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Cited by 66Thyroid Disorders and TreatmentsLipoproteins and Cardiovascular HealthThyroid and Parathyroid Surgery

The lipid‐lowering effect of levothyroxine in patients with subclinical hypothyroidism: A systematic review and meta‐analysis of randomized controlled trials

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Li, Xiang, Wang, Yupeng, Guan, Qingbo, Zhao, Jiajun, Gao, Ling·2017·Clinical Endocrinology
DOI 10.1111/cen.13338
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Abstract

Summary: Objectives: Dyslipidaemia is common in patients with subclinical hypothyroidism (SCH). To date, there is no universal agreement regarding the lipid‐lowering effect of substitution treatment with L‐T4 in patients with SCH. We aimed to clarify the effect by conducting this systematic review and meta‐analysis of randomized controlled trials (RCT s). Design: We systematically searched PubMed, the Cochrane Library, ClinicalTrials.gov and EMBASE for RCT s comparing substitution treatment to placebo treatment or observation. We focused on the primary outcomes of changes from baseline of total, low‐density lipoprotein and high‐density lipoprotein cholesterol (TC, LDL‐C and HLD‐C) and triglycerides. Subgroup analyses were performed, assessing the effect of treatment duration, disease severity and ethnicity on the occurrence of discrepancy. Results: Twelve trials, with 940 participants, were eligible for analysis. Compared with the control group, levothyroxine substitution yielded a mean reduction in TC (−0.29 mmol/L, [−0.42 to −0.16]) and LDL‐C (−0.22 mmol/L, [−0.36 to −0.09]), with no significant effects on HDL‐C (−0.04 mmol/L, [−0.08 to 0.01]) or triglycerides (−0.04 mmol/L, [−0.08 to 0.00]). Trials in which only patients with mild SCH (thyrotropin <10 mIU/L) were enrolled showed equivalent effects. The lowering effects were weaker, but still significant, in long‐term treatment (>6 months) compared with short‐term treatment (≤6 months) for TC (−0.19 mmol/L [−0.35, −0.03] vs −0.50 mmol/L [−0.68, −0.31], P=.047) and LDL‐C (−0.09 mmol/L [−0.16, −0.02] vs −0.46 mmol/L [−0.68, −0.25], P=.006). Conclusions: Levothyroxine treatment has clear benefits on TC and LDL‐C in SCH patients, including those with mild SCH.

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  • Hypothyroidism negatively impacts glucose and lipid metabolism, possibly favoring insulin resistance and hypercholesterolemia, which may be at least partly reverted by replacement therapy.

    “Finally, the presence of hypothyroidism negatively impacts glucose and lipid metabolism possibly favoring the onset of insulin resistance and hypercholesterolemia which may, at least in part, be reverted by replacement therapy [9, 10].”

    From Thyroid and heart, a clinically relevant relationship (2021) · cites this paper as [10]

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Authors
Li, X., Wang, Y., Guan, Q., Zhao, J., & Gao, L.
Affiliations
Shandong University (CN)
Corresponding author
Gao, Ling
ORCID
Venue
Clinical Endocrinology
Publisher
Wiley
Published
2017-04-24
Volume
87
Issue
1
Pages
1-9
ISSN
  • 0300-0664 (ISSN-L)
  • 1365-2265
DOI
10.1111/cen.13338
OpenAlex
W2598836722
Cited by
66
References
40
Citations by year
2026: 9 · 2025: 5 · 2024: 9 · 2023: 4 · 2022: 10 · 2021: 8 · 2020: 9 · 2019: 7 · 2018: 4
FWCI
0.80
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Clinical Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
Funders
Chinese Medical Association (15010010589)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
Keywords
levothyroxine, subclinical hypothyroidism, dyslipidemia, hypolipidemic effect, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, thyroid hormone replacement, treatment duration, disease severity, ethnic differences
MeSH terms
Humans, Hypothyroidism, Cholesterol, HDL, Cholesterol, LDL, Thyroxine, Triglycerides, Randomized Controlled Trials as Topic, Dyslipidemias

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