title: Effects of L-thyroxine treatment on early markers of atherosclerotic disease in children with subclinical hypothyroidism.
abstract: OBJECTIVE
  To investigate the effect of levothyroxine (L-T4) treatment on early markers of atherosclerotic disease in children with mild idiopathic subclinical hypothyroidism (SH).
  
  
  METHODS
  Two-year, open, case-control prospective study.
  
  
  METHODS
  A total of 39 children, aged 9.18±3.56 years, with SH and 39 healthy controls were enrolled in the study. Waist-to-height ratio (WHtR), blood pressure, triglycerides, total cholesterol (total-C), HDL-C, LDL-C, non-HDL-C, triglycerides/HDL-C, atherogenic index (AI), homocysteine (Hcy), asymmetric dimethylarginine (ADMA), flow-mediated dilation (FMD) and intima-media thickness (IMT) were evaluated at baseline and after 2 years of L-T4 treatment in SH children and after 2 years of follow-up in controls.
  
  
  RESULTS
  At study entry WHtR was higher in SH subjects compared with controls (0.56±0.08 vs 0.49±0.07, P=0.04) and significantly decreased after 2 years of treatment (0.50±0.06, P<0.0001). Mean HDL-C levels (50.47±11.43 vs 61.06±13.83mg/dL, P=0.002) were lower, while triglycerides/HDL-C (1.63±1.07 vs 1.19±0.69, P=0.05), AI (3.32±0.90 vs 2.78±0.68, P=0.005), and Hcy (9.35±2.61 vs 7.71±1.94μmol/L, P=0.01) were higher in SH subjects compared with controls and improved after 2 years of treatment (HDL-C 56.26±13.76mg/dL, P<0.0001; triglycerides/HDL-C 1.23±0.78, P=0.006; AI 2.82±0.68, P<0.0001; and Hcy 8.25±2.09μmol/L, P=0.06). ADMA concentrations at baseline were higher in SH subjects compared with controls (0.77±0.21 vs 0.60±0.16μmol/L, P=0.001) and decreased after therapy (0.58±0.13μmol/L, P<0.0001). FMD, IMT and other metabolic parameters were not different among SH subjects and controls at baseline and after 2 years.
  
  
  CONCLUSIONS
  Children with SH may have subtle pro-atherogenic abnormalities. Although L-T4 treatment exerts some beneficial effects, the long-term impact of therapy on metabolic outcomes in SH children still remains unclear.
authors.affiliation: Pediatric Endocrinology UnitDepartment of Translational Medical Sciences, University "Federico II" of Naples, Naples, Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Cerbone
authors.affiliation: Pediatric Endocrinology UnitDepartment of Translational Medical Sciences, University "Federico II" of Naples, Naples, Italy.
authors.forename: Donatella
authors.initials: D
authors.lastname: Capalbo
authors.affiliation: Department of Pediatric, Gynecological, Microbiological and Biomedical SciencesUniversity of Messina, Messina, Italy.
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Wasniewska
authors.affiliation: Pediatric Endocrinology UnitDepartment of Translational Medical Sciences, University "Federico II" of Naples, Naples, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Alfano
authors.affiliation: Department of PharmacyUniversity "Federico II" of Naples, Naples, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Mattace Raso
authors.affiliation: Internal Medicine SectionDepartment of Translational Medical Sciences, University "Federico II" of Naples, Naples, Italy.
authors.forename: Ugo
authors.initials: U
authors.lastname: Oliviero
authors.affiliation: Internal Medicine SectionDepartment of Translational Medical Sciences, University "Federico II" of Naples, Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cittadini
authors.affiliation: Department of Pediatric, Gynecological, Microbiological and Biomedical SciencesUniversity of Messina, Messina, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: De Luca
authors.affiliation: Pediatric Endocrinology UnitDepartment of Translational Medical Sciences, University "Federico II" of Naples, Naples, Italy salerno@unina.it.
authors.forename: Mariacarolina
authors.initials: M
authors.lastname: Salerno
mesh_terms: D000293:Adolescent; D050197:Atherosclerosis / Q000097:blood / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure / Q000502:physiology; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D002648:Child; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000097:blood / Q000188:drug therapy*; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D013974:Thyroxine / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D008078:Cholesterol, LDL; D013974:Thyroxine