title: Association of Subclinical Hypothyroidism with Dyslipidemia and Increased Carotid Intima-Media Thickness in Children.
abstract: OBJECTIVE
  Subclinical hypothyroidism (SH) is defined as an elevated serum thyroid-stimulating hormone (TSH) level with free thyroxine (fT4) level in the normal range. There are very few studies in the literature reporting on the effect of SH on lipid metabolism and carotid intima-media thickness (CIMT) in children.
  
  
  METHODS
  The study included 38 children diagnosed with SH and a control group comprising 38 healthy, euthyroid children. SH was diagnosed based on an elevated TSH level (4.2-20 mIU/L) and normal fT4 level measured in two morning fasting blood samples obtained at an interval of 2 to 6 weeks. Blood samples were collected by venipuncture in the morning after an overnight fast.
  
  
  RESULTS
  The patient group included 38 children (16 male, 22 female) with SH and the control group -38 healthy, euthyroid children (20 male, 18 female). Mean age was 8.1±3.6 (range, 3.5-15) years in the patient group and 8.9±2.4 (range, 4.5-15) years in the control group. In the patient group, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), TC/high-density lipoprotein cholesterol (HDL-C), and LDL-C/HDL-C were higher compared to the control group (p=0.049, p=0.014, p=0.002, and 0.003, respectively). In the patient group, CIMT was also significantly higher compared to the control group (p=0.001). The patient group was further divided into two subgroups based on their serum TSH level: (I) patients with mildly elevated TSH (TSH=4.2±10 mIU/L) (n=33) and (II) patients with high TSH (TSH≥10 mIU/L) (n=5). However, no significant difference was found between the patients with mild and severe SH with regard to TC, LDL-C, HDL-C, triglyceride level and CIMT levels (p=0.635, p=0.424, p=0.310, p=0.342, and 0.610, respectively).
  
  
  CONCLUSIONS
  Subclinical hypothyroidism leads to increased dyslipidemia (increased TC and LDL) and increased CIMT, which leads to increased risk of cardiovascular disease. Further studies are needed to substantiate these findings in children with SH.
authors.affiliation: Dicle University Faculty of Medicine, Department of Pediatric Endocrinology, Diyarbakır, Turkey, Phone: +90 412 248 80 01 E-mail: edip76@yahoo.com.
authors.forename: Edip
authors.initials: E
authors.lastname: Unal
authors.forename: Alper
authors.initials: A
authors.lastname: Akın
authors.forename: Ruken
authors.initials: R
authors.lastname: Yıldırım
authors.forename: Vasfiye
authors.initials: V
authors.lastname: Demir
authors.forename: İsmail
authors.initials: İ
authors.lastname: Yildiz
authors.forename: Yusuf Kenan
authors.initials: YK
authors.lastname: Haspolat
mesh_terms: D000293:Adolescent; D002318:Cardiovascular Diseases / Q000097:blood*; D059168:Carotid Intima-Media Thickness; D002648:Child; D002675:Child, Preschool; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D050171:Dyslipidemias / Q000097:blood*; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000097:blood*; D008297:Male; D012307:Risk Factors; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D013972:Thyrotropin; D002784:Cholesterol; D013974:Thyroxine
keywords: Subclinical hypothyroidism; carotid intima-media thickness; dyslipidemia childhood.