med. 2001; 344(7):501-9. DOI: 10.1056/NEJM200102153440707. View

Shavdatuashvili T . Lipoprotein profile and endothelial function in patients with subclinical and overt hypothyroidism. Georgian Med News. 2006; (129):57-60. View

Monzani F, Caraccio N, Kozakowa M, Dardano A, Vittone F, Virdis A . Effect of levothyroxine replacement on lipid profile and intima-media thickness in subclinical hypothyroidism: a double-blind, placebo- controlled study. J Clin Endocrinol Metab. 2004; 89(5):2099-106. DOI: 10.1210/jc.2003-031669. View

SURKS M, Ocampo E . Subclinical thyroid disease. Am J Med. 1996; 100(2):217-23. DOI: 10.1016/s0002-9343(97)89462-4. View

Hak A, Pols H, Visser T, Drexhage H, Hofman A, Witteman J . Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam Study. Ann Intern Med. 2000; 132(4):270-8. DOI: 10.7326/0003-4819-132-4-200002150-00004. View

Arem R, ESCALANTE D, Arem N, Morrisett J, Patsch W . Effect of L-thyroxine therapy on lipoprotein fractions in overt and subclinical hypothyroidism, with special reference to lipoprotein(a). Metabolism. 1995; 44(12):1559-63. DOI: 10.1016/0026-0495(95)90075-6. View

10.

Imaizumi M, Akahoshi M, Ichimaru S, Nakashima E, Hida A, Soda M . Risk for ischemic heart disease and all-cause mortality in subclinical hypothyroidism. J Clin Endocrinol Metab. 2004; 89(7):3365-70. DOI: 10.1210/jc.2003-031089. View

11.

Razvi S, Shakoor A, Vanderpump M, Weaver J, Pearce S . The influence of age on the relationship between subclinical hypothyroidism and ischemic heart disease: a metaanalysis. J Clin Endocrinol Metab. 2008; 93(8):2998-3007. DOI: 10.1210/jc.2008-0167. View

12.

Cappola A, Fried L, Arnold A, Danese M, Kuller L, Burke G . Thyroid status, cardiovascular risk, and mortality in older adults. JAMA. 2006; 295(9):1033-41. PMC: 1387822. DOI: 10.1001/jama.295.9.1033. View

13.

OLeary D, Polak J . Intima-media thickness: a tool for atherosclerosis imaging and event prediction. Am J Cardiol. 2002; 90(10C):18L-21L. DOI: 10.1016/s0002-9149(02)02957-0. View

14.

Taddei S, Caraccio N, Virdis A, Dardano A, Versari D, Ghiadoni L . Impaired endothelium-dependent vasodilatation in subclinical hypothyroidism: beneficial effect of levothyroxine therapy. J Clin Endocrinol Metab. 2003; 88(8):3731-7. DOI: 10.1210/jc.2003-030039. View

15.

Nagasaki T, Inaba M, Henmi Y, Kumeda Y, Ueda M, Tahara H . Decrease in carotid intima-media thickness in hypothyroid patients after normalization of thyroid function. Clin Endocrinol (Oxf). 2003; 59(5):607-12. DOI: 10.1046/j.1365-2265.2003.01893.x. View

16.

Dagre A, Lekakis J, Protogerou A, Douridas G, Papaioannou T, Tryfonopoulos D . Abnormal endothelial function in female patients with hypothyroidism and borderline thyroid function. Int J Cardiol. 2006; 114(3):332-8. DOI: 10.1016/j.ijcard.2005.12.013. View

17.

Vanderpump M, Tunbridge W, French J, Appleton D, Bates D, Clark F . The development of ischemic heart disease in relation to autoimmune thyroid disease in a 20-year follow-up study of an English community. Thyroid. 1996; 6(3):155-60. DOI: 10.1089/thy.1996.6.155. View

18.

Rodondi N, Newman A, Vittinghoff E, de Rekeneire N, Satterfield S, Harris T . Subclinical hypothyroidism and the risk of heart failure, other cardiovascular events, and death. Arch Intern Med. 2005; 165(21):2460-6. DOI: 10.1001/archinte.165.21.2460. View

19.

Kim S, Kim S, Park K, Park S, Cho Y . Regression of the increased common carotid artery-intima media thickness in subclinical hypothyroidism after thyroid hormone replacement. Endocr J. 2009; 56(6):753-8. DOI: 10.1507/endocrj.k09e-049. View

20.

Corretti M, Anderson T, Benjamin E, Celermajer D, Charbonneau F, Creager M . Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery: a report of the International Brachial Artery Reactivity Task Force. J Am Coll Cardiol. 2002; 39(2):257-65. DOI: 10.1016/s0735-1097(01)01746-6. View