Lipid profile in patients with hypothyroidism

Hipotireoza je čest metabolički poremećaj u općoj populaciji. Češća je u žena, a prevalencija raste s dobi. Karakterizira ju niska razina T4 i T3 te visoka razina TSH u krvi. Kako hormoni štitnjače reguliraju brojne metaboličke procese u organizmu, hipotireoza je udružena s brojnim metaboličkim abnormalnostima. Pacijenti s hipotireozom često imaju dislipidemiju s povišenim vrijednostima ukupnog kolesterola i LDL-kolesterola. Lipidne abnormalnosti u hipotireozi predisponiraju razvoju ateroskleroze. Metabolički poremećaji i hemodinamske promjene udružene s hipotireozom dodatno povećavaju rizik za kardiovaskularne bolesti. Nadomjesna terapija levotiroksinom značajno poboljšava lipidni status. U pacijenata s dislipidemijom je često prisutna hipotireoza. Stoga je u pacijenata s dislipidemijom, prije započinjanja terapije antihiperlipemicima, potrebno procijeniti funkciju štitnjače. Najprije treba korigirati hipotireozu levotiroksinom, tek nakon toga dolazi u obzir terapija antihiperlipemicima.Hypothyroidism is a common metabolic disorder in the general population. Thyroid failure is more common in women and its prevalence rises with age. Hypothyroidism is characterised by low serum T4 and T3 levels and high TSH levels. Thyroid disease is associated with various metabolic abnormalities, due to the effects of thyroid hormones on nearly all major metabolic pathways. Dyslipidaemia is a common finding in patients with hypothyroidism, consisting of high levels of total and LDL cholesterol. Lipid abnormalities associated with hypothyroidism predispose to the development of atherosclerotic disease. Coexisting metabolic abnormalities in thyroid disease in combination with the thyroid hormone-induced hemodynamic alterations further contribute to increasing cardiovascular disease risk. Administration of substitution therapy with L-thyroxin significantly improves lipid metabolism abnormalities. The presence of overt hypothyroidism in patients with dyslipidaemia is not rare. Therefore, before starting hypolipidemic therapy, the evaluation of thyroid function is needed. It is imperative to firstly correct thyroid disfunction with thyroxine substitution therapy and then treat the underlying dyslipidaemia with statins