LIPID LEVELS AND ATHEROGENIC INDICIS IN PRE- AND POSTMENOPAUSAL WOMEN WITH AUTOIMMUNE HYPOTHYROIDISM IN RELATION TO TSH VALUES


Authors: Antoaneta Argatska, Boyan Nonchev
Keywords: autoimmune hypothyroidism, thyroid stimulating hormone, free thyroxine, lipids, atherogenic indicis

Abstract:
Introduction
According to current guidelines target levels of TSH below 2.5 mIU/l are recommended for the treatment of primary hypothyroidism but data on the benefits of this approach are inconclusive.
Aim
To compare lipid levels and atherogenic indices in pre- and postmenopausal women with autoimmune hypothyroidism on levothyroxine replacement therapy according to TSH values and evaluate their relationship with thyroid function tests.
Patients and methods
84 pre- and 54 postmenopausal women on levothyroxine replacement therapy in euthyroid state (TSH 0.4-4.2 mIU/l) were included in the study. Serum levels of TSH, free thyroxine, total cholesterol, HDL and triglycerides were measured; LDL values and atherogenic indicis were calculated.
Results
No differences between lipid parameters were found in premenopausal women with TSH below or above 2.5 mIU/l. No correlation between TSH levels and lipids and atherogenic indicis was observed. In postmenopausal women with TSH below 2.5 the levels of total (р=0.022) and LDL cholesterol (р=0.016) were significantly higher compared to those with TSH above 2.5 mIU/l. In addition, there was significant negative correlation between TSH and total cholesterol (р<0.05), LDL (р<0.05), I1, I2, AC (р<0.05) without relationship between the levels of FT4 and the studied parameters.
Conclusion
Our results suggest that there are no benefits in terms of lipid parameters in TSH below or above 2.5 mIU/l during treatment of autoimmune hypothyroidism. In postmenopausal women however a more unfavorable lipid profile may be observed raising the question whether TSH correctly reflects tissue thyroid hormone levels during levothyroxine treatment, particularly in older patients. Download article