Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
Department of Pediatrics in Bytom, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland.
Pharmacology. 2023;108(3):255-264. doi: 10.1159/000529242. Epub 2023 Mar 6.
Autoimmune thyroiditis seems to be associated with increased cardiometabolic risk. Statins, the mainstay of cardiovascular risk reduction and prevention, were found to reduce thyroid antibody titers. The aim of this study was to investigate plasma markers of cardiometabolic risk in statin-treated women with thyroid autoimmunity.
We compared two matched groups of euthyroid women with hypercholesterolemia receiving atorvastatin treatment: subjects with autoimmune (Hashimoto's) thyroiditis (group A, n = 29) and subjects without thyroid pathology (group B, n = 29). Plasma lipids, glucose homeostasis markers, as well as circulating levels of uric acid, high-sensitivity C-reactive protein (hsCRP), fibrinogen, homocysteine, and 25-hydroxyvitamin D were measured before atorvastatin treatment and 6 months later.
At entry, both groups differed in antibody titers, insulin sensitivity, and plasma levels of uric acid, hsCRP, fibrinogen, homocysteine, and 25-hydroxyvitamin D. Atorvastatin-induced reduction in hsCRP and homocysteine, but not in total cholesterol and LDL-cholesterol, was more pronounced in group B than in group A. Only in group B, the drug decreased uric acid and fibrinogen and increased 25-hydroxyvitamin D. In group A, atorvastatin reduced insulin responsiveness.
The obtained results indicate that euthyroid women with Hashimoto's thyroiditis may benefit to a lesser degree from atorvastatin treatment than other populations of women with hypercholesterolemia.
自身免疫性甲状腺炎似乎与增加的心血管代谢风险相关。他汀类药物是降低心血管风险和预防的主要药物，已被发现可降低甲状腺抗体滴度。本研究旨在探讨甲状腺自身免疫的他汀类药物治疗女性的心血管代谢风险的血浆标志物。
我们比较了两组接受阿托伐他汀治疗的甲状腺功能正常的高胆固醇血症女性：自身免疫性（桥本氏）甲状腺炎（A 组，n = 29）和无甲状腺病变的患者（B 组，n = 29）。在阿托伐他汀治疗前和 6 个月后测量了血浆脂质、葡萄糖稳态标志物以及尿酸、高敏 C 反应蛋白（hsCRP）、纤维蛋白原、同型半胱氨酸和 25-羟维生素 D 的循环水平。
在进入时，两组在抗体滴度、胰岛素敏感性以及尿酸、hsCRP、纤维蛋白原、同型半胱氨酸和 25-羟维生素 D 的血浆水平方面存在差异。阿托伐他汀引起的 hsCRP 和同型半胱氨酸的降低，但总胆固醇和 LDL 胆固醇没有，在 B 组比在 A 组更为明显。只有在 B 组，药物降低了尿酸和纤维蛋白原，增加了 25-羟维生素 D。在 A 组，阿托伐他汀降低了胰岛素反应性。
研究结果表明，与其他高胆固醇血症女性群体相比，甲状腺功能正常的桥本氏甲状腺炎女性可能从阿托伐他汀治疗中获益较少。
