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PubMed · 14616885

Decrease in carotid intima-media thickness in hypothyroid patients after normalization of thyroid function.

Toshiki Nagasaki·Masaaki Inaba·Yasuko Henmi·Yasuro Kumeda·Misako Ueda·Hideki Tahara·Shigeru Sugiguchi·Shigehiko Fujiwara·Masanori Emoto·Eiji Ishimura·Naoyoshi Onoda·Tetsuro Ishikawa·Yoshiki Nishizawa
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Abstract

OBJECTIVE: This case-control study was carried out to assess whether levothyroxine (L-T4) replacement might cause regression of the enhanced atherosclerosis seen in hypothyroid patients. PATIENTS AND METHODS: Intima-media thickness (IMT) in the common carotid artery (CCA) was measured from digitalized still images taken during scanning by high-resolution ultrasonography as an indicator of early atherosclerosis. Thirty-five hypothyroid patients were examined for their CCA IMT before and 1 year after normalization of thyroid function by L-T4 replacement. As control, 35 healthy subjects were enrolled from among the participants in a local health-check programme conducted at the Osaka City University Hospital. RESULTS: Basal CCA IMT was significantly higher in hypothyroid patients [0.635 +/- 0.018 (mean +/- SE) mm] than in control subjects (0.559 +/- 0.021 mm, P < 0.005). After 1 year of euthyroidism, 34 out of 35 patients showed a significant decrease of CCA IMT, to 0.552 +/- 0.015 mm (P < 0.0001), a level comparable to normal controls. CCA IMT change was closely associated with basal levels of total cholesterol (r = -0.472, P= 0.0031), low-density lipoprotein (LDL) cholesterol (r = -0.441, P= 0.0076) and the total/HDL cholesterol ratio (r =-0.435, P= 0.0057), but not with any of the other variables measured except for age (r = -0.353, P= 0.0296). CONCLUSIONS: This study demonstrated that L-T4 treatment might have the potential to reverse the progression of atherosclerosis in hypothyroid patients. Furthermore, it suggests that increased levels of LDL cholesterol and the total/HDL cholesterol ratio have an important role in the increased common carotid intima-media thickness in hypothyroid patients.

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Carotid Artery DiseasesCarotid Artery, CommonCase-Control StudiesCholesterolCholesterol, HDLCholesterol, LDLFemaleHumansHypothyroidismImage Processing, Computer-AssistedMaleMiddle AgedProspective StudiesRisk FactorsThyroxineTunica IntimaUltrasonographyJournal Article

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Toshiki Nagasaki, Masaaki Inaba, Yasuko Henmi, Yasuro Kumeda, Misako Ueda, Hideki Tahara, Shigeru Sugiguchi, Shigehiko Fujiwara, Masanori Emoto, Eiji Ishimura, Naoyoshi Onoda, Tetsuro Ishikawa, Yoshiki Nishizawa. 2003. Decrease in carotid intima-media thickness in hypothyroid patients after normalization of thyroid function.. https://doi.org/10.1046/j.1365-2265.2003.01893.x

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