Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2011) 26 P405

ECE2011 Poster Presentations Thyroid (non cancer) (78 abstracts)

Awareness of secondary hypothyroidism in GH deficient hypopituitary adults has improved their lipid status

M-L Hartoft-Nielsen 1 , M Klose 1 , O Klefter 1 , V Gavan 2 , Æ K Rasmussen 1 & U Feldt-Rasmussen 1


1Department of Endocrinology, Rigshospitalet, University Hospital of Copenhagen, PE-2131 Copenhagen, Denmark; 2Department of Thyroid Related Disorders, National Institute of Endocrinology ‘C.I. Parhon’, Bucharest, Romania.


Introduction: To evaluate if improved thyroid status in patients with hypopituitarism would improve cardiovascular risk markers.

Patients and methods: A total of 85 hypopituitary patients (45 women) with GH deficiency; 7 had isolated GH deficiency, 25, 16 and 22 patients had 1, 2 and 3 additional deficits respectively. Fifteen patients had panhypopituitarism. Biochemical and body composition assessment was performed at baseline (when patients were GH naïve), and at follow-up (median 4.7 years (3.0–5.5) after initiation of GH replacement). Patients were divided into TSH sufficient (TSHsuff) (not on levothyroxine and free T4 >12 (n=23)), and TSH deficient (TSHdef), that were further divided into tertiles according to baseline free T4.

Results: Baseline free T4 was negatively associated to BMI (P=0.003) and total fat mass (P=0.01). TSHdef patients with lowest tertile free T4 had higher total (P=0.01) and LDL cholesterol (P=0.05) and triglycerides (P<0.01) compared to TSHsuff patients, also after adjustment for gender, age, BMI and IGF1. At follow-up 9 patients initially defined as TSHsuff had initiated levothyroxine treatment. 53 and 28% of patients with free T4 from the low and median tertiles respectively, received an increased levothyroxine dose compared to baseline, whereas 40% of patients with free T4 from the median/high tertile groups had had a dose reduction. None recovered from TSHdef. Free T4 at follow-up was not significantly correlated to body-composition or cholesterol variables, nor were there any group differences comparing patients in the four groups according to TSH and free T4. Delta free T4 (follow-up−baseline) was negatively correlated to delta total cholesterol (r=−0.23; P=0.06) and LDL cholesterol (r=−0.30; P=0.01) and remained so after adjustment for the change in IGF1 (P=0.02).

Conclusion: After ~5 years of GH replacement also the secondary hypothyroidism was better adjusted with an improvement of the lipids of a higher magnitude than seen after GH replacement alone.

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