alexa Metabolic and Cardiovascular Aspects of Subclinical Hypothyroidism: Effects of L-Thyroxin Replacement Therapy | OMICS International | Abstract
ISSN: 2167-7948

Journal of Thyroid Disorders & Therapy
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Case Report

Metabolic and Cardiovascular Aspects of Subclinical Hypothyroidism: Effects of L-Thyroxin Replacement Therapy

Mehtap Evran1*, Murat Sert1, Tamer Tetiker1, Murat Çaylı2
1Cukurova University Medical Faculty, Department of Internal Medicine, Division of Endocrinology Adana, Turkey
2Adana Numune Education and Research Hospital, Department of Cardiology, Adana, Turkey
Corresponding Author : Mehtap Evran
Cukurova University Medical Faculty,Department of Internal Medicine
Division of Endocrinology, 01330 Adana, Turkey
Tel: +905327818634
Fax: 00903223386879
E-mail: [email protected]
Received March 03, 2012; Accepted June 01, 2012; Published June 08, 2012
Citation: Evran M, Sert M, Tetiker T, Çayli M (2012) Metabolic and Cardiovascular Aspects of Subclinical Hypothyroidism: Effects of L-Thyroxin Replacement Therapy. Thyroid Disorders Ther 1:112. doi:10.4172/2167-7948.1000112
Copyright: © 2012 Evran M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Background: Subclinical hypothyroidism (SH) is a common clinical issue, presented with high serum TSH and normal T4, T3 levels. Various clinical and metabolic derangements were reported related to SH. L-T4-replacement is a challenge in daily practice. We investigated the efficacy of L-T4-replacement on certain metabolic and cardiovascular parameters in subjects with SH.

Methods: Fifty-three (40 female; 13 male) subjects were included. Of the 53 subjects, 29 were randomly given L-T4 replacement, 24 were followed as control group through 6-months. Before L-T4 replacement (basal) and at the end of the study; symptoms, physical examination, serum metabolic parameters, Holter ECG and trans-thoracic echocardiography were performed. Two groups were compared.

Results: Mean age of the patients was 44.02 ± 13.9; body mass index 29.4 ± 6.4 kg/m2. In the T4-replacement group, there was a significant difference between serum TSH and FT3 levels compared to the basal measurements (p = 0.005 and p = 0.017). LDL-cholesterol levels of the replacement group were not changed significantly, but of the control group significantly increased (p=0.01). Mean ejection fraction (EF) did not show significant change at both basal and 6-month. Peak transmitral early diastolic flow speed (E) decreased in the control group (p = 0.013). Peak transmitral late diastolic flow speeds (Em/Am) of the controls were found to be decreased compared to the basal ratio (p = 0.005). Isovolumetric relaxation times (IVRT) of both groups were prolonged at the time of basal measurements (123 ± 45.8 msc). Long IVRT persisted in the control group through the study (p=0.012).

Conclusion: Symptoms of hypothyroidism are common in subjects with SH, and L-T4 replacement can improve the Cand metabolic derangements.

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