Brenta Gabriela, Fretes Osvaldo
Pediatr Endocrinol Rev. 2014 Jun;11(4):390-9.
Abnormalities in plasma lipids are most frequently the result of the interaction between the individual and the environment; therefore, it is essential to look for secondary causes in all patients with dyslipidemia.
To describe the pathogenesis of dyslipidemia and in particular the role of hypothyroidism as a secondary dyslipidemia.
Overt hypothyroidism (OH) is associated to impairment of the lipid profile both quantitatively and qualitatively. Subclinical hypothyroidism (5CH) has been also related to lipid derangement albeit with milder impact. Moreover, the association between low thyroid function and lipid plasma levels has been also found to extend into the normal range of TSH. However, confounders such as age, gender and body weight may modify this association. The effects of treatment with levothyroxine for cholesterol reduction are warranted in OH while in SCH, larger interventional studies on lipid reduction with levothyroxine are lacking.
Hypothyroidism should always be considered in the evaluation of patients with dyslipidemia.
血浆脂质异常通常是个体与环境相互作用的结果；因此，对所有血脂异常患者寻找继发原因至关重要。
描述血脂异常的发病机制，特别是甲状腺功能减退作为继发性血脂异常的作用。
显性甲状腺功能减退（OH）在数量和质量上均与血脂谱受损有关。亚临床甲状腺功能减退（SCH）也与脂质紊乱有关，尽管影响较轻。此外，还发现甲状腺功能低下与血浆脂质水平之间的关联延伸至促甲状腺激素（TSH）的正常范围。然而，年龄、性别和体重等混杂因素可能会改变这种关联。左甲状腺素治疗对降低胆固醇的效果在OH中是有必要的，而在SCH中，缺乏关于左甲状腺素降脂的大型干预性研究。
在评估血脂异常患者时应始终考虑甲状腺功能减退。
