Resposta ao tratamento com levotiroxina de biomarcadores cardiometabólicos em idosos com hipotiroidismo subclínico

Resumo original em inglês

O que aconteceu

Randomized controlled trials (RCTs) found no cardioprotective effects of levothyroxine therapy in older adults with subclinical hypothyroidism.

The aim of this study was to assess levothyroxine effects on cardiometabolic biomarkers, which may serve as more sensitive treatment indicators.

Post-hoc analysis using (baseline and 12-month) data from two double-blind RCTs in older adults (≥65 years) with subclinical hypothyroidism.

O que encontraram

Cardiometabolic biomarkers included seven clinically relevant lipid measures (apolipoprotein B (ApoB), total cholesterol (Total-C), non-high-density lipoprotein cholesterol (non-HDL-C), remnant cholesterol (RC), low-density lipoprotein cholesterol (LDL-C), HDL-C, and triglycerides (TG)) and 167 standardized metabolomic measures from nuclear magnetic resonance. Analyses were additionally stratified by baseline TSH levels.

Among 286 included participants (48% women; median age 75 [70, 82] years; median baseline TSH 6.44 [5.36, 7.81] mIU/L), 142 were randomized to levothyroxine. Overall, levothyroxine showed no effects on ApoB (-0.03 [95% CI: -0.07, 0.00] g/L), Total-C (-0.17 [-0.34, 0.00] mmol/L), non-HDL-C (-0.15 [-0.31, 0.00] mmol/L), RC (-0.09 [-0.16, -0.01] mmol/L), LDL-C (-0.07 [-0.15, 0.02] mmol/L), and TG (-0.07 [-0.15, 0.01] mmol/L). In participants with baseline TSH ≥10 mIU/L (n = 27), potentially beneficial changes (P < .05, but not significant after multiple-testing correction) were observed for all clinically relevant lipids except HDL-C, as well as for ApoB-containing lipoproteins, VLDL size, and fatty acids.

Por que isso importa

In older adults with subclinical hypothyroidism, levothyroxine treatment showed no effects on cardiometabolic biomarkers, although potentially favorable changes in lipids and lipoproteins were observed for individuals with baseline TSH ≥10 mIU/L.

Resumo publicado sob licença CC BY. A tradução para o português ainda não chegou a este estudo.