title: Increased serum chitotriosidase activity following restoration of euthyroidism in patients with subclinical hypothyroidism.
abstract: OBJECTIVE
  Whether to treat subclinical hypothyroidism (SH) remains controversial. Serum chitotriosidase activity, a marker of activated macrophages, predicts new cardiovascular events. Chitotriosidase activity (ChT) is a new cardiovascular risk marker and is independent of C-reactive protein. The purpose of this study was to determine ChT levels in SH and to examine the effect of levothyroxine replacement on ChT.
  
  
  METHODS
  A cohort of 60 patients with subclinical hypothyroidism and 62 healthy controls were enrolled in this study. Serum total and LDL cholesterol, total homocysteine (t-Hyc), highly sensitive C-reactive protein (hsCRP) levels and serum ChT in patients with subclinical hypothyroidism at baseline and after achieving euthyroid state by levothyroxine were assessed.
  
  
  RESULTS
  Pretreatment levels of TSH (10.06+/-5.09 vs. 2.08+/-0.95 mIU/L, p<0.05), and free T4 (0.94+/-0.21 vs. 1.35+/-0.26 ng/dl, p<0.05) were significantly higher than controls while total cholesterol, LDL cholesterol, t-Hyc, ChT and hsCRP levels were not different. ChT levels significantly increased after replacement therapy (137.2+/-14.18 vs. 156.88+/-13.10 nmol/mL/h, p<0.05). T-Hyc and hsCRP levels were not significantly different after treatment with levothyroxine therapy even in this subgroup of patients. None of the other biochemical risk factors improved after euthyroidism in patients with SH with average dose of 85+/-30 mug/day when compared to pretreatment levels.
  
  
  CONCLUSIONS
  We conclude that clinical management of subclinical hypothyroidism does not decrease the serum hsCRP or t-Hyc levels but does increase the serum ChT levels. The clinical significance of this increment should be studied in further studies.
authors.affiliation: Department of Family Medicine Gulhane School of Medicine, Etlik, Ankara, Turkey.
authors.forename: Muhammed
authors.initials: M
authors.lastname: Erdal
authors.forename: Mustafa
authors.initials: M
authors.lastname: Sahin
authors.forename: Kenan
authors.initials: K
authors.lastname: Saglam
authors.forename: Adnan
authors.initials: A
authors.lastname: Hasimi
authors.forename: Gokhan
authors.initials: G
authors.lastname: Uckaya
authors.forename: Mustafa Yalcin
authors.initials: MY
authors.lastname: Yarpuz
authors.forename: Abdullah
authors.initials: A
authors.lastname: Taslipinar
authors.forename: Hossein
authors.initials: H
authors.lastname: Gharib
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kutlu
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000097:blood; D005260:Female; D006596:Hexosaminidases / Q000097:blood* / Q000187:drug effects; D020249:Hormone Replacement Therapy; D006801:Humans; D007037:Hypothyroidism / Q000188:drug therapy* / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013974:Thyroxine / Q000009:adverse effects*
chemical_list: D015415:Biomarkers; D006596:Hexosaminidases; C086400:chitotriosidase; D013974:Thyroxine