Body Mass Index Is Associated with Hypercholesterolemia following Thyroid Hormone Withdrawal in Thyroidectomized Patients

Abstract

Thyroid hormone withdrawal (THW) for postoperative radioiodine adjuvant therapy or diagnostic radioiodine whole body scan in patients with differentiated thyroid cancers results in acute thyroid hormone deficiency and abnormal lipid profiles. To better clarify the clinical pattern of dyslipidemia occurring after THW, we retrospectively analyzed the association between serum total cholesterol level after THW and various clinical factors in a total of 61 patients who underwent total thyroidectomy due to papillary thyroid cancers from January 2010 to March 2012, in Severance Hospital, Seoul, Korea. Preoperative baseline total cholesterol was significantly correlated with post-THW total cholesterol level; however, age, gender, or elevated TSH level after THW itself was not correlated with post-THW total cholesterol level. A significant correlation between preoperative measured BMI and post-THW total cholesterol level was found (r = 0.263, P = 0.041). In multiple logistic analysis, BMI was an independent determining factor of post-THW total cholesterol level (P = 0.012).

Association between Thyroid-Stimulating Hormone Level after Total Thyroidectomy and Hypercholesterolemia in Female Patients with Differentiated Thyroid Cancer: A Retrospective Study

“…To the best of our knowledge, this is the first study to show that normal TSH levels are associated with increased hypercholesterolemia risk in DTC patients receiving levothyroxine after total thyroidectomy. Although changes in the serum lipid levels during thyroxine withdrawal after total thyroidectomy have been assessed in some studies, the risk of hypercholesterolemia during levothyroxine therapy has not been [22,23,24,25]. Owing to the fact that thyroid cancers are detected early these days, leading to a low risk, and that most DTC patients have a favorable clinical course [26], the unsuppressed range of TSH may be applied to many such cases according to current management guidelines [3,4].…”

The role of thyroid hormone in metabolism and metabolic syndrome

“…19,29,30,42,55,71,79,102 The association between serum FT4 and MetS diagnosis was not always found. However, when this association occurred, it was reported as positive (with higher serum FT4 levels) in some studies, 38,53,102 while negative in others. 24,54,95 Higher levels of serum FT3 related to MetS were also detected in some studies.…”

Body mass index and cholesterol level predict surgical outcome in patients with hepatocellular carcinoma in Taiwan - a cohort study

“…In addition, the fact that other confounding molecular cues, including elevated levels of insulin-like growth factors [ 14 ], leptin [ 15 ], hormones [ 16 ] and cytokines [ 17 ] were not adjusted in studies, could also result in the divergent interpretations for prognosis after hepatectomy between lean and obese subjects. With a causal link between BMI and total cholesterol level in many cancers, it was interestingly found an inverse correlation between preoperative total cholesterol levels and clinical postoperative outcomes of HCC patients in several studies [ 18 - 20 ]. Further examination in these studies suggested that poorer surgical outcome in patients with lower preoperative total cholesterol level and BMI might be caused by long-term liver dysfunction and malnutrition implying the potential role of lipid composition for determination of operative outcomes in HCC patients.…”