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Cited by 79Thyroid Disorders and TreatmentsHormonal and reproductive studiesThyroid and Parathyroid Surgery

Effects of 18 months of l‐T4 replacement in women with subclinical hypothyroidism

Adrees, M., Gibney, J., El‐Saeity, N., Boran, G.·2009·Clinical Endocrinology
DOI 10.1111/j.1365-2265.2008.03509.x
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Abstract

Summary: Context Some of the cardiovascular and renal abnormalities seen in overt hypothyroidism have also been reported in subclinical hypothyroidism (SCH). Short‐term l‐T4 replacement in SCH improves cardiovascular risk markers and reduces carotid intima‐media thickness (CIMT), a surrogate marker of atherosclerosis. The haemodynamic and renal effects of l‐T4 replacement in SCH are poorly understood. Objectives To compare cardiovascular risk factors and renal variables in women with SCH and normal women. To study the effects of l‐T4 replacement in SCH subjects on these variables and on structural and functional changes in common carotid and brachial arteries. Design Fifty‐six women with SCH before and after l‐T4 replacement for 18 months and 56 normal women of similar age distribution were studied. Blood Pressure (BP), plasma lipids and homocysteine were measured and renal function evaluated [estimation of glomerular filtration rate (eGFR) using standard equations and measurement of serum Cystatin‐C] in women with SCH before and after 18 months of l‐T4, and in healthy women. CIMT and endothelial function (using brachial artery ultrasound) were studied before and after l‐T4 in a subgroup of women with SCH. Results Systolic and diastolic BP, total cholesterol, triglyceride, LDL‐cholesterol, lipoprotein(a) and homocysteine were greater in SCH (P < 0·05), and following l‐T4 replacement decreased (P < 0·05) to levels that no longer differed from normal subjects. Estimated GFR was reduced and serum Cystatin‐C increased (P < 0·05) in SCH. These variables also normalized following l‐T4. Following l‐T4 replacement the carotid artery baseline diameter increased by 7·1% and CIMT decreased by a mean value of 13%, while brachial artery diameter increased basally by 12·5% and following endothelium‐dependent vasodilatation by 17·5% (P < 0·05). However, the increment following reactive hyperaemia did not differ before or following l‐T4 replacement. Conclusion Normalization of cardiovascular risk factors following l‐T4 replacement in SCH potentially explains reduced CIMT. Increased carotid and brachial artery diameters and normalized eGFR indicates a haemodynamic effect of l‐T4 replacement, the importance of which requires further investigation.

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Crossref · 10.1111/j.1365-2265.2008.03509.x

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Authors
Adrees, M., Gibney, J., El‐Saeity, N., & Boran, G.
Affiliations
Tallaght University Hospital (IE)
Corresponding author
Gibney, J.
ORCID
Gibney, J.
Venue
Clinical Endocrinology
Publisher
Wiley
Published
2009-07-06
Volume
71
Issue
2
Pages
298-303
ISSN
  • 0300-0664 (ISSN-L)
  • 1365-2265
DOI
10.1111/j.1365-2265.2008.03509.x
OpenAlex
W2105188119
Cited by
79
References
44
Citations by year
2025: 3 · 2024: 2 · 2023: 4 · 2021: 3 · 2020: 7 · 2019: 3 · 2018: 8 · 2017: 7 · 2016: 6 · 2015: 6 · 2014: 8 · 2013: 6 · 2012: 6
FWCI
2.42
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Clinical Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
  • Lenus, The Irish Health Repository (Dr Steevens Hospital Library) (submittedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
Keywords
subclinical hypothyroidism, levothyroxine replacement, women, cardiovascular risk factors, carotid intima-media thickness, atherosclerosis, endothelial function, brachial artery, renal function, glomerular filtration rate, cystatin C, blood pressure, plasma lipids, homocysteine, carotid artery diameter
MeSH terms
Adult, Blood Pressure, Cholesterol, Female, Follow-Up Studies, Heart, Humans, Hypothyroidism, Kidney, Middle Aged, Thyroxine, Triglycerides, Hormone Replacement Therapy

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