Subclinical hypothyroidism, lipid metabolism and cardiovascular disease

Eur J Intern Med. 2017 Mar:38:17-24. doi: 10.1016/j.ejim.2016.12.015. Epub 2016 Dec 28.

Abstract

Subclinical hypothyroidism is defined by elevated serum thyrotropin in presence of normal free thyroid hormones. Lipid metabolism is influenced by thyroid hormone and many reports showed that lipids status worsen along with TSH level. Subclinical hypothyroidism has been also linked to other cardiovascular risk factors such as alteration in blood pressure and increased atherosclerosis. Further evidences suggested that mild dysfunction of thyroid gland is associated with metabolic syndrome and heart failure. Thyrotropin level seems the best predictor of cardiovascular disease, in particular when its levels are above 10mU/L. However, despite these observations, there is no clear evidence that levothyroxine therapy in subjects with milder form of subclinical hypothyroidism could improve lipid status and the other cardiovascular risk factors. In this review, we address the effect of thyroid hormone and cardiovascular risk, with a focus on lipid metabolism.

Keywords: Cardiovascular disease; Cardiovascular risk; Lipid metabolism; Subclinical hypothyroidism.

Publication types

  • Review

MeSH terms

  • Blood Pressure
  • Cardiovascular Diseases / complications*
  • Carotid Intima-Media Thickness
  • Humans
  • Hypothyroidism / complications*
  • Lipid Metabolism*
  • Metabolic Syndrome / complications*
  • Risk Factors
  • Thyroid Gland / physiopathology*
  • Thyrotropin / blood*
  • Thyroxine / therapeutic use

Substances

  • Thyrotropin
  • Thyroxine