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Cited by 725Thyroid Disorders and TreatmentsCholesterol and Lipid MetabolismLipid metabolism and disorders

Thyroid disease and lipids

Duntas, Leonidas H.·2002·Thyroid
DOI 10.1089/10507250252949405
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Abstract

The composition and the transport of lipoproteins are seriously disturbed in thyroid diseases. Overt hypothyroidism is characterized by hypercholesterolaemia and a marked increase in low-density lipoproteins (LDL) and apolipoprotein B (apo A) because of a decreased fractional clearance of LDL by a reduced number of LDL receptors in the liver. The high-density lipoprotein (HDL) levels are normal or even elevated in severe hypothyroidism because of decreased activity of cholesteryl-ester transfer protein (CETP) and hepatic lipase (HL), which are enzymes regulated by thyroid hormones. The low activity of CETP, and more specifically of HL, results in reduced transport of cholesteryl esters from HDL(2) to very low-density lipoproteins (VLDL) and intermediate low-density lipoprotein (IDL), and reduced transport of HDL(2) to HDL(3). Moreover, hypothyroidism increases the oxidation of plasma cholesterol mainly because of an altered pattern of binding and to the increased levels of cholesterol, which presents a substrate for the oxidative stress. Cardiac oxygen consumption is reduced in hypothyroidism. This reduction is associated with increased peripheral resistance and reduced contractility. Hypothyroidism is often accompanied by diastolic hypertension that, in conjunction with the dyslipidemia, may promote atherosclerosis. However, thyroxine therapy, in a thyrotropin (TSH)-suppressive dose, usually leads to a considerable improvement of the lipid profile. The changes in lipoproteins are correlated with changes in free thyroxine (FT(4)) levels. Hyperthyroidism exhibits an enhanced excretion of cholesterol and an increased turnover of LDL resulting in a decrease of total and LDL cholesterol, whereas HDL are decreased or not affected. The action of thyroid hormone on Lp(a) lipoprotein is still debated, because both decrease or no changes have been reported. The discrepancies are mostly because of genetic polymorphism of apo(a) and to the differences between the various study groups. Subclinical hypothyroidism (SH) is associated with lipid disorders that are characterized by normal or slightly elevated total cholesterol levels, increased LDL, and lower HDL. Moreover, SH has been associated with endothelium dysfunction, aortic atherosclerosis, and myocardial infarction. Lipid disorders exhibit great individual variability. Nevertheless, they might be a link, although it has not been proved, between SH and atherosclerosis.

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  • Hypothyroidism is associated with a small but significant increase in lipid parameters, particularly low-density lipoprotein elevation.

    “Hypothyroidism is associated with a small but significant increase in lipid parameters (31), in particular, an elevation of low-density lipoproteins (LDLs) (32).”

    From Thyroid Hormones and Cardiovascular Function and Diseases (2018) · cites this paper as [32]

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Authors
Duntas, L. H.
Affiliations
National and Kapodistrian University of Athens (GR)
Corresponding author
Duntas, Leonidas H.
ORCID
Duntas, Leonidas H.
Venue
Thyroid
Publisher
SAGE Publications
Published
2002-04
Volume
12
Issue
4
Pages
287-293
ISSN
  • 1050-7256 (ISSN-L)
  • 1557-9077
DOI
10.1089/10507250252949405
OpenAlex
W2103734592
Cited by
725
References
81
Citations by year
2026: 17 · 2025: 27 · 2024: 26 · 2023: 34 · 2022: 41 · 2021: 41 · 2020: 49 · 2019: 40 · 2018: 35 · 2017: 28 · 2016: 44 · 2015: 39 · 2014: 38 · 2013: 39 · 2012: 43
FWCI
2.48
Type
journal article
Language
en
Open access
closed
Licence
www.liebertpub.com/nv/resources-tools/text-and-data-mining-policy/121/ (tdm)
Locations
  • Thyroid (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Surgery › Cholesterol and Lipid Metabolism
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
Keywords
thyroid dysfunction, dyslipidemia, hypothyroidism, hyperthyroidism, subclinical hypothyroidism, lipoproteins, LDL cholesterol, HDL cholesterol, apolipoprotein B, LDL receptor, cholesteryl ester transfer protein, hepatic lipase, cholesterol oxidation, atherosclerosis, thyroxine therapy, TSH suppression, lipoprotein(a), endothelial dysfunction
MeSH terms
Humans, Hyperthyroidism, Hypothyroidism, Thyroid Diseases, Thyroid Hormones, Lipid Metabolism

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