PREVALENCE AND CORRECTION OF HYPOTHYROIDISM IN A LARGE COHORT OF PATIENTS REFERRED FOR DYSLIPIDEMIA
PREVALENCE AND CORRECTION OF HYPOTHYROIDISM IN A LARGE COHORT OF PATIENTS REFERRED FOR DYSLIPIDEMIA
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DOI：
10.1001/archinte.155.14.1490
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发表时间：
1995-07-24
影响因子：
--
通讯作者：
WIERSINGA, WM
中科院分区：
文献类型：
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作者：
DIEKMAN, T;LANSBERG, PJ;WIERSINGA, WM
背景：高胆固醇血症的治疗可以降低过早发生动脉粥样硬化的风险。甲状腺功能减退症引起的高胆固醇血症可能通过甲状腺激素替代治疗逆转。我们确定了甲状腺功能减退症的患病率提到一所大学的脂质研究诊所，并研究了恢复甲状腺功能正常状态的脂质和脂蛋白水平的变化。方法：进行回顾性随访研究。在所有1509个连续转诊的严重血脂异常，促甲状腺激素水平进行了测量。从1989年1月1日至1993年7月1日，通过计算机数据库识别甲状腺功能减退症患者，首先通过左旋甲状腺素钠药物治疗，其次通过血清促甲状腺素值大于5 mU/L。21例患者可用于评估恢复甲状腺功能正常状态对血脂和脂蛋白水平的影响。结果：观察到的甲状腺功能减退症的患病率为4.2%（64/1509）。25例患者先前已知该疾病，39例患者新诊断为该疾病（11例明显甲状腺功能减退症，28例亚临床甲状腺功能减退症）。显着降低总胆固醇和低密度脂蛋白胆固醇水平只发生在患者的预处理促甲状腺激素值为10 mU/L或更高。结论：新诊断的病例明显甲状腺功能减退症的患者转介到一个脂质诊所的患病率约为一般人群的两倍。在轻度亚临床甲状腺功能减退症患者中，左旋甲状腺素治疗没有显著降低总胆固醇和低密度脂蛋白胆固醇水平（促甲状腺激素水平，
Background: Treatment of hypercholesterolemia can reduce the risk of developing premature atherosclerosis. The hypercholesterolemia caused by hypothyroidism is potentially reversible by thyroid hormone replacement therapy. We determined the prevalence of hypothyroidism in patients referred to a university lipid research clinic and studied the changes in lipid and lipoprotein levels on restoration of the euthyroid state.Methods: A retrospective follow-up study was performed. In all 1509 consecutive referrals for severe dyslipidemia, thyrotropin levels were measured. Patients with hypothyroidism were identified by means of a computed database, from January 1, 1989, to July 1, 1993, first by levothyroxine sodium medication and second by serum thyrotropin values greater than 5 mU/L. Twenty-one patients were available to evaluate the effect of restoration of the euthyroid state on plasma lipid and lipoprotein levels.Results: The observed prevalence of hypothyroidism proved to be 4.2% (64/1509). The disorder was previously known in 25 patients and newly diagnosed in 39 patients (11 with overt hypothyroidism and 28 with subclinical hypothyroidism). Significant reductions in total cholesterol and low-density lipoprotein cholesterol levels occurred only in patients with pretreatment thyrotropin values of 10 mU/L or more.Conclusions: The prevalence of newly diagnosed cases of overt hypothyroidism in patients referred to a lipid clinic is approximately two times that in the general population. The absence of significant reductions in total cholesterol and low-density lipoprotein cholesterol levels on levothyroxine treatment in patients with minor subclinical hypothyroidism (thyrotropin level,