Abstract

In this study, we aimed to evaluate serum irisin and apelin levels in patients with subclinical hypothyroidism (SCH) when they were subclinical hypothyroid and become euthyroid after levothyroxine therapy and association of these adipokines with markers of atherosclerosis such as serum homocysteine levels and carotid intima-media thickness (IMT). The study included 160 patients with newly diagnosed subclinical hypothyroidism due to Hashimoto's thyroiditis and 86 euthyroid healty subjects. Serum glucose and lipid profile, insulin, HOMA, TSH, free T3, free T4, anti-thyroperoxidase and anti-thyroglobulin antibodies, homocysteine, apelin and irisin levels were measured in all study subjects. Thyroid and carotid ultrasound examinations were performed. The subclinical hypothyroid group was reevaluated after 12-weeks of levothyroxine therapy when they became euthyroid. Clinical characteristics of the patient and control group were similar. Glucose, insulin and HOMA levels, lipid parameters and free T3 were similar between the two groups.. Serum homocystein was higher and apelin was lower in patients with SCH, but irisin levels were similar between the two groups. While thyroid volume was lower, carotid IMT was significantly greater in patients with SCH (pCarotidIMT:0,01). After 12-weeks of levothyroxine therapy, all the studied parameters remained unchanged except, serum freeT4, TSH, homocystein and apelin. While homocystein decreased (p: 0,001), apelin increased significantly (p = 0,049). In multivariate analysis, low apelin levels significantly contributed to carotid IMT (p = 0,041). Apelin-APJ system may play a role in vascular and cardiac dysfunction in patients with SCH and treatment of this condition may improve the risk of cardiovascular disease.

Highlights

  • Subclinical hypothyroidism (SCH) is defined by elevated serum levels of TSH, with normal levels of free T3 and T4

  • We aimed to investigate the correlation of these adipokines with surrogate markers of atherosclerosis such as serum homocysteine levels and carotid intimamedia thickness (IMT)

  • Insulin levels, Homeostasis model assessment (HOMA) values, lipid parameters and free T3 were similar between the 2 groups (Table 2)

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Summary

Introduction

Subclinical hypothyroidism (SCH) is defined by elevated serum levels of TSH, with normal levels of free T3 and T4. In this study, we aimed to investigate serum irisin and apelin levels – which were reported to be associated with increased cardiometabolic risk – in patients with SCH and the effect of levothyroxine therapy on these adipokines. Insulin levels, HOMA values, lipid parameters and free T3 were similar between the 2 groups (Table 2).

Results
Conclusion
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