Gender impact on the correlation between thyroid function and serum lipids in patients with differentiated thyroid cancer

Abstract

The present study aimed to explore the association between thyroid stimulating hormone (TSH) and serum lipids in patients with differentiated thyroid cancer (DTC), with a focus on the risk of hyperlipidemia between different genders. The study included 352 DTC patients who were ready to receive I-131 therapy as well as 352 matched normal controls. In the DTC group, 157 patients were monitored for TSH and lipid parameters prior to and after 1 month of thyroxine therapy. Results were analyzed using t-tests, Pearson bivariate correlation and binary logistic regression analyses. All participants were divided into 3 subgroups according to TSH levels: Subgroup 1 (normal TSH level), subgroup 2 (TSH between 5 and 30 µIU/ml), and subgroup 3 (TSH >30 µIU/ml). Serum total cholesterol (TC), triglycerides (TG), and low-density lipoprotein-cholesterol (LDL-C) levels were significantly higher in the DTC group than in the control group. The levels of these parameters decreased after thyroxine therapy and significant positive correlations were observed between TSH and TC, and TG and LDL-C in both genders. Binary logistic regression demonstrated that female DTC patients had higher risks of developing hyperlipidemia than male patients, and these risks increased when TSH increased. For example, the odds ratios (ORs) of high TC in subgroup 2 were 3.30 in males and 4.60 in females, respectively. However, in subgroup 3, the ORs were 9.40 in males and 13.12 in females, respectively. The results of the present study showed that after thyroidectomy, the risk of dyslipidemia markedly increased in DTC patients. More importantly, female patients had a higher risk than male patients.

Lipid ratios as a predictive marker of Subclinical Atherosclerosis inflammation among Type 1 Diabetic patients with Thyroid Dysfunction

“…Thus, the results of the present study indicate that sex hormones may actively contribute to atherosclerosis disease development. Li et al and Tognini et al also found that the gender difference had considerable effects on the association between TSH levels and serum lipid levels, and their conclusions were in agreement with those of the present study 38,39 .…”

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].…”

“…Furthermore, hard cardiovascular outcomes such as myocardial infarction, stroke, and death were not assessed, although hypercholesterolemia is a major risk factor for cardiovascular disease [28]. Third, our results may not be directly generalizable to male patients, because of the potential interaction of sex with the relationship between thyroid function and lipid metabolism [23,29]. Fourth, as this was a single-center study mainly comprising middle-aged patients in Korea, the findings should be interpreted with caution when applied to patients with different genetic, demographic, or geographic backgrounds.…”

Dyslipidemia Risk in Thyroid Cancer Patients: A Nationwide Population-Based Cohort Study

“…In an Israeli cohort study, TC survivors showed higher all-cause mortality with a higher prevalence of dyslipidemia and CVD than matched individuals without TC (17). Similarly, Li et al showed that after thyroidectomy, the risk of dyslipidemia markedly increased in patients with differentiated TC (22). When the changes in serum cholesterol levels were evaluated according to postoperative TSH levels, patients receiving levothyroxine after total thyroidectomy with normal TSH levels had a higher risk of hypercholesterolemia than did those with mildly suppressed TSH levels (18).…”

“…Moreover, opposite changes occur in conditions resulting from thyroid hormone deficiency (12)(13)(14). However, only few studies have investigated dyslipidemia risk in patients with TC, and these have yielded conflicting results (15)(16)(17)(18)(19)(20)(21)(22)(23)(24), possibly because of differences in the study population, sample size, and follow-up period.…”