Alzahrani Mahmoud A, Baqar Fatemah S, Alzahrani Basil A, Badri Ziyad A, Alshamrani Rayan, Aljuhani Jamal
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.
King Saud Bin Abdulaziz University for Health Sciences, College of Medicine, King Abdullah International Medical Research Center, Jeddah, SAU.
Cureus. 2024 Jul 26;16(7):e65433. doi: 10.7759/cureus.65433. eCollection 2024 Jul.
Background Patients with subclinical hypothyroidism (SCH) have a high serum concentration of thyroid-stimulating hormone (TSH), whereas their serum-free thyroxine concentrations are normal. Lipid metabolism is regulated in large part by thyroid hormones. It could be connected to a changed lipid profile. This study aimed to evaluate the relationship between SCH and alterations in the lipid profile. Methodology Data from 99 patients with SCH and 109 euthyroid cases were collected from King Abdulaziz Medical City, Jeddah, Saudi Arabia, from 2016 to 2022. Patients older than 18 years were included in the study. The groups were matched in terms of gender, age, and body mass index. SCH was defined as a TSH value of 4.5 to 10 mIU/L, and normal T4 as 5 to 18 μg/dL. Control cases had a normal TSH ranging from 0.45 to 4.5 mIU/L. The total serum cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglyceride (TG) levels in both groups were examined and the results were recorded. Results In comparison to the control group, SCH patients had greater median glycated hemoglobin (HbA1C) (p = 0.001) and lower median vitamin D levels (p = 0.004) before therapy. Before therapy, SCH patients also showed considerably lower HDL levels and significantly higher LDL and TG levels (p < 0.001). Conclusions There is a substantial correlation between SCH and reduced HDL and vitamin D levels. It was linked to increased TG, LDL, and HbA1c levels. Only vitamin D and LDL were pathologically high. Treatment with levothyroxine raised total and LDL cholesterol levels. Future research should look into the affordability of treating SCH.
亚临床甲状腺功能减退症（SCH）患者血清促甲状腺激素（TSH）浓度较高，而血清游离甲状腺素浓度正常。脂质代谢在很大程度上受甲状腺激素调节。这可能与脂质谱的改变有关。本研究旨在评估SCH与脂质谱改变之间的关系。
2016年至2022年期间，从沙特阿拉伯吉达阿卜杜勒阿齐兹国王医疗城收集了99例SCH患者和109例甲状腺功能正常患者的数据。纳入研究的患者年龄大于18岁。两组在性别、年龄和体重指数方面进行了匹配。SCH定义为TSH值为4.5至10 mIU/L，正常T4为5至18 μg/dL。对照组TSH正常范围为0.45至4.5 mIU/L。检测两组患者的血清总胆固醇、高密度脂蛋白（HDL）胆固醇、低密度脂蛋白（LDL）胆固醇和甘油三酯（TG）水平，并记录结果。
与对照组相比，SCH患者治疗前糖化血红蛋白（HbA1C）中位数更高（p = 0.001），维生素D水平中位数更低（p = 0.004）。治疗前，SCH患者的HDL水平也显著更低，LDL和TG水平显著更高（p < 0.001）。
SCH与HDL和维生素D水平降低之间存在显著相关性。它与TG、LDL和HbA1c水平升高有关。只有维生素D和LDL在病理上偏高。左甲状腺素治疗可提高总胆固醇和LDL胆固醇水平。未来的研究应探讨治疗SCH的可承受性。
