Study on the Relationship between Thyroid Stimulating Hormone and Lipid Profiles in Patients with Subclinical Hypothyroidism_West China Medical Journal

Authors：

 YEWen-chun , FANGXiang-ming , WANGYu-rong , GAOLi , HUANGJing

Department of Endocrinology, Mianyang Central Hospital, Mianyang, Sichuan 621000, P. R. China;

Corresponding author：

Keywords：

Subclinical hypothyroidism; Dyslipidemia; Thyroid stimulating hormone

DOI：

10.7507/1002-0179.20150244

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Objective To investigate the relationship between thyroid stimulating hormone (TSH) and the blood lipid level in patients with subclinical hypothyroidism (SCH). Methods We carried out a retrospective analysis on the clinical data of 264 patients with their first diagnosis of subclinical hypothyroidism without treatment from 2010 January to 2014 January. A total of 288 healthy controls were chosen from communities. The patients were groups based on TSH≥10.0 mU/L and 3.6 mU/L≤ TSH< 10.0 mU/L. We investigated the relationship between TSH and the level of blood lipids by analyzing liver and renal function, blood lipids, thyroid function, and thyroid peroxidase antibody (TPO-Ab) in the patients. Results Triglyceride (TG) and high density lipoprotein cholesterol levels were not significantly different among the three groups (P>0.05). Total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) levels of the group with TSH≥10 mU/L were respectively (5.93±1.12) and (3.82±1.11) mmol/L, which were significantly higher than those in the controls[(4.43±1.12) and (2.66±0.43) mmol/L] (P<0.05). TC, TG and LDL-C levels of the group with 3.6 mU/L≤ TSH< 10.0 mU/L were higher than the controls, but the differences were not significant (P>0.05). After thyroid hormone replacement therapy within 12 weeks, TG, LDL-C, and TC levels of TPO-Ab positive patients with subclinical hypothyroidism (n=112) were respectively (4.62±1.03), (2.97±0.52), and (1.17±0.62) mmol/L, which were significantly lower than those levels before treatment[(5.43±1.18), (3.62±0.58), and (2.03±0.71) mmol/L] (P<0.05). Conclusion The disorder of lipid metabolism exists in patients with subclinical hypothyroidism. Especially, the level of TSH greater than or equal to 10 mU/L is a high risk factor for dyslipidemia. In TPO-Ab positive patients, therapy of thyroid hormone replacement can effectively improve the blood lipid abnormalities in patients with subclinical hypothyroidism, and it may be an effective measure to improve the disorder of lipid metabolism economically and effectively.

Citation： YEWen-chun, FANGXiang-ming, WANGYu-rong, GAOLi, HUANGJing. Study on the Relationship between Thyroid Stimulating Hormone and Lipid Profiles in Patients with Subclinical Hypothyroidism. West China Medical Journal, 2015, 30(5): 846-849. doi: 10.7507/1002-0179.20150244 Copy

1.	Oner FA, Yurdakul S, Oner E, et al. Evaluation of the effect of L-thyroxin therapy on cardiac functions by using novel tissue doppler-derived indices in patients with subclinical hypothyroidism[J]. Acta Cardiol, 2011, 66(1):47-55.
2.	Rotondi M, Magri F, Chiovato L. Risk of coronary heart disease and mortality for adults with subclinical hypotyroidism[J]. JAMA, 2010, 304(22):2481-2482.
3.	Tagami T, Tamanaha T, Shimazu S, et al. Lipid profiles in the untreated patients with Hashimoto thyroiditis and the effects of thyroxine treatment on subclinical hypothyroldism with Hashimoto thyroiditis[J]. Endocr J, 2010, 57(1):253-258.
4.	Hollowell JG, Staehling NW, Flanders WD, et al. Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994):National Health and Nutrition Examination Survey (NHANES Ⅲ)[J]. J Clin Endocrinol Metab, 2002, 87(2):489-499.
5.	Wang F, Tan Y, Wang C, et al. Thyroid-stimulating hormone levels within the reference range are associated with serum lipid profiles independent of thyroid hormones[J]. J Clin Endocrinol Metab, 2012, 97(8):2724-2731.
6.	Tian L, Song Y, Xing M, et al. A novel role for thyroid-stimulating hormone:up-regulation of hepatic 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase expression through the cyclic adenosine monophosphate/protein kinase A/cyclic adenosine monophosphate-responsive element binding protein pathway[J]. Hepatology, 2010, 52(4):1401-1409.
7.	Monzani F, Del GP, Caraccio N, et al. Subclinical hypothyroidism:neurobehavioral features and beneficial effect of L-thyroxine treatment[J]. Clin Investig, 1993, 71(5):367-371.
8.	张国峰. 左甲状腺素对甲状腺功能减退症及亚临床甲状腺功能减退症患者血脂的影响[J]. 中国全科医学, 2010, 13(7B):2213-2215.
9.	董梅, 齐宝庆. 亚临床甲状腺功能减退症的研究进展[J]. 内科, 2008, 3(5):767.

1. Oner FA, Yurdakul S, Oner E, et al. Evaluation of the effect of L-thyroxin therapy on cardiac functions by using novel tissue doppler-derived indices in patients with subclinical hypothyroidism[J]. Acta Cardiol, 2011, 66(1):47-55.
2. Rotondi M, Magri F, Chiovato L. Risk of coronary heart disease and mortality for adults with subclinical hypotyroidism[J]. JAMA, 2010, 304(22):2481-2482.
3. Tagami T, Tamanaha T, Shimazu S, et al. Lipid profiles in the untreated patients with Hashimoto thyroiditis and the effects of thyroxine treatment on subclinical hypothyroldism with Hashimoto thyroiditis[J]. Endocr J, 2010, 57(1):253-258.
4. Hollowell JG, Staehling NW, Flanders WD, et al. Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994):National Health and Nutrition Examination Survey (NHANES Ⅲ)[J]. J Clin Endocrinol Metab, 2002, 87(2):489-499.
5. Wang F, Tan Y, Wang C, et al. Thyroid-stimulating hormone levels within the reference range are associated with serum lipid profiles independent of thyroid hormones[J]. J Clin Endocrinol Metab, 2012, 97(8):2724-2731.
6. Tian L, Song Y, Xing M, et al. A novel role for thyroid-stimulating hormone:up-regulation of hepatic 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase expression through the cyclic adenosine monophosphate/protein kinase A/cyclic adenosine monophosphate-responsive element binding protein pathway[J]. Hepatology, 2010, 52(4):1401-1409.
7. Monzani F, Del GP, Caraccio N, et al. Subclinical hypothyroidism:neurobehavioral features and beneficial effect of L-thyroxine treatment[J]. Clin Investig, 1993, 71(5):367-371.
8. 张国峰. 左甲状腺素对甲状腺功能减退症及亚临床甲状腺功能减退症患者血脂的影响[J]. 中国全科医学, 2010, 13(7B):2213-2215.
9. 董梅, 齐宝庆. 亚临床甲状腺功能减退症的研究进展[J]. 内科, 2008, 3(5):767.

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West China Medical Journal

Study on the Relationship between Thyroid Stimulating Hormone and Lipid Profiles in Patients with Subclinical Hypothyroidism

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