Thyroid Antibody Titers and Hypothalamic-Pituitary-Thyroid Axis Activity in Levothyroxine-Treated Women With Autoimmune Subclinical Hypothyroidism Receiving Atorvastatin or Metformin. 2022

Robert Krysiak, and Karolina Kowalcze, and Bogusław Okopień
Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.

Both metformin and statins reduce thyroid antibody titers in individuals with Hashimoto thyroiditis. The present study compared the impact of low-grade systemic inflammation and insulin resistance on levothyroxine action in subjects with this disorder. The study included 3 groups of women with autoimmune subclinical hypothyroidism matched for thyroid antibody titers and hormone levels: patients receiving atorvastatin (group A) or metformin (group B) and statin- and metformin-naïve women (group C). Over the entire study period (6 months), all individuals received levothyroxine. Titers of thyroid antibodies, as well as concentrations of thyrotropin, free thyroid hormones, prolactin, lipids, glucose, insulin, high-sensitivity C-reactive protein (hsCRP), and 25-hydroxyvitamin D were assessed at baseline and 6 months later. At baseline, the study groups differed in plasma lipids, insulin sensitivity, and hsCRP. In all groups of patients, levothyroxine decreased thyroid antibody titers, reduced thyrotropin levels and increased free thyroid hormone levels. Treatment-induced changes in antibody titers and free thyroid hormone levels were strongest in group A, while the changes in thyrotropin were most pronounced in group B. The decrease in antibody titers correlated to a greater degree with hsCRP levels than with insulin sensitivity. The obtained results suggest that low-grade systemic inflammation is a more important factor determining the impact of levothyroxine on thyroid autoimmunity and thyroid hormone levels than insulin resistance.

UI MeSH Term Description Entries
D007037 Hypothyroidism A syndrome that results from abnormally low secretion of THYROID HORMONES from the THYROID GLAND, leading to a decrease in BASAL METABOLIC RATE. In its most severe form, there is accumulation of MUCOPOLYSACCHARIDES in the SKIN and EDEMA, known as MYXEDEMA. It may be primary or secondary due to other pituitary disease, or hypothalamic dysfunction. Central Hypothyroidism,Primary Hypothyroidism,Secondary Hypothyroidism,TSH Deficiency,Thyroid-Stimulating Hormone Deficiency,Central Hypothyroidisms,Deficiency, TSH,Deficiency, Thyroid-Stimulating Hormone,Hormone Deficiency, Thyroid-Stimulating,Hypothyroidism, Central,Hypothyroidism, Primary,Hypothyroidism, Secondary,Hypothyroidisms,Primary Hypothyroidisms,Secondary Hypothyroidisms,TSH Deficiencies,Thyroid Stimulating Hormone Deficiency,Thyroid-Stimulating Hormone Deficiencies
D007249 Inflammation A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. Innate Inflammatory Response,Inflammations,Inflammatory Response, Innate,Innate Inflammatory Responses
D007333 Insulin Resistance Diminished effectiveness of INSULIN in lowering blood sugar levels: requiring the use of 200 units or more of insulin per day to prevent HYPERGLYCEMIA or KETOSIS. Insulin Sensitivity,Resistance, Insulin,Sensitivity, Insulin
D008687 Metformin A biguanide hypoglycemic agent used in the treatment of non-insulin-dependent diabetes mellitus not responding to dietary modification. Metformin improves glycemic control by improving insulin sensitivity and decreasing intestinal absorption of glucose. (From Martindale, The Extra Pharmacopoeia, 30th ed, p289) Dimethylguanylguanidine,Dimethylbiguanidine,Glucophage,Metformin HCl,Metformin Hydrochloride,HCl, Metformin,Hydrochloride, Metformin
D002097 C-Reactive Protein A plasma protein that circulates in increased amounts during inflammation and after tissue damage. C-Reactive Protein measured by more sensitive methods often for coronary heart disease risk assessment is referred to as High Sensitivity C-Reactive Protein (hs-CRP). High Sensitivity C-Reactive Protein,hs-CRP,hsCRP,C Reactive Protein,High Sensitivity C Reactive Protein
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000069059 Atorvastatin A pyrrole and heptanoic acid derivative, HYDROXYMETHYLGLUTARYL-COA REDUCTASE INHIBITOR (statin), and ANTICHOLESTEREMIC AGENT that is used to reduce serum levels of LDL-CHOLESTEROL; APOLIPOPROTEIN B; and TRIGLYCERIDES. It is used to increase serum levels of HDL-CHOLESTEROL in the treatment of HYPERLIPIDEMIAS, and for the prevention of CARDIOVASCULAR DISEASES in patients with multiple risk factors. (3R,5R)-7-(2-(4-Fluorophenyl)-5-isopropyl-3-phenyl-4-(phenylcarbamoyl)-1H-pyrrol-1-yl)-3,5-dihydroxyheptanoic acid,Atorvastatin Calcium,Atorvastatin Calcium Anhydrous,Atorvastatin Calcium Hydrate,Atorvastatin Calcium Trihydrate,Atorvastatin, Calcium Salt,CI 981,CI-981,Lipitor,Liptonorm,CI981
D013963 Thyroid Hormones Natural hormones secreted by the THYROID GLAND, such as THYROXINE, and their synthetic analogs. Thyroid Hormone,Hormone, Thyroid,Hormones, Thyroid
D013972 Thyrotropin A glycoprotein hormone secreted by the adenohypophysis (PITUITARY GLAND, ANTERIOR). Thyrotropin stimulates THYROID GLAND by increasing the iodide transport, synthesis and release of thyroid hormones (THYROXINE and TRIIODOTHYRONINE). Thyrotropin consists of two noncovalently linked subunits, alpha and beta. Within a species, the alpha subunit is common in the pituitary glycoprotein hormones (TSH; LUTEINIZING HORMONE and FSH), but the beta subunit is unique and confers its biological specificity. Thyroid-Stimulating Hormone,TSH (Thyroid Stimulating Hormone),Thyreotropin,Thyrotrophin,Hormone, Thyroid-Stimulating,Thyroid Stimulating Hormone

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