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Journal of Endocrinological Investigation

Erschienen in:

01.07.2018 | Original Article

Hyperhomocysteinemia in acute iatrogenic hypothyroidism: the relevance of thyroid autoimmunity

verfasst von: F. Cicone, M. G. Santaguida, G. My, G. Mancuso, A. Papa, R. Persechino, C. Virili, N. Brusca, A. Tofani, F. Scopinaro, M. Centanni

Erschienen in: Journal of Endocrinological Investigation | Ausgabe 7/2018

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Abstract

Purpose

Hyperhomocysteinemia is a known cardiovascular risk factor and a key player in the inflammatory activation of autoimmune diseases. Hashimoto’s thyroiditis (HT) is the leading cause of hypothyroidism which, in itself, has been associated with a significant raise of homocysteine (Hcy) levels and increased cardiovascular risk. Our aim was to assess the impact of HT on Hcy levels in patients with acute hypothyroidism.

Methods

We prospectively enrolled 121 patients (mean age: 46 years, F/M = 102/19) with acute post-surgical hypothyroidism. Based on the presence of anti-thyroid antibodies and the histological description of an inflammatory infiltrate, 26 and 95 patients were classified as HT and non-HT, respectively. Several parameters including thyroid-stimulating hormone (TSH), levels of serum free T3 and free T4, weight, glucose levels, total cholesterol, creatinine, vitamin B₁₂, ferritin and erythrocyte sedimentation rate were obtained from all patients and correlated with Hcy levels.

Results

Median Hcy level in the whole cohort was 16.8 µmol/L (normal values: < 12 µmol/l). Among all parameters analysed, only Hcy levels were significantly different between HT and non-HT patients (median Hcy = 19.7 vs 16.2 µmol/L, respectively; p = 0.018, Mann–Whitney U test). Analysis of covariance showed the presence of HT to be the strongest predictor of Hcy levels (coefficient = 0.25534, p = 0.001). Serum TSH was not significantly associated with Hcy levels (p = 0.943).

Conclusion

In patients with iatrogenic hypothyroidism, those with HT have significantly higher Hcy levels than those without HT. The increase of Hcy levels appears to be mainly determined by the HT-related immune-inflammatory condition.

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Titel: Hyperhomocysteinemia in acute iatrogenic hypothyroidism: the relevance of thyroid autoimmunity
verfasst von: F. Cicone
M. G. Santaguida
G. My
G. Mancuso
A. Papa
R. Persechino
C. Virili
N. Brusca
A. Tofani
F. Scopinaro
M. Centanni
Publikationsdatum: 01.07.2018
Verlag: Springer International Publishing
Erschienen in: Journal of Endocrinological Investigation / Ausgabe 7/2018
Elektronische ISSN: 1720-8386
DOI: https://doi.org/10.1007/s40618-017-0811-y

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