Abstract
Patients with subclinical hypothyroidism (SCH) have impaired endothelial function probably related to dyslipidemia. The present study compares the effects of simvastatin versus levothyroxine (LT-4) treatment on lipid profile and endothelial function in patients with SCH. Fifty-nine patients with newly diagnosed SCH were enrolled. Patients were randomized into 3 groups to receive no treatment (n = 19), LT-4 (n = 20), or simvastatin (n = 20). We measured endothelium-dependent vasodilation (EDV) and endothelium-independent vasodilation (EIV) at baseline and after 8 months. Serum total cholesterol, triglycerides and LDL-cholesterol were significantly lower following simvastatin. EDV increased significantly in simvastatin treatment group (7.5% ± 3.3% vs 14.0% ± 4.5% (P < 0.01). The improvement of EDV correlated with the percent decrease of LDL-cholesterol (ρ = 0.68, P < 0.01). Although LT-4 therapy caused a trend towards an increase in EDV compared to baseline, statistical significance was not achieved. EIV remained unchanged in all three groups. Simvastatin but not LT-4 treatment significantly improves EDV of the brachial artery and dyslipidemia in patients with SCH. Improvement in brachial artery endothelial function may be related in part to a hypolipidemic effect of simvastatin treatment.
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References
M Helfand CC Redfern (1998) ArticleTitleClinical guideline, part 2. Screening for thyroid disease: an update. American College of Physicians Ann Intern Med 129 144–158 Occurrence Handle1:STN:280:DyaK1czhvVWqug%3D%3D Occurrence Handle9669977
GJ Canaris NR Manowitz G Mayor EC Ridgway (2000) ArticleTitleThe Colorado Thyroid Disease Prevalence Study Arch Intern Med 160 526–534 Occurrence Handle10.1001/archinte.160.4.526 Occurrence Handle1:STN:280:DC%2BD3c7lvVansg%3D%3D Occurrence Handle10695693
JG Hollowell NW Staehling WD Flanders (2002) ArticleTitleSerum TSH, T4 and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III) J Clin Endocrinol Metab 87 489–499 Occurrence Handle10.1210/jc.87.2.489 Occurrence Handle1:CAS:528:DC%2BD38XhsVSjtbw%3D Occurrence Handle11836274
CT Sawin WP Castelli JM Hershman P McNamara P Bacharach (1985) ArticleTitleThe aging thyroid: thyroid deficiency in the Framingham Study Arch Intern Med 145 1386–1388 Occurrence Handle10.1001/archinte.145.8.1386 Occurrence Handle1:STN:280:DyaL2M3nvVGjsQ%3D%3D Occurrence Handle4026469
JV Parle JA Franklyn KW Cross SC Jones MC Sheppard (1991) ArticleTitlePrevalence and follow-up of abnormal thyrotropin (TSH) concentrations in the elderly in the United Kingdom Clin Endocrinol (Oxf) 34 77–83 Occurrence Handle1:STN:280:DyaK3M7mvVCisg%3D%3D
DS Cooper R Halpern LC Wood AA Levin EC Ridgway (1984) ArticleTitleL-thyroxine therapy in subclinical hypothyroidism. A double-blind, placebo-controlled trial Ann Intern Med 101 18–24 Occurrence Handle1:STN:280:DyaL2c3ivFKnsw%3D%3D Occurrence Handle6428290
F Monzani N Caraccio P Del Guerra A Casolaro E Ferrannini (1999) ArticleTitleNeuromuscular symptoms and dysfunction in subclinical hypothyroid patients: beneficial effect of L-T4 replacement therapy Clin Endocrinol (Oxf) 51 237–242 Occurrence Handle10.1046/j.1365-2265.1999.00790.x Occurrence Handle1:CAS:528:DyaK1MXlvFGls70%3D
M Tièche GA Lupi F Gutzwiller PJ Grob H Studer H Bürgi (1981) ArticleTitleBorderline low thyroid function and thyroid autoim-munity. Risk factors for coronary heart disease? Br Heart J 46 202–206 Occurrence Handle7272132
JP Walsh AP Bremner MK Bulsara P O'Leary PJ Leedman P Feddema V Michelangeli (2005) ArticleTitleSubclinical thyroid dysfunction as a risk factor for cardiovascular disease Arch Intern Med 165 2467–2472 Occurrence Handle10.1001/archinte.165.21.2467 Occurrence Handle16314542
MP Vanderpump WM Tunbridge JM French (1996) ArticleTitleThe development of ischemic heart disease in relation to autoimmune thyroid disease in a 20-year follow-up study of an English community Thyroid 6 155–160 Occurrence Handle1:STN:280:DyaK28vjsVemsQ%3D%3D Occurrence Handle8837320
AE Hak HA Pols TJ Visser HA Drexhage A Hofman JC Witteman (2000) ArticleTitleSubclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly woman: the Rotterdam Study Ann Intern Med 132 270–278 Occurrence Handle1:STN:280:DC%2BD3c7jt1egsg%3D%3D Occurrence Handle10681281
M Imaizumi M Akahoshi S Ichimaru (2004) ArticleTitleRisk for ischemic heart disease and all-cause mortality in subclinical hypothyroidism J Clin Endocrinol Metab 89 IssueID7 3365–3370 Occurrence Handle10.1210/jc.2003-031089 Occurrence Handle1:CAS:528:DC%2BD2cXlslegsbs%3D Occurrence Handle15240616
GJ Kahaly (2000) ArticleTitleCardiovascular and atherogenic aspects of subclinical hypothyroidism Thyroid 10 665–679 Occurrence Handle10.1089/10507250050137743 Occurrence Handle1:STN:280:DC%2BD3cvmt1alsg%3D%3D Occurrence Handle11014311
DC Bauer B Ettinger WS Browner (1998) ArticleTitleThyroid functions and serum lipids in older women: a population-based study Am J Med 104 546–551 Occurrence Handle10.1016/S0002-9343(98)00116-8 Occurrence Handle1:STN:280:DyaK1czjslCktg%3D%3D Occurrence Handle9674717
S Miura M Iitaka H Yoshimura (1994) ArticleTitleDisturbed lipid metabolism in patients with subclinical hypothyroidism: effect of L-thyroxine therapy Intern Med 33 413–417 Occurrence Handle1:STN:280:DyaK2M%2Fjs12msg%3D%3D Occurrence Handle7949641
C Meier JJ Staub CB Roth M Guglielmetti M Kunz AR Miserez J Drewe P Huber R Herzog B Muller (2001) ArticleTitleTSH-controlled L-thyroxine therapy reduces cholesterol levels and clinical symptoms in subclinical hypothyroidism: a double blind, placebo-controlled trial (Basel Thyroid Study) J Clin Endocrinol Metab 86 IssueID10 4860–4866 Occurrence Handle10.1210/jc.86.10.4860 Occurrence Handle1:CAS:528:DC%2BD3MXptVarsbo%3D Occurrence Handle11600554
Z Efstathiadou S Bitsis HJ Milionis (2001) ArticleTitleLipid profile in subclinical hypothyroidism: is L-thyroxine substitution beneficial?. European Journal of Endocrinology 145 705–710 Occurrence Handle10.1530/eje.0.1450705 Occurrence Handle1:CAS:528:DC%2BD3MXpt1Ght7o%3D
R Fathi B Haluska N Isbel L Short TH Marwick (2004) ArticleTitleThe relative importance of vascular structure and function in predicting cardiovascular events J Am Coll Cardiol 18 43 IssueID4 616–623 Occurrence Handle10.1016/j.jacc.2003.09.042
AL Moens I Goovaerts MJ Claeys CJ Vrints (2005) ArticleTitleFlow-mediated vasodilation: a diagnostic instrument, or an experimental tool? Chest 127 2254–2263 Occurrence Handle10.1378/chest.127.6.2254 Occurrence Handle15947345
J Lekakis C Papamichael M Alevizaki G Piperingos P Marafelia J Mantzos (1997) ArticleTitleFlow mediated, endothelium-dependent vasodilatation is impaired in subject with hypothyroidism, borderline hypothyroidism, and high-normal serum thyrotropin (TSH) values Thyroid 7 411–444 Occurrence Handle1:STN:280:DyaK2szmvFOksw%3D%3D Occurrence Handle9226212 Occurrence Handle10.1089/thy.1997.7.411
S Taddei N Caraccio A Virdis (2003) ArticleTitleImpaired endothelium-dependent vasodilatation in subclinical hypothyroidism: beneficial effect of levotiroxine therapy J Clin Endocrinol Metab 88 3731–3737 Occurrence Handle10.1210/jc.2003-030039 Occurrence Handle1:CAS:528:DC%2BD3sXmsFOktL4%3D Occurrence Handle12915662
O Tamai H Matsuoka H Itabe Y Wada K Kohno T Imaizumi (1997) ArticleTitleSingle LDL apheresis improves endothelium-dependent vasodilatation in hypercholesterolemic humans Circulation 95 76–82 Occurrence Handle1:STN:280:DyaK2s7kslKnug%3D%3D Occurrence Handle8994420
G O'Driscoll D Green RR Taylor (1997) ArticleTitleSimvastatin, an HMG-coenzyme: a reductase inhibitor, improves endothelial function within 1 month Circulation 95 1126–1131 Occurrence Handle9054840
CB Treasure JL Klein WS Weintraub (1995) ArticleTitleBeneficial effects of cholesterol-lowering therapy on the coronary endothelium in patients with coronary artery disease N Engl J Med 332 481–487 Occurrence Handle10.1056/NEJM199502233320801 Occurrence Handle1:STN:280:DyaK2M7jtF2ltQ%3D%3D Occurrence Handle7830728
H Omori H Nagashima Y Tsurumi (2002) ArticleTitleDirect in vivo evidence of a vascular statin: a single dose of cerivastatin rapidly increases vascular endothelial responsiveness in healthy normocholesterolaemic subjects Br J Clin Pharmacol 54 395–399 Occurrence Handle10.1046/j.1365-2125.2002.01677.x Occurrence Handle1:CAS:528:DC%2BD38XpsVWitLw%3D Occurrence Handle12392587
RS Rosenson (1999) ArticleTitleNon-lipid-lowering effects of statins on atherosclerosis Curr Cardiol Rep 1 225–232 Occurrence Handle1:STN:280:DC%2BD3M%2FlsF2qsA%3D%3D Occurrence Handle10980846
S Wolfrum KS Jensen J Liao (2003) ArticleTitleEndothelium-dependent effects of statins Arterioscler Thromb Vasc Biol 23 729–736 Occurrence Handle10.1161/01.ATV.0000063385.12476.A7 Occurrence Handle1:CAS:528:DC%2BD3sXjtlaktLw%3D Occurrence Handle12615672
MC Corretti TJ Anderson EJ Benjamin (2002) ArticleTitleInternational Brachial Artery Reactivity Task Force. Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilatation of the brachial artery J Am Coll Cardiol 39 257–265 Occurrence Handle10.1016/S0735-1097(01)01746-6 Occurrence Handle11788217
B Biondi EA Palmieri G Lombardi S Fazio (2002) ArticleTitleEffects of subclinical hypothyroid dysfunction on the heart Ann Intern Med 137 904–914 Occurrence Handle12458990
M Perk O Neill (1997) ArticleTitleThe effect of hormone therapy on angiographic coronary artery disease progression Can J Cardiol 13 273–276 Occurrence Handle1:CAS:528:DyaK2sXivVehsLk%3D
N Rodondi AB Newman E Vittinghoff N de Rekeneire S Satterfield TB Harris DC Bauer (2005) ArticleTitleSubclinical Hypothyroidism and the Risk of Heart Failure, Other Cardiovascular Events, and Death Arch Intern Med 165 2460–2466 Occurrence Handle10.1001/archinte.165.21.2460 Occurrence Handle16314541
T Neunteufl R Katzenschlager A Hassan (1997) ArticleTitleSystemic endothelial dysfunction is related to the extent and severity of coronary artery disease Atherosclerosis 129 111–118 Occurrence Handle10.1016/S0021-9150(96)06018-2 Occurrence Handle1:CAS:528:DyaK2sXhsFKmsb8%3D Occurrence Handle9069525
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Duman, D., Sahin, S., Esertas, K. et al. Simvastatın improves endothelial function in patents with subclinical hypothyroidism. Heart Vessels 22, 88–93 (2007). https://doi.org/10.1007/s00380-006-0950-0
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DOI: https://doi.org/10.1007/s00380-006-0950-0