Endocrine Abstracts (2009) 20 P92

Autoimmune thyroiditis, Graves' disease and cardiovascular risk factors

Celestino Neves1, Marta Alves1, Luís Miguel Pereira1, Ema Carvalho1, Isolina Pimentel1, Renata Carvalho2, Cristina Guimarães2, João Pedro Ramos2, Davide Carvalho1, José Luís Delgado2 & José Luís Medina1


1Endocrinology Service, Faculty of Medicine, S João Hospital, University of Porto, Porto, Portugal; 2Immunology Service, Faculty of Medicine, S João Hospital, University of Porto, Porto, Portugal.


Aims: To examine whether treated autoimmune thyroiditis (AIT) and Graves’ disease (GD) are associated with increased cardiovascular risk factors.

Patients and methods: We analysed the levels of total cholesterol (TC), HDL, LDL, triglycerides (TG), ApoB, ApoA1, Lp[a], homocysteine, CRP, folic acid and vitamin B12 in 50 patients with GD and in 130 patients with AIT, after normalization of thyroid function. Patients with GD were treated with propylthiouracil until they normalized TSH, FT3 and FT4 levels. Patients with AIT were treated with levothyroxine, in order to normalize FT3, FT4 and TSH levels. Statistical analyses were made with t-Student and with Pearson’s correlation test. A two-tailed P<0.05 was considered significant.

Results: The ApoB levels were significantly higher in patients with AIT than in patients with GD (102.00±21.78 vs 94.73±24.64 mg/dl; P<0.05). The TG levels were also significantly higher in patients with AIT than in patients with GD (0.12±0.77 vs 0.11±0.56 g/l; P<0.05). We found that patients with AIT had significantly higher levels of CRP (0.50±0.60 vs 0.23±0.16 mg/dl; P<0.05), anti-TPO (805.56±587.14 vs 403.18±495.18 UI/ml; P<0.05), and anti-Tg (127.53±116.43 vs 74.64±69.68 UI/ml; P<0.05). In patients with AIT there were positive correlations between TSH and CT (r=0.83, P<0.01), LDL (r=0.75, P<0.01), TG (r=0.76, P<0.01), and ApoB (r=0.56, P<0.01). In patients with GD, HDL negatively correlated with FT3 (r=−0.37, P<0.05), and there were significant correlations between TG and TRAb (antibody against receptor for TSH), (r=0.37, P<0.05).

Conclusions: Even in the euthyroid range, TSH was positively associated with total cholesterol, LDL, Apo B and TG, in this group of patients with autoimmune thyroid disease. These findings suggest a pro-atherogenic pattern associated to the low grade of chronic inflammation in euthyroid patients with autoimmune thyroid disease.