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Thyroid, Lipids, and Risk of Atherosclerosis

  • Gabriela Brenta
  • Laura Schreier
Chapter
  • 32 Downloads

Abstract

Lipoprotein metabolism is largely recognized as a target of thyroid hormone (TH) action which includes both synthesis and degradation of lipids. Furthermore, thyrotropin (TSH) through novel extrathyroidal effects can also increase cholesterol synthesis and lower hepatic excretion of bile acids.

Depending on the level of TH, balance will be tilted toward an excess in catabolism that occurs in thyrotoxicosis or lipid accumulation due to lower catabolism as in hypothyroidism.

Overt hypothyroidism is associated with atherosclerosis, and secondary dyslipidemia is in great part responsible for this. The consequences of subclinical hypothyroidism (ScH) as shown in different studies are milder and may reflect normal or mildly increased cholesterol levels.

Although elevated total and LDL cholesterol (C) levels describe the main lipoprotein alteration in hypothyroidism, VLDL accumulation and its atherogenic remnants, known as RLP, are also accumulated in circulation, both in overt and ScH.

Levothyroxine replacement can reverse the lipid alterations described in hypothyroid patients, but the degree of restoration to normal will depend upon the severity of the thyroid deficit.

In this chapter, the regulation by TH on the lipoprotein metabolism will be described together with the changes associated with both overt and ScH. Evidence from both the available observational and intervention studies will be described together with data on possible thyromimetics devoided of the undesired thyroid action in the heart.

Keywords

Lipoproteins Hypercholesterolemia Triglycerides Hypothyroidism Hyperthyroidism 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Gabriela Brenta
    • 1
  • Laura Schreier
    • 2
  1. 1.Unidad Asistencial Dr. César Milstein/PAMI-INSSJPBuenos AiresArgentina
  2. 2.Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Laboratorio de Lípidos y AterosclerosisUniversidad de Buenos AiresBuenos AiresArgentina

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