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  3. Investigation of the effect of levothyroxine treatment on serum lipids in patients with mild hypothyroidism

Investigation of the effect of levothyroxine treatment on serum lipids in patients with mild hypothyroidism

Number of pages: 95 File Format: word File Code: 32100
Year: Not Specified University Degree: PhD Category: Medical Sciences
Tags/Keywords: chol - hypothyroid - LDL - Levothyroxine - lipid - Mild hypothyroidism - Mild hypothyroidism - Serum level - Serum lipids - TG
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  • Summary of Investigation of the effect of levothyroxine treatment on serum lipids in patients with mild hypothyroidism

    Dissertation for the degree of Doctor of General Medicine

    Abstract:

    Title: Investigating the effect of treatment with levothyroxine on serum lipids in patients with mild hypothyroidism

    Introduction:

    Mild hypothyroidism is the biochemical evidence of thyroid hormone deficiency in patients whose clinical features of hypothyroidism are very minor or not present at all. In these patients, at the same time, a slight increase in serum TSH level can be seen.

    Given that a slight increase in TSH level causes fat metabolism disorder, dyslipidemia in these patients can be the cause of cardiovascular problems in them. Our study investigated the effect of early treatment with levothyroxine on serum lipids in patients with mild hypothyroidism. Materials and methods: During this randomized clinical trial, 82 patients with subclinical hypothyroidism from the outpatient clinic of Shahid Beheshti Hospital in Qom were randomly examined. who had a normal serum T4 level and a serum TSH level>5.2 mu/L. The baseline level of serum lipids of the patients was measured, and then the patients were randomly divided into two groups, the control and the case, and for the treated group, treatment with levothyroxine was started for three months, and then the patients of both groups were re-evaluated.

    Results:

    Average age in the case group 68.39 and in the control group it was 63.37. After 3 months of treatment with levothyroxine in the intervention group, the amount of T4 increased significantly and the amount of TSH, TG, chol, LDL HDL, decreased significantly. Mild thyroid can significantly reduce the serum level of LDL, TG, chol.

    Key words: mild hypothyroidism, levothyroxine, lipid

    Chapter one:

    Research introduction

    1-1: expression Issue:

    By definition, the term subclinical hypothyroidism is generally used to describe patients with normal FT4 levels and mildly elevated serum TSH levels. Other terms used for these conditions; Mild hypothyroidism is preclinical hypothyroidism or reduced thyroid reserve. The amount of TSH increase in these patients is low and is around 10-4 mu/L. (1)

    In fact, mild hypothyroidism is the biochemical evidence of thyroid hormone deficiency in patients whose clinical features of hypothyroidism are very minor or not present at all. In these patients, at the same time, a slight increase in the serum level of TSH can be seen. (1)

    Although mild hypothyroidism is often asymptomatic, 30% of patients have evidence that suggests thyroid hormone deficiency. One of the side effects and at the same time mild hypothyroid symptoms is the impact on cardiopulmonary function. In a study conducted in this field, it is stated that: Myocardial function is disturbed in patients with mild hypothyroidism and mild hypothyroidism has been evaluated as a risk factor for cardiovascular diseases. In various studies, it has been clearly emphasized that dyslipidemia caused by mild hypothyroidism is the main cause of cardiovascular problems in these patients. (2).

    Approaches that have been published recently, the treatment of patients is not recommended until their TSH level is below 10 mu/L, and dyslipidemia is not considered as one of the indications for treatment. (1)

    At the same time, dyslipidemia also exists in this group of patients and can be the cause of cardiovascular problems in these patients. Therefore, approaching this research and considering that the importance of dyslipidemia in mild hypothyroid patients and the effects of thyroid hormone replacement on lipids are still controversial, and in a number of studies conducted in recent years, treatment with levothyroxine in mild hypothyroid patients has been able to reduce serum LDL levels and improve cardiac function.. Therefore, approaching this research and taking into account that the importance of dyslipidemia in mild hypothyroid patients and the effects of thyroid hormone replacement on lipids are still controversial, and in a number of studies conducted in recent years, treatment with levothyroxine in mild hypothyroid patients has been able to reduce serum LDL levels and improve heart function (3,4), but on the other hand, in a significant number of studies, treatment of such patients with levothyroxine significantly reduced serum total cholesterol levels. or did not follow LDL (5)

    In addition, the existence of such contradictory results in this issue also raises the importance of other factors affecting dyslipidemia, including race and ethnicity, and environmental effects, as in some studies, the effect of gene factors on the development and response to treatment of dyslipidemia in mild hypothyroid patients has been proven (6)

    Therefore, considering the rare number of studies Similar in this field in the country and the absence of a similar study in the city of Qom, we considered it necessary to investigate this issue in a study whether treatment with levothyroxine in patients with mild hypothyroidism whose serum TSH level is below 10 mu/L and who do not have other indications for treatment with levothyroxine including (anti-TPO positive, pregnancy, suffering from goiter) can reduce the serum lipid level in patients. No.

    Certainly proving that treatment with levothyroxine reduces serum lipid levels in mild hypothyroid patients will play an important role in preventing cardiovascular diseases, improving health and quality of life in this category of patients.

     

     

     

     

     

     

     

    1-2 goals Research:

    main objective:

    determine the effect of treatment with levothyroxine on serum lipids in patients with mild hypothyroidism

    sub-objectives:

    1. Determination of the average level of serum TG, LDL, HDL before treatment with levothyroxine in the intervention group

    2. Determination of the average level of serum TG, LDL, HDL before starting the study in the control group

    3. Determination of the average level of serum TG, LDL, HDL after treatment with levothyroxine in the intervention group

    4. Determining the average level of serum TG, LDL, HDL after completing the study in the control group

    5. Comparison of the average level of serum TG, LDL, HDL before and after treatment in the intervention group

    6.  Comparison of the average level of serum TG, LDL, HDL before and after the completion of the study in the control group

    7. Comparison of the average levels of serum TG, LDL, and HDL before and after treatment in the control and intervention groups

    -3 research questions:

    1. What is the average level of serum TG, LDL, HDL before treatment with levothyroxine in the intervention group?

    2. What is the average level of serum TG, LDL, HDL at the beginning of the study in the control group?

    3. What is the average level of serum TG, LDL, HDL after treatment with levothyroxine in the intervention group?

    4. What is the average level of serum TG, LDL, HDL at the end of the study in the control group? rtl;"> 

     

     

     

     

     

     

     

     

     

     

     

     

     

    Assumptions Research:

    1. The levels of TG, LDL, and HDL serum before and after treatment are different in the intervention group

    2

  • Contents & References of Investigation of the effect of levothyroxine treatment on serum lipids in patients with mild hypothyroidism

    List:

    Chapter One: Introduction to Research.1

    1-1 Statement of the Problem: 2

    1-2 Research Objectives.5

    1-3 Research Questions and Assumptions.6

    Chapter Two: Knowledge Available in Research.7

    1-2 Part One: Conceptual Framework.8

    2-1-1 Gland Thyroid. 8.

    2-1-2 Hypothyroidism. 17

    2-1-3 Dyslipidemia. 28

    2-2 Part Two: Review of the studies done. Sixth: conclusions and suggestions. 75

    Resources..76

     

    Source:

     

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Investigation of the effect of levothyroxine treatment on serum lipids in patients with mild hypothyroidism
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