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ES Journal of Cardiology

ISSN: 2768-0533

Stepwise interpretation of low density lipoprotein hypercholesterolemia and total lipid profile in clinical and subclinical hypothyroidism

  • Research article

  • Maria Marcílio Rabelo1, Lisia Marcílio Rabelo1, Anita L. R. Saldanha2, André Luis Valera Gasparoto2, Ana Paula Pantoja Margeotto3 and Tania Leme da Rocha Martinez2*
  • 1Departamento de Saúde da Família, Federal University of Bahia, Brazil
  • 2Nephrology Department, BP - A Beneficência Portuguesa de São Paulo, Brazil
  • 3Intensive Care Unit, BP - A Beneficência Portuguesa de São Paulo, Brazil
  • *Corresponding author: Tania Leme da Rocha Martinez, Nephrology Department, BP - A Beneficência Portuguesa de São Paulo, São Paulo – Brazil
  • Received: Jan 30, 2020; Accepted: Feb 20, 2020; Published: Feb 22, 2020

Abstract

The association between hypothyroidism and atherosclerosis is a most important clinical theme and as such hypothetized by the lipid alterations concurrent with the condition .This issue is being more relevant in the recent papers on the issue of coincidence or etiology. The methodology of this review is all based on major publications of the subject in distinguished journals. The results show that hypothyroidism occur from four to eleven percent in hyperlipidemic patients. The main mechanism of cholesterol elevation is the reduction of LDL-c clearance by interference of TH in the expression of LDL-c liver receptors. There is no higher production, but poor removal. The thyroid condition is treatable, be it primary, clinical or subclinical. Sites of action of thyroid hormones are described and linked to the lipid abnormalities their failure of function may lead to .Lipid profile alterations are described mechanistically to explain the elevation of apoB containing lipoproteins that constitute an increase in risk for cardiovascular events. Lipoprotein (a) is also mainly considered in the literature as higher in this condition. In the case of hyperlipidemia even after normalization of the thyroid a treatment for the lipids abnormality should be considered and put into practice. Statins are the first line hypolipidemic agents to be considered. In the case of introduction of combination therapy it is important to remember that the use of fibrates should be avoided due to a possible potentiation of myopathy induced by it. The use of Cholestyramine, in association with thyroid hormone, makes it difficult to absorb the latter.

Keywords

Cholesterol, Thyroid, Hypothyroidism, Heart risk, Atherosclerosis, Triglycerides, Dense LDL, Lipoproteins