Hypothyroidism Clinical Trial
Official title:
Effect of Levothyroxine on Serum Adiponectin, Insulin Resistance and Cardiovascular Risk in Patients With Hypothyroidism
The aim of this study is to evaluate plasma adiponectin level, insulin resistance, cardiovascular risk and their correlation (if any) in patients with hypothyroidism and also to investigate the effect of levothyroxine on these parameters. The study may explore the lacunae in present treatment protocol and can suggest the possibilities of add-on therapies for a better management.
Hypothyroidism is associated with premature atherosclerosis and increased prevalence of
coronary artery diseases. Long-term hypothyroidism is associated with severe cardiovascular
manifestations including reduced intravascular volume, increased systemic vascular
resistance, and hypertension. Hypothyroidism is one of the main causes of secondary
dyslipidemia. The classic manifestations of hypothyroidism are raised VLDL, LDL and apo A.
The increase in cardiovascular risk is not only due to dyslipidemia, but also to hemodynamic
changes, endothelial dysfunction, hormonal and metabolic changes. Insulin resistance and the
metabolic syndrome are important cardiovascular risk factors as insulin-resistant individuals
with raised TSH have higher LDL concentrations.
Among the various markers associated with obesity and insulin resistance, of particular
importance is adiponectin which is inversely related to the degree of adiposity, increases
insulin sensitivity, and has antiatherogenic and anti-inflammatory properties, hence may be
cardioprotective. Hypoadiponectinaemia is associated with obesity, insulin resistance and
type II diabetes, as well as atherosclerosis, hypertension and coronary artery disease.
Treating hypothyroidism with levothyroxine has an antioxidant and cholesterol reducing
effect, and thus already has proven beneficial impact on cardiovascular function, blood
pressure and lipid profile. But the association of adiponectin and insulin resistance in
hypothyroid state and future cardiovascular risk is still not clear because there are few
published studies in this domain and result of some the studies are contradictory. The aim of
this study is to evaluate plasma adiponectin level, insulin resistance, cardiovascular risk
and their correlation (if any) in patients with hypothyroidism and also to investigate the
effect of levothyroxine on these parameters.
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