Endocrine Abstracts

Hypothyroidism is one of the most common endocrine disorders. The long-time debatable question is whether patients with subclinical hypothyroidism (SH) should be treated with levothyroxine. Data are contradictory and treatment decision depends on several factors: TSH level, anti-TPO level, age, presence of symptoms etc. Hypothyroidism is associated with cardiovascular disease. Even a minor increase in C-reactive protein (CRP) is considered a cardiovascular risk, therefore evidence of beneficial effect of levothyroxine treatment on CRP could be an argument in favour of therapy. The aim of the study was to assess the level of high sensitivity CRP (hs-CRP) in patients with overt and subclinical hypothyroidism and to evaluate the (potential) effect of levothyroxine treatment on hs-CRP. Parametric data were tested by one way ANOVA and non-parametric data – by Kruskal Wallis test. Effect of treatment was assessed by paired t-test or Wilcoxon signed Rank test. Analysis of frequencies was performed with the use of Pearson Chi-Square tests using Bonferroni-correction for multiple comparisons. P<0.05 was considered significant. 37 patients (17 with overt hypothyroidism, OH and 20 with SH) and 37 healthy controls were included in the study. TSH, fT4, total cholesterol (TC), HDL-C, LDL-C, creatinine, creatin kinase (CK) were determined in all participants. hs-CRP was measured at baseline visit, then after 2 and 4 months of levothyroxine therapy. hs-CRP was significantly increased in OH (P<0.001) and SH (P=0.001) at baseline as compared to controls. hs-CRP significantly decreased in SH (2.2±1.6 mg/l at baseline visit, 1.4±1.1 mg/l after 2 months of treatment, P=0.017) and tended to decrease in OH (2.3±1.6 mg/l at baseline visit, 1.6±1.1 mg/l after 4 months of treatment, P=0.067*). Mean hs-CRP in the control group was 0.9±0.4 mg/l. Only 17.6 % of patients with OH and 30 % of those with SH had a hs-CR P<1 mg/l at baseline visit, as compared to control group, where 71.1 % of persons were at low cardiovascular risk. After 4 months of treatment 41.2 % and 40 % of patients with OH and SH respectively decreased their hs-CR P<1 mg/l. Levothyroxine treatment did not change the rest of biochemical biomarkers in patients with SH. Body mass index (BMI) was highest (29.1±3.7 kg/m²) in the subgroup of patients with hs-CR P> 3 mg/l and lowest (23.8±4 kg/m²) in the subgroup of patients with hs-CR P<1 mg/l (P=0.03), which highlights the role of body weight in inflammation.