Hyperlipidemia in Patients With Primary and Secondary Hypothyroidism

O’Brien, Timothy; Dinneen, Seán F.; O’Brien, Peter C.; Palumbo, Pasquale

doi:10.1016/s0025-6196(12)60694-6

Cited by 168 publications

(133 citation statements)

References 27 publications

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“…A relação entre as presenças de hipotireoidismo e hiperlipidemias já foi relatada por diversos pesquisadores (38)(39)(40)(41)(42)(43)(44)(45)(46). No presente estudo, observou-se que, do total de indivíduos com hipotireoidismo (n= 121), 89,3% apresentavam, simultaneamente, hiperlipidemia.…”

Section: Discussionunclassified

Hiperlipidemias e fatores dietéticos: estudo transversal entre nipo-brasileiros

Bevilacqua

Gimeno

Matsumura

et al. 2007

Arq Bras Endocrinol Metab

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RESUMOEste estudo teve como objetivo avaliar a associação entre hiperlipidemia e dieta de nipo-brasileiros de Bauru, município do Estado de São Paulo. Foram obtidos de 1.330 indivíduos dados mediante questionários previamente testados (dados demográficos e dietéticos). Os exames físicos e laboratoriais incluíram a coleta (ou dosagem) antropométrica, de pressão arterial, de glicemia de jejum e de 2 horas, de perfil lipídico e de TSH e T4 livre. Utilizaram-se teste qui-quadrado e medida de odds ratio para avaliar associação entre as variáveis estudadas e presença de hiperlipidemia. Foi encontrado 81,5% de hiperlipidêmicos e acometeu, principalmente, indivíduos tabagistas, com excesso de peso, hipotireoidismo, hipertensão arterial e intolerância a glicose. Observaram-se, mediante análise bruta, relações entre hiperlipidemia e ácido graxo saturado, ácido oléico e fibras de grãos e cereais. Após o ajuste para as variáveis de controle, observaram-se associações entre hiperlipidemia e consumo de lípides (totais, ácido oléico, saturados e trans), fibras e álcool. Conclui-se que mudanças no estilo de vida, particularmente no hábito alimentar, podem levar a uma melhora do quadro hiperlipidêmico e que o consumo de lípides pode ser um dos principais fatores para o aumento da hiperlipidemia. Estudos prospectivos auxiliarão para testar essas hipóteses nos nipo-brasileiros de Bauru. This study aimed at evaluating the association between hyperlipidemia and dietary patterns of Japanese Brazilians with and without hypothyroidism from Bauru, city in the State of São Paulo. We evaluated 1,330 individuals by means of demographic and dietary measurement, whom were gotten through standardized questionnaires previously tested. Clinical examination and laboratory data were anthropometry, blood pressure, fasting and 2-h glucose load, lipid profile and TSH and free T4. The chi-square and the odds ratio were used to evaluate associations between hyperlipidemia with studied variables. The prevalence of hyperlipidemia was 81.5% and it was associated with smokers, overweight, hypothyroid, hypertensive and glucose intolerants. We observed, in crude analysis, relationships with the presence of hyperlipidemia and fat saturated, oleic acid and dietary fiber from grains and cereals. After adjusting for the control variables, we observed relationships between hyperlipidemia (hypercholesterolemia and hypertriglyceridemia) with habitual intake of total fat, oleic acid, saturated fat, trans fat, dietary fiber and alcohol. As a conclusion, changes in the style of life, particularly in the dietary habits, can improve lipidic profile and that lipids intake can be a risk factor for hyperlipidemia. Prospectives studies will help test the hypothesis in Japanese Brazilians from Bauru. (Arq Bras Endocrinol Metab 2007;51/4:547-558)

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Section: Discussionunclassified

Hiperlipidemias e fatores dietéticos: estudo transversal entre nipo-brasileiros

Bevilacqua

Gimeno

Matsumura

et al. 2007

Arq Bras Endocrinol Metab

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“…Furthermore, secondary hypothyroidism may coexist with adrenal cortical insuf®ciency, and the latter condition may produce additional negative effects on the cardiovascular system. 2 …”

Section: Lipoprotein Metabolismmentioning

confidence: 99%

Thyroid and lipid metabolism

2000

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Thyroid hormones in¯uence all major metabolic pathways. Their most obvious and well-known action is an increase in basal energy expenditure obtained acting on protein, carbohydrate and lipid metabolism. With speci®c regard to lipid metabolism, thyroid hormones affect synthesis, mobilization and degradation of lipids, although degradation is in¯uenced more than synthesis. The main and best-known effects on lipid metabolism include: (a) enhanced utilization of lipid substrates; (b) increase in the synthesis and mobilization of triglycerides stored in adipose tissue; (c) increase in the concentration of non-esteri®ed fatty acids (NEFA); and (d) increase of lipoprotein-lipase activity. While severe hypothyroidism is usually associated with an increased serum concentration of total cholesterol and atherogenic lipoproteins, the occurrence of acute myocardial infarction (AMI) in hypothyroid patients is not frequent. However, hypothyroid patients appear to have an increased incidence of residual myocardial ischemia following AMI. Even in subclinical hypothyroidism, which is characterized by raised serum TSH levels with normal serum thyroid hormone concentrations, mild hyperlipidemia is present and may contribute to an increased risk of atherogenesis. Prudent substitution therapy with L-thyroxine is indicated in patients with both overt and subclinical hypothyroidism, with or without angina, to counteract the cardiovascular risk resulting from hyper-dyslipidemia.

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“…Hypercholesterolemia is found in patients with hypothyroidism and in those with resistance to thyroid hormone (2)(3)(4). Elevated serum cholesterol levels in hypothyroidism are restored to normal levels upon treatment with thyroid hormone (2,5). In contrast, thyroid hormone treatment occasionally has paradoxical effects on serum cholesterol levels in patients with resistance to thyroid hormone (4).…”

mentioning

confidence: 99%

Cross-talk between Thyroid Hormone Receptor and Liver X Receptor Regulatory Pathways Is Revealed in a Thyroid Hormone Resistance Mouse Model

Hashimoto

Cohen

Yamada

et al. 2006

Journal of Biological Chemistry

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Hypercholesterolemia is found in patients with hypothyroidism and resistance to thyroid hormone. In this study, we examined cholesterol metabolism in a thyroid hormone receptor ␤ (TR-␤) mutant mouse model of resistance to thyroid hormone. Whereas studies of cholesterol metabolism have been reported in TR-␤ knock-out mice, generalized expression of a non-ligand binding TR-␤ protein in this knock-in model more fully recapitulates the hypothyroid state, because the hypothyroid effect of TRs is mediated by the unliganded receptor. In the hypothyroid state, a high cholesterol diet increased serum cholesterol levels in wild-type animals (WT) but either did not change or reduced levels in mutant (MUT) mice relative to hypothyroidism alone. 7␣-Hydroxylase (CYP7A1) is the rate-limiting enzyme in cholesterol metabolism and mRNA levels were undetectable in the hypothyroid state in all animals. triiodothyronine replacement restored CYP7A1 mRNA levels in WT mice but had minimal effect in MUT mice. In contrast, a high cholesterol diet markedly induced CYP7A1 levels in MUT but not WT mice in the hypothyroid state. Elevation of CYP7A1 mRNA levels and reduced hepatic cholesterol content in MUT animals are likely because of cross-talk between TR-␤ and liver X receptor ␣ (LXR-␣), which both bind to a direct repeat ؉ 4 (DR؉4) element in the CYP7A1 promoter. In transfection studies, WT but not MUT TR-␤ antagonized induction of this promoter by LXR-␣. Electromobility shift analysis revealed that LXR/RXR heterodimers bound to the DR؉4 element in the presence of MUT but not WT TR-␤. A mechanism for cross-talk, and potential antagonism, between TR-␤ and LXR-␣ is proposed.

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Hyperlipidemia in Patients With Primary and Secondary Hypothyroidism

Cited by 168 publications

References 27 publications

Hiperlipidemias e fatores dietéticos: estudo transversal entre nipo-brasileiros

Hiperlipidemias e fatores dietéticos: estudo transversal entre nipo-brasileiros

Thyroid and lipid metabolism

Cross-talk between Thyroid Hormone Receptor and Liver X Receptor Regulatory Pathways Is Revealed in a Thyroid Hormone Resistance Mouse Model

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