Reversible morbidity markers in subclinical hypothyroidism

Hennessey, James V.; Espaillat, Ramon

doi:10.1080/00325481.2015.998158

Cited by 7 publications

(3 citation statements)

References 84 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We also observed no relationship between SCH and depression in older patients. A probable interpretation of this disparity could be the over-diagnosis of SCH among the elderly due to the lack of age-associated serum TSH reference ranges in the original studies included in the meta-analysis 32 . Indeed, movement of the serum TSH distribution curve to higher levels during ordinary ageing may result in misclassification of older patients as suffering from SCH 33 , 34 .…”

Section: Discussionmentioning

confidence: 99%

Subclinical hypothyroidism and depression: a meta-analysis

et al. 2018

View full text Add to dashboard Cite

The objective of this study was to evaluate the relationship between subclinical hypothyroidism (SCH) and depression. We also analysed the effect of levothyroxine (L-T4) on depression in SCH patients. We found an insignificant difference for the composite endpoint: standard mean difference (SMD) of 0.23 (95% confidence interval (CI) −0.03, 0.48, P = 0.08, I2 = 73.6%). The odds ratio (OR) for depressive patients was 1.75 (95% CI 0.97, 3.17 P = 0.064, I2 = 64.6%). Furthermore, sub-group analysis according to age found that SCH was related to depression in younger patients (<60 years old), as defined by the diagnosis of depression: OR of 3.8 (95% CI 1.02, 14.18, P = 0.047, I2 = 0.0%) or an increase on the depressive scale: SMD of 0.42 (95% CI 0.03, 0.82, P = 0.036, I2 = 66.6%). Meanwhile, SCH did not associate with depression in older patients (≥60 years old), as defined by the diagnosis of depression: OR of 1.53 (95% CI 0.81, 2.90, P = 0.193, I2 = 71.3%) or an increase on the depressive scale: SMD of 0.03 (95%CI −0.31, 0.37, P = 0.857, I2 = 79.8%). We also found an insignificant difference in the composite endpoint between the L-T4 supplementation group and placebo group in SCH patients. The estimated SMD was 0.26 (95% CI −0.09, 0.62, P = 0.143, I2 = 52.9%). This meta-analysis demonstrates that SCH is not connected to depression. However, sub-group analysis according to age found that SCH is related to depression in younger patients, but not in older patients. Furthermore, we failed to find an effect of L-T4 supplementation treatment for SCH on depression.

show abstract

Section: Discussionmentioning

confidence: 99%

Subclinical hypothyroidism and depression: a meta-analysis

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Because SCH has an obviously adverse impact on cardiovascular function, it has been proposed that restoring TSH level to the normal range through LT4 therapy may reverse its negative impact on cardiovascular function ( 5 , 9 , 66 ). Some studies have shown that certain risk factors of cardiovascular disease can be reversed by LT4 therapy among SCH patients ( 65 , 67 ). Though a meta-analysis published in 2007 concluded that LT4 therapy was not effective in decreasing cardiovascular morbidity in SCH patients ( 68 ), several recent studies found that LT4 therapy could reverse some detrimental impacts caused by SCH ( 21 , 22 , 69 , 70 ).…”

Section: Discussionmentioning

confidence: 99%

Effect of Levothyroxine on Blood Pressure in Patients With Subclinical Hypothyroidism: A Systematic Review and Meta-Analysis

Zhang

et al. 2018

Front. Endocrinol.

View full text Add to dashboard Cite

Background: Patients with subclinical hypothyroidism (SCH) have elevated blood pressure, but the effect of levothyroxine (LT4) therapy on blood pressure among those patients is still unclear. This study aimed to assess whether LT4 therapy could reduce blood pressure in SCH patients through a systematic review and meta-analysis.Methods: PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science were searched. Randomized controlled trials (RCTs) assessing the effect of LT4 therapy on blood pressure or prospective follow-up studies comparing the blood pressure level before and after LT4 treatment were included, and the mean difference of systolic blood pressure (SBP) or diastolic blood pressure (DBP) was pooled using random-effect meta-analysis.Results: Twenty-nine studies including 10 RCTs and 19 prospective follow-up studies were eligible for the analysis. Meta-analysis of 10 RCTs suggested that LT4 therapy could significantly reduce SBP in SCH patients by 2.48 mmHg (95% CI −4.63 to −0.33, P = 0.024). No heterogeneity was observed among these 10 RCTs (I2 = 0%). Meta-analysis of the 19 prospective follow-up studies found that LT4 therapy significantly decreased SBP and DBP by 4.80 mmHg (95%CI −6.50 to −3.09, P < 0.001) and 2.74 mmHg (95%CI −4.06 to −1.43, P < 0.001), respectively.Conclusion: The findings suggest that LT4 replacement therapy can reduce blood pressure in SCH patients, which needs to be validated in more clinical trials with larger samples.

show abstract

“…The American Thyroid Association recommends that patients with hypothyroidism and thyroid peroxidase antibodies in pregnancy should be treated with levothyroxine sodium tablets. The American Endocrine Society and the European Thyroid Association recommend levothyroxine sodium tablets for SCH women during pregnancy (14). Moreover, whether levothyroxine sodium tablets can improve the harm caused by SCH to pregnant women and their offspring has not yet formed a clear conclusion (15).…”

Section: Introductionmentioning

confidence: 99%

Systematic review and meta-analysis of the efficacy and pregnancy outcomes of levothyroxine sodium tablet administration in pregnant women complicated with hypothyroidism

Geng¹,

Chen²,

Wang³

et al. 2022

Ann Palliat Med

View full text Add to dashboard Cite

Background: In recent years, the detection rate of pregnancy complicated with hypothyroidism [subclinical hypothyroidism (SCH) during pregnancy] has increased significantly. Levothyroxine sodium tablet is the main drug for the treatment of SCH during pregnancy, but its effect on the treatment of SCH during pregnancy and the effect of pregnancy outcome are still controversial.Methods: PubMed, Web of Science, Medline, and Embase databases were screened to retrieve clinical studies on levothyroxine sodium tablets in the treatment of pregnancy complicated with hypothyroidism from the date of establishment to June 2021. Meta-analysis was performed with RevMan5.3 software. The differences in the incidence of preterm birth, miscarriage, gestational hypertension, postpartum hemorrhage, placental abruption, and abnormal neonatal weight were compared between the observation group and the control group. Heterogeneity of results was assessed with chi-square test and I 2 in RevMan5.3 software.Results: Nine articles with a total of 2,873 pregnant women were included. The Cochrane assessments were all grade B and above, and the Jadad scale scores were all >3 points. The incidences of preterm birth, abortion, postpartum hemorrhage, and low birth weight infants in the pregnant women treated with levothyroxine sodium were lower than those in the control group [odds ratio (OR) =0.

show abstract

Reversible morbidity markers in subclinical hypothyroidism

Abstract: Future large, well-controlled studies will not only clarify the role of SCH but also help identify patients for whom levothyroxine treatment will provide the most benefit.

Cited by 7 publications

References 84 publications

Subclinical hypothyroidism and depression: a meta-analysis

Subclinical hypothyroidism and depression: a meta-analysis

Effect of Levothyroxine on Blood Pressure in Patients With Subclinical Hypothyroidism: A Systematic Review and Meta-Analysis

Systematic review and meta-analysis of the efficacy and pregnancy outcomes of levothyroxine sodium tablet administration in pregnant women complicated with hypothyroidism

Contact Info

Product

Resources

About