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Effects of Thyrotropin on Peripheral Thyroid Hormone Metabolism and Serum Lipids

Effects of Thyrotropin on Peripheral Thyroid Hormone Metabolism and Serum Lipids

Carolien M Beukhof, Elske T Massolt, Theo J Visser, Tim I M Korevaar, Marco Medici, Wouter W de Herder, Jeanine E Roeters van Lennep, Monique T Mulder, Yolanda B de Rijke, Christoph Reiners, Frederik A Verburg, etc.

Thyroid. 2018 Feb;28(2):168-174.

PMID: 29316865

Abstract:

Background:
Subclinical hypothyroidism is associated with dyslipidemia and atherosclerosis. Whether these effects are in part mediated via direct effects of thyrotropin (TSH) on peripheral thyroid hormone (TH) metabolism and/or concentrations of serum lipids is not clear.
Objective:
This study examined whether TSH has direct effects on peripheral TH metabolism and serum lipids.
Methods:
Eighty-two patients with differentiated thyroid cancer were retrospectively analyzed. All patients had undergone total thyroidectomy and 131I remnant ablation. During follow-up, two successive injections of recombinant human TSH (rhTSH) were administered to patients on a stable dose of levothyroxine. In all patients, TSH, thyroxine (T4), free T4 (fT4), triiodothyronine (T3), reverse T3 (rT3), total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, apolipoprotein B, lipoprotein(a), and triglyceride levels were measured immediately before the first and approximately 72 hours after the second injection of rhTSH.
Results:
After rhTSH stimulation, T3 values decreased (from 1.91 to 1.81 nmol/L; p < 0.001). T4, fT4, and rT3 did not change. After rhTSH, median apolipoprotein B increased from 0.90 to 0.92 g/L (p = 0.03), lipoprotein(a) from 0.21 to 0.24 g/L (p < 0.001), and triglycerides from 1.98 to 2.50 mmol/L (p < 0.001). Serum high-density lipoprotein cholesterol decreased from 0.98 to 0.81 mmol/L (p < 0.001). Multiple regression analysis showed that the changes in lipids were most closely associated with the decrease in T3 levels.
Conclusions:
TSH has direct effects on peripheral TH metabolism by decreasing T3 levels in levothyroxine-treated thyroidectomized patients. This decrease in T3 levels is accompanied by unfavorable changes in serum lipids.

Chemicals Related in the Paper:

Catalog Number	Product Name	Structure	CAS Number	Price
IAR4248766	Serum Replacement 2 (50×)			Price

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