Effect of Thyroxin Treatment on Carotid Intima–Media Thickness (CIMT) Reduction in Patients with Subclinical Hypothyroidism (SCH): a Meta-Analysis of Clinical Trials
| Autor: | Sankalp Das, Dixitha Anugula, Ali Adus, Archana Machavarapu, Rehan Malik, Adnan Younus, Emir Veledar, Idrees Khan, Michelle Nguyen, Muhammad Aziz, Yugandhar Kandimalla, Khurram Nasir, Aisha Rasool, Muhammad A. Latif, Choudhry Humayun, Anshul Saxena |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
030209 endocrinology & metabolism Review 030204 cardiovascular system & hematology Carotid Intima-Media Thickness Gastroenterology Euthyroid/Euthyroidism 03 medical and health sciences Clinical trials 0302 clinical medicine Hypothyroidism Risk Factors Subclinical hypothyroidism Internal medicine Internal Medicine medicine Humans cardiovascular diseases Subclinical infection Clinical Trials as Topic medicine.diagnostic_test Surrogate endpoint business.industry Biochemistry (medical) Carotid intima–media thickness medicine.disease Confidence interval Thyroxine Meta-analysis Endocrinology Dyslipidemia Intima-media thickness Cardiovascular Diseases cardiovascular system Cardiology and Cardiovascular Medicine Lipid profile business Thyroxin treatment Lipoprotein |
| Zdroj: | Journal of Atherosclerosis and Thrombosis |
| ISSN: | 1880-3873 1340-3478 |
| DOI: | 10.5551/jat.39917 |
| Popis: | Aim: Research shows that subclinical hypothyroidism (SCH) is related to an increased carotid intima –media thickness (CIMT), a surrogate marker of subclinical cardiovascular disease (CVD). It is controversial whether or not SCH should be treated to reduce CVD morbidity and mortality. This meta-analysis aimed to determine whether SCH is associated with an increase in CIMT as compared to Euthyroidism (EU) and whether thyroxin (T4) treatment in SCH can reverse the change in CIMT. Methods: Two independent reviewers conducted an extensive database research up to December 2016. A total of 12 clinical trials discussed the effect of Thyroxin on CIMT values at pre- and post-treatment in subjects with SCH. Results: CIMT was significantly higher among SCH (n = 280) as compared to EU controls (n = 263) at baseline; the pooled weighted mean difference (WMD) of CIMT was 0.44 mm [95% confidence interval (CI) 0.14, 0.74], p = 0.004; I2 = 65%. After treatment with thyroxin in subjects with SCH (n = 314), there was a statistically significant decrease in CIMT from pre- to post-treatment; the pooled WMD of CIMT decrease was [WMD −0.32; 95% CI (−0.47, −0.16), p = < 0.0001; I2 = 2%], and it was no longer different from EU controls [WMD 0.13 mm; 95% CI (−0.04, 0.30); p = 0.14; I2 = 27%]. The total cholesterol (TC), triglycerides (TG), and low-density lipoprotein (LDL) were higher in SCH as compared to EU controls and decreased significantly after treatment with thyroxin. Conclusion: This meta-analysis shows that thyroxin therapy in subjects with SCH significantly decreases CIMT and improves lipid profile, modifiable CVD risk factors. Thyroid hormone replacement in subjects with SCH may play a role in slowing down or preventing the progression of atherosclerosis. |
| Databáze: | OpenAIRE |
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