Levothyroxine treatment response of cardiometabolic biomarkers in older adults with subclinical hypothyroidism.
Publisher DOI
PubMed ID
41965091
Abstract
Context
Randomized controlled trials (RCTs) found no cardioprotective effects of levothyroxine therapy in older adults with subclinical hypothyroidism.Objective
To assess levothyroxine effects on cardiometabolic biomarkers, which may serve as more sensitive treatment indicators.Design
Post hoc analysis using (baseline and 12-month) data from two double-blind randomised controlled trials in older adults (≥ 65 years) with subclinical hypothyroidism.Main Outcome Measure(s)
Cardiometabolic biomarkers included seven clinically relevant lipid measures (apolipoprotein B (ApoB), total cholesterol (Total-C), non-high-density lipoprotein cholesterol (non-HDL-C), remnant cholesterol (RC), low-density lipoprotein cholesterol (LDL-C), HDL-C, and triglycerides (TG)) and 167 standardised metabolomic measures from nuclear magnetic resonance. Analyses were additionally stratified by baseline TSH levels.Results
Among 286 included participants (48% women; median age 75 [70, 82] years; median baseline TSH 6.44 [5.36, 7.81] mIU/L), 142 were randomized to levothyroxine. Overall, levothyroxine showed no effects on ApoB (-0.03 [95% CI: -0.07, 0.00] g/L), Total-C (-0.17 [-0.34, 0.00] mmol/L), non-HDL-C (-0.15 [-0.31, 0.00] mmol/L), RC (-0.09 [-0.16, -0.01] mmol/L), LDL-C (-0.07 [-0.15, 0.02] mmol/L), and TG (-0.07 [-0.15, 0.01] mmol/L). In participants with baseline TSH ≥10 mIU/L (n=27), potentially beneficial changes (P-values < 0.05, but not significant after multiple-testing correction) were observed for all clinically relevant lipids except HDL-C, as well as for ApoB-containing lipoproteins, VLDL size and fatty acids.Conclusion
In older adults with subclinical hypothyroidism, levothyroxine treatment showed no effects on cardiometabolic biomarkers, although potentially favourable changes in lipids and lipoproteins were observed for individuals with baseline TSH ≥ 10 mIU/L.
Randomized controlled trials (RCTs) found no cardioprotective effects of levothyroxine therapy in older adults with subclinical hypothyroidism.Objective
To assess levothyroxine effects on cardiometabolic biomarkers, which may serve as more sensitive treatment indicators.Design
Post hoc analysis using (baseline and 12-month) data from two double-blind randomised controlled trials in older adults (≥ 65 years) with subclinical hypothyroidism.Main Outcome Measure(s)
Cardiometabolic biomarkers included seven clinically relevant lipid measures (apolipoprotein B (ApoB), total cholesterol (Total-C), non-high-density lipoprotein cholesterol (non-HDL-C), remnant cholesterol (RC), low-density lipoprotein cholesterol (LDL-C), HDL-C, and triglycerides (TG)) and 167 standardised metabolomic measures from nuclear magnetic resonance. Analyses were additionally stratified by baseline TSH levels.Results
Among 286 included participants (48% women; median age 75 [70, 82] years; median baseline TSH 6.44 [5.36, 7.81] mIU/L), 142 were randomized to levothyroxine. Overall, levothyroxine showed no effects on ApoB (-0.03 [95% CI: -0.07, 0.00] g/L), Total-C (-0.17 [-0.34, 0.00] mmol/L), non-HDL-C (-0.15 [-0.31, 0.00] mmol/L), RC (-0.09 [-0.16, -0.01] mmol/L), LDL-C (-0.07 [-0.15, 0.02] mmol/L), and TG (-0.07 [-0.15, 0.01] mmol/L). In participants with baseline TSH ≥10 mIU/L (n=27), potentially beneficial changes (P-values < 0.05, but not significant after multiple-testing correction) were observed for all clinically relevant lipids except HDL-C, as well as for ApoB-containing lipoproteins, VLDL size and fatty acids.Conclusion
In older adults with subclinical hypothyroidism, levothyroxine treatment showed no effects on cardiometabolic biomarkers, although potentially favourable changes in lipids and lipoproteins were observed for individuals with baseline TSH ≥ 10 mIU/L.
Date Issued
2026-08-13
Publication Type
Article
Subject(s)
Subjects
cardiometabolic biomarkers
•
levothyroxine
•
lipids
•
older adults
•
subclinical hypothyroidism
Language(s)
en
Author(s)
Ao, Linjun | |
Noordam, Raymond | |
Trompet, Stella | |
van Vliet, Nicolien A | |
Sattar, Naveed | |
Kearney, Patricia M | |
Quinn, Terry | |
Jukema, J Wouter | |
Gussekloo, Jacobijn | |
Mooijaart, Simon P | |
Willems van Dijk, Ko | |
Poortvliet, Rosalinde K E | |
van Heemst, Diana |
Journal
The Journal of Clinical Endocrinology & Metabolism
Publisher
Oxford University Press
ISSN
1945-7197
0021-972X
Access(Rights)
open.access