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Subclinical hypothyroidism, lipid metabolism and cardiovascular disease

  • Alessandro P Delitala
    Correspondence
    Corresponding author at: Azienda Ospedaliero-Universitaria (AOU) di Sassari, Clinica Medica, Viale San Pietro 8, Sassari 07100, Italy.
    Affiliations
    Clinica Medica, Azienda Ospedaliero Universitaria di Sassari, Viale San Pietro 8, 07100, Sassari, Italy
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  • Giuseppe Fanciulli
    Affiliations
    Department of Clinical and Experimental Medicine, University of Sassari – Azienda Ospedaliero Universitaria di Sassari, Viale San Pietro 8, 07100 Sassari, Italy
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  • Margherita Maioli
    Affiliations
    Center for developmental biology and reprogramming - CEDEBIOR, Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/B, 07100 Sassari, Italy

    Istituto di Ricerca Genetica e Biomedica, Consiglio Nazionale delle Ricerche (CNR), Monserrato, Cagliari, Italy

    National Institute of Biostructures and Biosystems at the Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola - Malpighi Hospital, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy
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  • Giuseppe Delitala
    Affiliations
    Department of Clinical and Experimental Medicine, University of Sassari – Azienda Ospedaliero Universitaria di Sassari, Viale San Pietro 8, 07100 Sassari, Italy
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Published:December 28, 2016DOI:https://doi.org/10.1016/j.ejim.2016.12.015

      Highlights

      • Thyroid hormones regulates lipid metabolism.
      • Subclinical hypothyroidism could worsen lipid status.
      • The beneficial effect of levo-thyroxine substitute therapy on lipids require further studies.

      Abstract

      Subclinical hypothyroidism is defined by elevated serum thyrotropin in presence of normal free thyroid hormones. Lipid metabolism is influenced by thyroid hormone and many reports showed that lipids status worsen along with TSH level. Subclinical hypothyroidism has been also linked to other cardiovascular risk factors such as alteration in blood pressure and increased atherosclerosis. Further evidences suggested that mild dysfunction of thyroid gland is associated with metabolic syndrome and heart failure. Thyrotropin level seems the best predictor of cardiovascular disease, in particular when its levels are above 10 mU/L. However, despite these observations, there is no clear evidence that levothyroxine therapy in subjects with milder form of subclinical hypothyroidism could improve lipid status and the other cardiovascular risk factors. In this review, we address the effect of thyroid hormone and cardiovascular risk, with a focus on lipid metabolism.

      Abbreviations:

      SCH (subclinical hypothyroidism), TSH (thyrotropin), LT4 (levothyroxine), CVD (cardiovascular disease), FT4 (free thyroxine), FT3 (free triiodothyronine), BMI (body mass index), LDL-C (low density lipoprotein cholesterol), LDL-R (low density lipoprotein receptor), HMG-CoA (hydroxymethylglutaryl coenzyme A reductase), SREBP-2 (sterol regulatory element-binding protein-2), HDL-C (high density lipoprotein cholesterol), TG (triglycerides), Lp(a) (lipoprotein (a)), TC (total cholesterol), CHD (coronary heart disease), IMT (intima media thickness), TR (thyroid hormone receptor)

      Keywords

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