title: Highly-sensitive C-reactive protein, a biomarker of cardiovascular disease risk, in radically-treated differentiated thyroid carcinoma patients after repeated thyroid hormone withholding.
abstract: OBJECTIVE
  In patients radically treated for differentiated thyroid carcinoma, we assessed the response of highly-sensitive C-reactive protein, an inflammatory biomarker for cardiovascular risk, after thyroid hormone withholding ("deprivation"), as well as factors potentially influencing this response.
  
  
  METHODS
  We included 52 adults (mean age 45.6±14.0 years, 35 females) who were disease-free after total thyroidectomy, radioiodine ablation and chronic thyroid hormone therapy. They were lifelong non-smokers without apparent inflammatory comorbidity, cardiovascular history beyond pharmacotherapy-controlled hypertension, anti-dyslipidemic medication, or C-reactive protein >10 mg/L in any study measurement. The index deprivation lasted ≥2 weeks, elevating serum thyrotropin >40 mIU/L or ≥100 × the individual's suppressed level. We examined the relationship of age, number of prior deprivations, and gender with the magnitude of post-deprivation C-reactive protein concentration through multivariable statistical analyses using the F test on linear regression models.
  
  
  RESULTS
  Post-deprivation, C-reactive protein reached intermediate cardiovascular risk levels (based on general population studies involving chronic elevation), 1-3 mg/L, in 44.2% of patients and high-risk levels, >3 mg/L, in another 17.3%. Mean C-reactive protein was 1.77±1.50 mg/L, differing significantly in females (2.12±1.66 mg/L) vs. males (1.05±0.69 mg/L, P <0.001). In multivariable analysis, patients ≤45 years old (odds ratio, 95% confidence interval 0.164 [0.049-0.548]) were less likely, and females, more likely (3.571 [1.062-12.009]) to have post-deprivation C-reactive protein ≥1 mg/L.
  
  
  CONCLUSIONS
  Thyroid hormone withdrawal frequently elevated C-reactive protein to levels that when present chronically, were associated with increased cardiovascular risk in general population studies.
authors: University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, România.
authors: A
authors: A
authors: Piciu
authors: D
authors: D
authors: Piciu
authors: R J
authors: RJ
authors: Marlowe
authors: A
authors: A
authors: Irimie
mesh_terms: D000328:Adult; D000367:Age Factors; D013956:Antithyroid Agents / Q000009:adverse effects / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D002277:Carcinoma / Q000097:blood* / Q000276:immunology / Q000473:pathology / Q000628:therapy; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology; D002471:Cell Transformation, Neoplastic / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D020249:Hormone Replacement Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012306:Risk; D012383:Romania / Q000453:epidemiology; D013961:Thyroid Gland / Q000187:drug effects / Q000276:immunology / Q000473:pathology / Q000601:surgery; D013963:Thyroid Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D013964:Thyroid Neoplasms / Q000097:blood* / Q000276:immunology / Q000473:pathology / Q000628:therapy; D013965:Thyroidectomy / Q000009:adverse effects
chemical_list: D013956:Antithyroid Agents; D015415:Biomarkers; D013963:Thyroid Hormones; D002097:C-Reactive Protein