title: Changes in arterial stiffness, carotid intima-media thickness, and epicardial fat after L-thyroxine replacement therapy in hypothyroidism.
abstract: OBJECTIVE
  To assess the relationship between primary hypothyroidism and subclinical atherosclerosis and its potential changes with L-thyroxine replacement therapy.
  
  
  METHODS
  A prospective cohort study including 101 patients with primary hypothyroidism and 101 euthyroid patients as controls was conducted from July 2011 to December 2013. Clinical, anthropometrical, biochemical, and ultrasonographic parameters were assessed at baseline and after one year of L-thyroxine replacement therapy.
  
  
  RESULTS
  At baseline, hypothyroid patients had significantly greater values of blood pressure, total cholesterol, VLDL cholesterol, left ventricular mass, epicardial fat, and carotid intima-media thickness as compared to controls. Total cholesterol, VLDL cholesterol, ventricular diastolic function, epicardial fat, carotid intima-media thickness, carotid local pulse wave velocity, pressure strain elastic modulus, and β arterial stiffness index showed a significant and positive correlation with TSH levels. After one year of replacement therapy, patients with hypothyroidism showed changes in total cholesterol, VLDL cholesterol, TSH, carotid intima-media thickness, and arterial stiffness parameters.
  
  
  CONCLUSIONS
  Primary hypothyroidism is characterized by an increased cardiovascular risk. In these patients, L-thyroxine replacement therapy for one year is related to decreased dyslipidemia and improvement in markers of subclinical carotid atherosclerosis.
authors.affiliation: Servicio de Endocrinología, Hospital Miguel Enríquez, La Habana, Cuba.
authors.forename: Abdel
authors.initials: A
authors.lastname: del Busto-Mesa
authors.affiliation: Unidad de Cuidados Coronarios Intensivos, Hospital Manuel Fajardo, La Habana, Cuba. Electronic address: jocabrera@infomed.sld.cu.
authors.forename: Julio Oscar
authors.initials: JO
authors.lastname: Cabrera-Rego
authors.affiliation: Unidad de Cuidados Coronarios Intensivos, Hospital Manuel Fajardo, La Habana, Cuba.
authors.forename: Lisván
authors.initials: L
authors.lastname: Carrero-Fernández
authors.affiliation: Departamento de Bioestadística, Hospital Miguel Enríquez, La Habana, Cuba.
authors.forename: Cristina Victoria
authors.initials: CV
authors.lastname: Hernández-Roca
authors.affiliation: Facultad de Medicina, Hospital Miguel Enríquez, La Habana, Cuba.
authors.forename: Jorge Luis
authors.initials: JL
authors.lastname: González-Valdés
authors.affiliation: Facultad de Medicina, Hospital Miguel Enríquez, La Habana, Cuba.
authors.forename: José Eduardo
authors.initials: JE
authors.lastname: de la Rosa-Pazos
mesh_terms: D000273:Adipose Tissue / Q000473:pathology*; D000328:Adult; D059168:Carotid Intima-Media Thickness; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D007037:Hypothyroidism / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D010496:Pericardium / Q000473:pathology*; D011446:Prospective Studies; D013974:Thyroxine / Q000627:therapeutic use*; D059289:Vascular Stiffness
chemical_list: D013974:Thyroxine
keywords: Arterial stiffness; Carotid intima-media thickness; Epicardial fat; Grasa epicárdica; Grosor íntima-media carotídeo; Hipotiroidismo; Hypothyroidism; Replacement therapy; Rigidez arterial; Tratamiento sustitutivo