Endocrine Abstracts

Aim: To asses the role of oral semaglutide (Sm) on weight & cardiac biomarkers (CB) in 69 patients with hypothyroidism optimally controlled using Liothyronine (T3)+Levothyroxine combination (T4) therapy (T3/T4).

Methods: Between January 2022 and March 2022, 69 hypothyroid patients, who were treated using T3/T4 while on regular follow up, initiated Sm with the intention of weight loss and were retrospectively analysed. Hypothyroidism was defined as TSH > 4.2 (irrespective of their thyroid antibody status) on > 2 occasions > 2 weeks apart. Protocol: Patients were on T3 (25 mg/day) along with varying doses of T4 to optimise the TSH (lower limit of normal reference range). Patients initiated Sm with 3mg and were asked to self titrate up to 14mg based on their symptoms. They were followed up every 2-3 mths for clinical & CB: weight-kg (W), body mass index (BMI-kg/m2), systolic BP (SBP-mm of Hg), diastolic BP (DBP-mm of Hg), TSH (mIU/ml), Lipid profile mg/dl (TC, LDL-C, TG, HDL) & Hs-CRP mg/l for 6 months. Continuous variables were analysed using paired t-test expressed as mean ± standard deviation. Bonferroni’s correction was applied & P value <0.007 was considered significant (S).

Results: Baseline (B) characters: Female:Male ratio 56/11 (84%/16%). Average [Age (42.59±10.81), BMI (31.92±6.75), W (82.43±19.23), SBP (119.89±13.09), DBP (82.8±9.73), TSH (1.79±1.67), TC (170.63±41.92), LCL-C (103.54±38.53), TG (121.68±54.52), HDL (48.86±7.97) & hs-CRP (5.95±7.97)]. Comparison between B & 6 mths: S reduction in W (-5.07±5.16), BMI (-1.96±2.01), TC (-11.79±30.3), LDL (-10.21±28.86), TG (-10.22±29) & hs-CRP (-1.97±5.32) was seen with Sm. There was no difference seen in SBP, DBP & HDL.

Conclusion: Oral Semaglutide is effective in causing weight loss and improving cardiac parameters (lipid profile) in patients with hypothyroidism. Sm might have beneficial long term cardiovascular effects in patients with hypothyroidism.