Metformin induces a reduction in TSH levels both in overt and in subclinical hypothyroidism. In contrast, no change in TSH levels is found in euthyroid patients.

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CS is significantly associated with markers of subclinical atherosclerosis and CV risk. These findings could help establish more specific CV prevention strategies in this clinical setting. Key messages A series of studies reported an increased cardiovascular risk in patients with Cushing's syndrome (CS). In the present meta-analysis we demonstrated that CS is associated with an increased intima-media thickness, higher prevalence of carotid plaques, and lower flow-mediated dilation as compared with controls. These data consistently suggest the need for a strict monitoring of early signs of subclinical atherosclerosis in CS patients.

Background: In addition to the well known role played on lactation and parturition, Oxytocin (OT) and OT receptor (OTR) are involved in many other aspects such as the control of maternal and social behavior, the regulation of the growth of the neocortex, the maintenance of blood supply to the cortex, the stimulation of limbic olfactory area to mother-infant recognition bond, and the modulation of the autonomic nervous system via vagal pathway. Moreover, OT and OTR show anti-inflammatory, anti-oxidant, anti-pain, antidiabetic, anti-dyslipidemic and anti-atherogenic effects. Objective: The aim of this narrative review is to summarize the main data coming from the literature dealing with the role of OT and OTR in physiology and pathologic conditions focusing on the most relevant aspects. Methods: Appropriate keywords and MeSH terms were identified and searched in Pubmed. Finally, references of original articles and reviews were examined. Results: We report the most significant and updated data about the role played by OT and OTR in physiology and in different clinical context. Conclusion: Emerging evidence indicates the involvement of OT system in several pathophysiological mechanisms influencing brain anatomy, cognition, language, sense of safety and trust and maternal behavior, with a possible use of exogenous administered OT in the treatment of specific neuro-psychiatric conditions. Furthermore, it modulates pancreatic β-cell responsiveness and lipid metabolism leading to possible therapeutic use in diabetic and dyslipidemic patients and for limiting and even reversing atherosclerotic lesions.

Context: Subclinical hypothyroidism (SH) is associated with some abnormalities in primary and secondary haemostasis.Objective: To evaluate changes in primary and secondary haemostasis induced by Levothyroxine (L-T4) treatment in SH patients.Design: Prospective cohort study with a 6-months follow-up.Study Setting: Outpatients referred to "Federico II" University of Naples.Patients: Subjects with a SH without previous/ongoing L-T4 therapy. Main OutcomeMeasure: Changes in major haemostatic/fibrinolytic variables and platelet reactivity (mean platelet volume [MPV], arachidonic acid [AA] or adenosinediphosphate [ADP] concentrations inducing a Ն50% irreversible aggregation [AC-50%]) in SH patients before and after a 6-month L-T4 treatment. Results: At baseline, 41 SH patients showed higher levels of FVII activity (123.9Ϯ20.4 vs 107.7Ϯ12.2, pϽ0.001), PAI-1 (33.6Ϯ13.9 vs 22.5Ϯ5.74, pϽ0.001) and t-PA (5.56Ϯ2.22 vs 4.75Ϯ1.61, pϭ0.010), with lower levels of D-Dimer (220.3Ϯ67.1 vs 252.1Ϯ72.4, pϭ0.017) compared with healthy controls.SH patients also showed a higher MPV (9.92Ϯ1.15 vs 8.9Ϯ0.9, pϽ0.001) and AC-50% to AA (0.18Ϯ0.12 vs 0.36Ϯ0.10, pϽ0.001) and to ADP (1.5Ϯ0.6 vs 1.9Ϯ1.3, pϭ0.024). After a 6-month L-T4 therapy, a reduction of FVII activity (from 123.9Ϯ20.4 to 102.6Ϯ14.3, pϽ0.001), PAI-1 (33.6Ϯ13.9 to 19.4Ϯ7.6, pϽ0.001) and t-PA (5.56Ϯ2.22 to 1.91Ϯ4:43, pϭ0.002) was found in SH subjects, with a marginal increase in D-Dimer (from 220.3Ϯ67.1 to 245.2Ϯ103.1, pϭ0.053). AC-50% to AA (from 0.18Ϯ0.12 to 0.54Ϯ0.3, pϽ0.001) and to ADP (from 1.5Ϯ0.6 to 1.86Ϯ0.3, pϭ0.042) were reduced, paralleled by a significant reduction of MPV (from 9.92Ϯ1.15 to 9.10Ϯ1.23, pϭ0.016).Conclusions: SH patients exhibit a pro-thrombotic status which is reverted by a 6-month L-T4 treatment.