Metabolic Changes after Radioiodine Correction of Grade 1 and Grade 2 Subclinical Hyperthyroidism

Abstract

<b><i>Objective:</i></b> Endogenous subclinical hyperthyroidism (eSCH) is defined by subnormal serum thyroid-stimulating hormone (TSH) level. There is limited evidence of metabolic changes induced by eSCH. The aim of our work was to evaluate changes in BMI and lipid parameters after radioiodine treatment in patients with grade 1 (TSH: 0.1–0.39 mlU/L) and 2 (TSH <0.1 mlU/L) eSCH. <b><i>Design:</i></b> A retrospective study was performed on 74 patients with eSCH caused by benign autonomous nodular goiter which was treated with radioiodine. <b><i>Methods:</i></b> We assessed BMI, lipids parameters, and TSH after radioiodine therapy. The 12-month follow-up time point was used to compare the primary outcome variables. TSH was measured by the electrochemiluminescence method. <b><i>Results:</i></b> After radioiodine therapy, the absolute and relative increases in BMI at 12 months were significantly higher in the grade 2 group than in the grade 1 group (1.07 ± 0.27 kg/m<sup>2</sup> vs. 0.26 ± 0.15 kg/m<sup>2</sup>, respectively; <i>p</i> = 0.023 and 4.01 ± 0.98% vs. 1.01 ± 0.56%, respectively; <i>p</i> = 0.026). Compared to baseline, significant increases in the levels of total cholesterol and LDL were observed after treatment in the grade 2 eSCH group (16.7 ± 4.5 mg/dL <i>p</i> < 0.01 and 14.3 ± 4.1 mg/dL <i>p</i> < 0.01, respectively) but not in the grade 1 group. In a multivariate model, a negative correlation was observed between pretreatment TSH levels and absolute BMI gain (<i>p</i> < 0.01). <b><i>Conclusions:</i></b> After correction of eSCH, increases in BMI and LDL levels were observed only in patients with grade 2 eSCH. Pretreatment serum TSH was the main independent factor associated with BMI changes after radioiodine treatment.

Lipoprotein alterations in endocrine disorders - a review of the recent developments in the field

“…However, the impact of subclinical hyperthyroidism treatment on lipid metabolism is uncertain. According to recent studies, definitive subclinical hyperthyroidism therapy is associated foremost with an increase in LDL-C, while the effect on other lipoproteins remains small or uncertain ( 16 , 17 ). Still, the increase in LDL-C, which is a significant atherosclerosis factor, should make clinicians vigilant of the need for lipid profile check-ups in such patients.…”