Serdar Hiršl Tihana, Đurić Koraljka, Čeprnja Marina, Zec Ivana, Kraljević Šmalcelj Marijana, Jukić Tomislav, Bobetić-Vranić Tanja, Somborac-Bačura Anita
Synlab Croatia, Polyclinic for Medical Laboratory Diagnostics, Zagreb, Croatia.
Srebrnjak Children's Hospital, Zagreb, Croatia.
Biochem Med (Zagreb). 2025 Feb 15;35(1). doi: 10.11613/BM.2025.010703. Epub 2024 Dec 15.
Subclinical hypothyroidism (SCH) is an independent risk factor for cardiovascular diseases due to endothelial dysfunction and atherosclerosis development. The aim of this study was to determine whether the levothyroxine therapy could impact the concentrations of endothelial dysfunction blood markers, namely endothelin-1 (ET-1), asymmetric dimethylarginine (ADMA) and endocan, in patients with a mild form of SCH (thyroid-stimulating hormone (TSH) ≤ 10 mIU/L).
In this case-control prospective study, SCH patients and healthy controls were recruited during their regular health examinations. Medical specialists prescribed levothyroxine to SCH patients if necessary. The endothelial dysfunction markers, as well as other biochemical markers, were measured in all subjects at baseline, and after 6 months of levothyroxine treatment following the euthyroidism.
Our study showed higher ADMA (248.00 (168.78-540.20) . 166.30 (140.60-243.40) μg/L, P = 0.002), endocan (114.30 (63.45-194.65) . 67.26 (50.80-126.10) ng/L, P = 0.004), low-density lipoprotein cholesterol (LDL) (3.3 ± 0.6 . 3.7 ± 0.9 mmol/L, P = 0.043) and non-high-density lipoprotein cholesterol (non-HDL) (3.8 ± 0.7 . 4.2 ± 1.0 mmol/L, P = 0.020) concentrations in patients with a mild form of SCH in comparison with healthy subjects. In SCH patients, after 6 months of levothyroxine treatment following the euthyroidism, we observed a significant decrease in endocan (91.47 (61.88-200.03) . 97.90 (55.18-154.88) ng/L, P = 0.004), and total cholesterol concentrations (CHOL) (6.2 ± 1.0 . 5.8 ± 1.0 mmol/L, P = 0.039).
A mild form of SCH is associated with higher concentrations of endocan, ADMA, LDL and non-HDL. The potential benefits of levothyroxine therapy were shown through the significant decrease of endocan and CHOL concentrations in SCH patients, thus contributing the atherosclerosis prevention.
亚临床甲状腺功能减退（SCH）是心血管疾病的独立危险因素，因其会导致内皮功能障碍和动脉粥样硬化发展。本研究的目的是确定左甲状腺素治疗是否会影响轻度SCH（促甲状腺激素（TSH）≤10 mIU/L）患者内皮功能障碍血液标志物，即内皮素-1（ET-1）、不对称二甲基精氨酸（ADMA）和内脂素的浓度。
在这项病例对照前瞻性研究中，SCH患者和健康对照者在定期健康检查期间被招募。必要时，医学专家会给SCH患者开左甲状腺素。在所有受试者基线时以及甲状腺功能正常后接受左甲状腺素治疗6个月后，测量内皮功能障碍标志物以及其他生化标志物。
我们的研究表明，与健康受试者相比，轻度SCH患者的ADMA（248.00（168.78 - 540.20）. 166.30（140.60 - 243.40）μg/L，P = 0.002）、内脂素（114.30（63.45 - 194.65）. 67.26（50.80 - 126.10）ng/L，P = 0.004）、低密度脂蛋白胆固醇（LDL）（3.3 ± 0.6. 3.7 ± 0.9 mmol/L，P = 0.043）和非高密度脂蛋白胆固醇（非HDL）（3.8 ± 0.7. 4.2 ± 1.0 mmol/L，P = 0.020）浓度更高。在SCH患者中，甲状腺功能正常后接受左甲状腺素治疗6个月后，我们观察到内脂素（91.47（61.88 - 200.03）. 97.90（55.18 - 154.88）ng/L，P = 0.004）和总胆固醇浓度（CHOL）（6.2 ± 1.0. 5.8 ± 1.0 mmol/L，P = 0.039）显著降低。
轻度SCH与内脂素、ADMA、LDL和非HDL浓度升高有关。左甲状腺素治疗的潜在益处通过SCH患者内脂素和CHOL浓度的显著降低得以体现，从而有助于预防动脉粥样硬化。
