J Korean Thyroid Assoc.  2014 Nov;7(2):172-179. 10.11106/cet.2014.7.2.172.

Effect of Short-Term Hypothyroid State on Lipid Profile and Cardiovascular Risk Markers in Subjects Preparing Radioactive Iodine Therapy

• Yeo HJ
• Jo AR
• Lee HW
• Yi DW
• Kang YH
• Son SM

• KMID: 2095130
• DOI: http://doi.org/10.11106/cet.2014.7.2.172

Abstract

BACKGROUND AND OBJECTIVES
The relationship between short-term hypothyroidism due to levothyroxine (LT4) withdrawal for radioactive iodine (RI) therapy in patients with differentiated thyroid cancer (DTC) and risk of cardiovascular disease is not clear. In this study, we evaluated the impact of short-term overt hypothyroidism on lipid profiles and cardiovascular parameters in patients with DTC.
MATERIALS AND METHODS
We recruited 195 patients with DTC who were preparing RI therapy from March 2008 to February 2012. We analyzed the effect of thyroid stimulating hormone (TSH) level on the clinical, biochemical, and cardiovascular risk markers at the end of LT4 withdrawal protocol (P2).
RESULTS
After LT4 withdrawal (P2), TSH and total cholesterol (TC) levels were significantly increased (p<0.005). After adjustment for multiple factors such as age, sex, body mass index (BMI), hypertension and diabetes mellitus (DM), the positive relationship between TSH and TC remained significant (p=0.04). Mean levels of homocysteine, low density lipoprotein-cholesterol, triglyceride were increased. However, levels of high density lipoprotein-cholesterol, cystatin C, C-reactive protein, apolipoprotein B (ApoB), apolipoprotein A1 (Apo A1), lipoprotein (a) (Lp[a]), aspartate transaminase, alanine aminotransferase, total bilirubin, uric acid remained within normal range. Splitting the whole cohort into the three different age groups, serum Apo B, Lp(a) levels and BMI increased with increasing age (p<0.05). And splitting into three different TSH level groups (1st group; <79 microIU/mL, 2nd group; 79-121 microIU/mL, 3rd group; >121 microIU/mL), all values did not have a statistical significant meaning except Apo A1.
CONCLUSION
Short-term hypothyroidism induced worsening of lipid metabolic parameters, but not enough to induce the cardiovascular risk in patients with thyroid cancer.

Keyword

Short-term hypothyroidism; Thyroid cancer; Cardiovascular risk markers; Radioactive iodine therapy

MeSH Terms

Alanine Transaminase
Apolipoprotein A-I
Apolipoproteins
Apolipoproteins B
Aspartate Aminotransferases
Bilirubin
Body Mass Index
C-Reactive Protein
Cardiovascular Diseases
Cholesterol
Cohort Studies
Cystatin C
Diabetes Mellitus
Homocysteine
Humans
Hypertension
Hypothyroidism
Iodine*
Lipoprotein(a)
Reference Values
Thyroid Neoplasms
Thyrotropin
Thyroxine
Triglycerides
Uric Acid
Alanine Transaminase
Apolipoprotein A-I
Apolipoproteins
Apolipoproteins B
Aspartate Aminotransferases
Bilirubin
C-Reactive Protein
Cholesterol
Cystatin C
Homocysteine
Iodine
Lipoprotein(a)
Thyrotropin
Thyroxine
Uric Acid

Figure

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  Fig. 1. Study protocols for evaluation of effect of short–term hypothyroid state on lipid and cardiovascular risk markers in subjects with thyroid cancer preparing radioiodine therapy.

Reference

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