Dyslipidemia in South African patients with hypothyroidism

IF 4.2 Q1 ENDOCRINOLOGY & METABOLISM Journal of Clinical and Translational Endocrinology Pub Date : 2022-09-01 DOI:10.1016/j.jcte.2022.100302
Brett S. Mansfield , Sindeep Bhana , Frederick J. Raal
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引用次数: 2

Abstract

Background

Overt hypothyroidism leads to increased cardiovascular risk, primarily through effects the disorder has on lipids. Most studies investigating lipids in the setting of hypothyroidism, have been performed in predominantly Caucasians in North America and Europe. Different patterns and prevalence of dyslipidemia have been described; one study reporting dyslipidemia in 90% of patients with hypothyroidism. The prevalence of dyslipidemia in overt hypothyroidism among the ethnically diverse predominantly black South African population is unknown.

Methodology

A retrospective case-control study evaluating lipid profiles of an ethnically diverse cohort of patients with overt hypothyroidism (TSH > 10 mIU/L) attending two academic hospitals in Johannesburg, South Africa from September 2006–September 2016. Patients with primary or secondary causes for dyslipidemia and those taking lipid-lowering therapy were excluded.

Results

Two hundred and six patients with hypothyroidism were included and compared to 412 euthyroid controls matched for sex, ethnicity, and age. Most hypothyroid patients were female (n = 180;67.5 %). Median TSH was similar across all ethnic groups (p = 0.09). Median TC, TG and LDL-C were higher in hypothyroid patients (p < 0.01). Normal lipid profiles were found in 29.44 % of all hypothyroid patients. However, a greater proportion, 47 of 124 (37.90 %), black African patients with hypothyroidism had a normal lipid profile.

Conclusion

Dyslipidemia is less common in black African patients with hypothyroidism. This is probably due to this population group being in an earlier stage of epidemiologic transition. Those with hypothyroidism were at greater overall cardiovascular risk based on TC/HDL-C ratio but did not reach high risk atherogenic profiles reported in previous studies.

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南非甲状腺功能减退患者的血脂异常
背景:甲状腺功能减退症主要通过对血脂的影响导致心血管风险增加。大多数关于甲状腺功能减退患者血脂的研究,主要是在北美和欧洲的白种人中进行的。血脂异常的不同模式和流行程度已被描述;一项研究报告90%的甲状腺功能减退患者存在血脂异常。在以黑人为主的种族多样化的南非人群中,显性甲状腺功能减退症中血脂异常的患病率尚不清楚。方法一项回顾性病例对照研究,评估不同种族的显性甲状腺功能减退症(TSH >10 mIU/L)于2006年9月至2016年9月在南非约翰内斯堡的两所学术医院就诊。排除有原发性或继发性血脂异常原因的患者和接受降脂治疗的患者。结果纳入126例甲状腺功能减退患者,并与412例性别、种族和年龄相匹配的甲状腺功能正常对照组进行比较。甲状腺功能减退患者以女性为主(180例,占67.5%)。中位TSH在所有种族中相似(p = 0.09)。甲状腺功能减退患者中位TC、TG和LDL-C较高(p <0.01)。29.44%的甲状腺功能减退患者血脂正常。然而,124名患有甲状腺功能减退症的非洲黑人患者中有47名(37.90%)血脂正常。结论非洲黑人甲状腺功能减退患者血脂异常较少见。这可能是由于这一人群处于流行病学转变的早期阶段。基于TC/HDL-C比值,甲状腺功能减退患者总体心血管风险更高,但未达到先前研究报道的高危动脉粥样硬化概况。
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来源期刊
CiteScore
6.10
自引率
0.00%
发文量
24
审稿时长
16 weeks
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