A cross-sectional retrospective study to identify indicators for initiating thyroid hormone replacement therapy in patients with subclinical hypothyroidism
Journal
International Journal of Clinical and Experimental Medicine
Journal Volume
9
Journal Issue
6
Pages
11534-11541
Date Issued
2016
Author(s)
Chen P.-C.
Abstract
Subclinical hypothyroidism (SCH) is defined by elevated serum thyroid stimulating hormone (TSH) levels and normal levels of total or free thyroxin. SCH is associated with increased risk of cardiovascular morbidity and mortality, but convenient risk indicators are lacking. We aimed to identify reliable indicators of cardiovascular risk for determining initiation of thyroid hormone replacement therapy in SCH patients. This is a cross-sectional retrospective study. Medical records of 412 consecutive healthy subjects with SCH who underwent routine health check-ups at National Taiwan University Hospital between January 1, 2009 and December 31, 2009 were reviewed. Demographic, physical and clinical data were collected, including waist circumference, body mass index, thyroid function tests, fasting blood glucose, glycohemoglobin (HbA1c), and lipid profiles. Subjects were divided into three groups by HbA1c level: ? 5.6%, 5.7%-6.4%, and ? 6.5%. National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII) risk assessment was used to estimate cardiovascular risk. Group 3 had significantly higher fasting blood glucose (P < 0.001), postprandial glucose (P < 0.001), triglycerides (P < 0.001) and lower HDL-C (P = 0.039) than groups 1 and 2. HbA1c levels > 5.7% are associated with cardiovascular risk in SCH patients. HbA1c is an objective, convenient parameter for determining initiation of thyroid hormone replacement therapy in SCH patients with higher cardiovascular risk. Further studies are needed to demonstrate HbA1c capability for predicting cardiovascular risk in SCH patients and whether T4 treatment can improve outcomes. ? 2016, E-Century Publishing Corporation. All rights reserved.
Subjects
Cardiovascular risk; HbA1c; Hyperlipidemia; Subclinical hypothyroidism; Thyroid hormone replacement
SDGs
Other Subjects
C reactive protein; glucose; glycosylated hemoglobin; hemoglobin A1c; high density lipoprotein cholesterol; low density lipoprotein cholesterol; triacylglycerol; uric acid; adult; anthropometry; Article; body mass; cardiovascular risk; controlled study; cross-sectional study; female; hormone substitution; human; lipid analysis; major clinical study; male; postprandial state; retrospective study; risk assessment; subclinical hypothyroidism; thyroid function test; waist circumference
Publisher
E-Century Publishing Corporation
Type
journal article