Exp Clin Endocrinol Diabetes 2015; 123(03): 182-186
DOI: 10.1055/s-0034-1396886
Article
© Georg Thieme Verlag KG Stuttgart · New York

Different Effects of Atorvastatin on Metabolic and Cardiovascular Risk Factors in Hypercholesterolemic Women with Normal Thyroid Function and Subclinical Hypothyroidism

R. Krysiak
1   Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
,
W. Gilowski
1   Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
2   Cardiology Department, Chrzanow District Hospital, Chrzanow, Poland
,
B. Okopien
1   Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
› Author Affiliations
Further Information

Publication History

received 01 October 2014
first decision 15 November 2014

accepted 15 December 2014

Publication Date:
06 February 2015 (online)

Abstract

Background: The presence of hypothyroidism seems to be associated with increased cardiovascular risk. No previous study compared circulating levels of plasma lipids and other cardiovascular risk factors in statin-treated patients with different thyroid function states.

Methods: We studied 15 women with untreated subclinical hypothyroidism (group A), 16 women with treated hypothyroidism (group B) and 17 women with normal thyroid function (group C) who, because of coexistent hypercholesterolemia, were treated with atorvastatin. Plasma lipids, glucose homeostasis markers and plasma levels of cardiovascular risk factors were assessed before and after 12 weeks of therapy. 46 patients completed the study.

Results: Baseline lipid levels were similar in all groups of patients. Plasma levels of high-sensitivity C-reactive protein (hsCRP), homocysteine and fibrinogen were higher in group A than in groups B and C. Although the effect on total and LDL cholesterol was observed in all treatment groups, it was less pronounced in patients with untreated hypothyroidism. Similarly, the effect of atorvastatin on hsCRP, homocysteine, fibrinogen and uric acid was stronger in groups B and C than in group A.

Conclusions: Our results suggest that the effect of atorvastatin on plasma lipids and circulating levels of other cardiovascular risk factors partially depends on thyroid function.

 
  • References

  • 1 Hak AE, Pols HAP, Visser TJ et al. Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam Study. Ann Intern Med 2000; 132: 270-278
  • 2 Vanderpump MP, Tunbridge WM, French JM et al. The development of ischemic heart disease in relation to autoimmune thyroid disease in a 20-year follow-up study of an English community. Thyroid 1996; 6: 155-160
  • 3 Ochs N, Auer R, Bauer D et al. Meta-analysis: subclinical thyroid dysfunction and the risk for coronary heart disease and mortality. Ann Intern Med 2008; 148: 832-845
  • 4 Singh S, Duggal J, Molnar J et al. Impact of subclinical thyroid disorders on coronary heart disease, cardiovascular and all-cause mortality: a meta-analysis. Int J Cardiol 2008; 125: 41-48
  • 5 Duntas LH, Brenta G. The effect of thyroid disorders on lipid levels and metabolism. Med Clin North Am 2012; 96: 269-281
  • 6 Duntas LH, Wartofsky L. Cardiovascular risk and subclinical hypothyroidism: focus on lipids and new emerging risk factors. What is the evidence?. Thyroid 2007; 17: 1075-1084
  • 7 Masaki M, Komamura K, Goda A et al. Elevated arterial stiffness and diastolic dysfunction in subclinical hypothyroidism. Circ J 2014; 78: 1494-1500
  • 8 Nagasaki T, Inaba M, Shirakawa K et al. Increased levels of C-reactive protein in hypothyroid patients and its correlation with arterial stiffness in the common carotid artery. Biomed Pharmacother 2007; 61: 167-172
  • 9 Türemen EE, Çetinarslan B, Şahin T et al. Endothelial dysfunction and low grade chronic inflammation in subclinical hypothyroidism due to autoimmune thyroiditis. Endocr J 2011; 58: 349-354
  • 10 Marongiu F, Barcellona D, Mameli A et al. Thyroid disorders and hypocoagulability. Semin Thromb Hemost 2011; 37: 11-16
  • 11 Heart Protection Study Collaborative Group . MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomized placebo-controlled trial. Lancet 2002; 360: 7-22
  • 12 Khush KK, Waters DD, Bittner V et al. Effect of high-dose atorvastatin on hospitalizations for heart failure: subgroup analysis of the Treating to New Targets (TNT) study. Circulation 2007; 115: 576-583
  • 13 Scandinavian Simvastatin Survival Study Group . Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study Group. Lancet 1994; 344: 1383-1389
  • 14 Ridker PM, Danielson E, Fonseca FA et al. JUPITER Study Group . Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med 2008; 359: 2195-2207
  • 15 Sirtori CR. The pharmacology of statins. Pharmacol Res 2014; Mar 20. pii: S1043-6618(14)00025-5
  • 16 Athyros VG, Kakafika AI, Tziomalos K et al. Pleiotropic effects of statins – clinical evidence. Curr Pharm Des 2009; 15: 479-489
  • 17 Palaniswamy C, Selvaraj DR, Selvaraj T et al. Mechanisms underlying pleiotropic effects of statins. Am J Ther 2010; 17: 75-78
  • 18 Surks MI. TSH reference limits: new concepts and implications for diagnosis of subclinical hypothyroidism. Endocr Pract 2013; 19: 1066-1069
  • 19 Besseling J, van Capelleveen J, Kastelein JJ et al. LDL cholesterol goals in high-risk patients: how low do we go and how do we get there?. Drugs 2013; 73: 293-301
  • 20 Raghavan VA. Insulin resistance and atherosclerosis. Heart Fail Clin 2012; 8: 575-587
  • 21 Ridker PM. Inflammatory biomarkers and risks of myocardial infarction, stroke, diabetes, and total mortality: implications for longevity. Nutr Rev 2007; 65 (12 Pt 2) S253-S259
  • 22 Kinlay S, Egido J. Inflammatory biomarkers in stable atherosclerosis. Am J Cardiol 2006; 98: 2P-8P
  • 23 Krysiak R, Okopien B, Herman Z. Effects of HMG-CoA reductase inhibitors on coagulation and fibrinolysis processes. Drugs 2003; 63: 1821-1854
  • 24 McCully KS. Homocysteine, vitamins, and vascular disease prevention. Am J Clin Nutr 2007; 86: 1563S-1568S
  • 25 Feig DI, Kang DH, Johnson RJ. Uric acid and cardiovascular risk. N Engl J Med 2008; 359: 1811-1821
  • 26 Krysiak R, Okopien B. The effect of levothyroxine and selenomethionine on lymphocyte and monocyte cytokine release in women with Hashimoto’s thyroiditis. J Clin Endocrinol Metab 2011; 96: 2206-2215
  • 27 Krysiak R, Okopien B. Haemostatic effects of levothyroxine and selenomethionine in euthyroid patients with Hashimoto’s thyroiditis. Thromb Haemost 2012; 108: 973-980
  • 28 Gullu S, Emral R, Bastemir M et al. In vivo and in vitro effects of statins on lymphocytes in patients with Hashimoto’s thyroiditis. Eur J Endocrinol 2005; 153: 41-48
  • 29 Kiernan TJ, Rochford M, McDermott JH. Simvastatin induced rhabdomyolysis and an important clinical link with hypothyroidism. Int J Cardiol 2007; 119: 374-376
  • 30 Tokinaga K, Oeda T, Suzuki Y et al. HMG-CoA reductase inhibitors (statins) might cause high elevations of creatine phosphokinase (CK) in patients with unnoticed hypothyroidism. Endocr J 2006; 53: 401-405
  • 31 Sathasivam S. Statin induced myotoxicity. Eur J Intern Med 2012; 23: 317-324
  • 32 Anwar S, Gibofsky A. Musculoskeletal manifestations of thyroid disease. Rheum Dis Clin North Am 2010; 36: 637-646