Does mild form of subclinical hypothyroidism needs treatment?
Journal
Endocrine Abstracts
Date Issued
2022-08-17
Author(s)
Velkoska Nakova, Valentina
Stevchevska Gjorgjievska, Aleksandra
DOI
10.1530/endoabs.83.to1
Abstract
Background
Overt hypothyroidisms warrants L-T4 treatment, but treatment in subclinical hypothyroidism (ScH), especially in mild form of ScH (TSH between 4,2-10mU/l and normal free thyroxine) is unknown.
Objectives
To compare the presence of risk factors for atherosclerosis in patients with mild form of ScH to euthyroid subjects.
Methods
Prospectively 67 consecutive patients with newly diagnosed ScH, and 30 healthy subjects were recruited from the outpatient department of University clinic of endocrinology in Skopje, R. of N. Macedonia. Measurement of thyroid hormones, thyroid antibodies, blood pressure, lipids, and carotid intima media thickness (CIMT) were performed in all patients.
Results
Mean TSH value in ScH group was 8.71G1,9 mU/l. TSH value above 7mU/l was associated and positively correlated with symptoms of hypothyroidism. Prevalence of hypertension in ScH group was higher than the control group (35.4% vs. 13.3%, PZ0,03), with a 3.5 times higher risk for hypertension (ORZ 3,5 95%CI 1,1 – 11,4). In patients with mild form of SCH statistical significant
difference in percentages of patients with arterial hypertension, hypertriglyceridemia,
and values of total cholesterol/HDL-C and LDL/HDL above upper reference value were found (33.9 vs. 13.3%, 33.9 vs. 10%, 26.5 vs. 6.9%, 30.6% vs. 10.3%, respectively P ! 0.05). Mean CIMT was statistically significantly higher in ScH patients than the control group (0.61 G 0.1 vs. 0,56 G 0,1 mm, PZ0.03), but not different between the mild form of ScH and control group (PZ 0.08). Positive thyroid antibodies in the ScH group have no statistically significant influence on the CIMT.
Conclusions
In a small study, mild form of ScH was associated with higher risk for atherosclerosis, so these patients may benefit with L-T4 treatment.
Overt hypothyroidisms warrants L-T4 treatment, but treatment in subclinical hypothyroidism (ScH), especially in mild form of ScH (TSH between 4,2-10mU/l and normal free thyroxine) is unknown.
Objectives
To compare the presence of risk factors for atherosclerosis in patients with mild form of ScH to euthyroid subjects.
Methods
Prospectively 67 consecutive patients with newly diagnosed ScH, and 30 healthy subjects were recruited from the outpatient department of University clinic of endocrinology in Skopje, R. of N. Macedonia. Measurement of thyroid hormones, thyroid antibodies, blood pressure, lipids, and carotid intima media thickness (CIMT) were performed in all patients.
Results
Mean TSH value in ScH group was 8.71G1,9 mU/l. TSH value above 7mU/l was associated and positively correlated with symptoms of hypothyroidism. Prevalence of hypertension in ScH group was higher than the control group (35.4% vs. 13.3%, PZ0,03), with a 3.5 times higher risk for hypertension (ORZ 3,5 95%CI 1,1 – 11,4). In patients with mild form of SCH statistical significant
difference in percentages of patients with arterial hypertension, hypertriglyceridemia,
and values of total cholesterol/HDL-C and LDL/HDL above upper reference value were found (33.9 vs. 13.3%, 33.9 vs. 10%, 26.5 vs. 6.9%, 30.6% vs. 10.3%, respectively P ! 0.05). Mean CIMT was statistically significantly higher in ScH patients than the control group (0.61 G 0.1 vs. 0,56 G 0,1 mm, PZ0.03), but not different between the mild form of ScH and control group (PZ 0.08). Positive thyroid antibodies in the ScH group have no statistically significant influence on the CIMT.
Conclusions
In a small study, mild form of ScH was associated with higher risk for atherosclerosis, so these patients may benefit with L-T4 treatment.
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