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Hypothyroidism is associated with premature atherosclerosis and cardiovascular disease. High levels of total cholesterol, low-density lipoprotein cholesterol (LDL-C), triglycerides and recently, homocysteine (Hcy) and C-reactive protein (CRP) emerged as additional cardiovascular risk factors. Sixty ambulatory patients with primary hypothyroidism receiving levothyroxine (L-T4) participated in the study. Patients were divided into 2 groups according to their TSH level. The first group was in TSH low-normal range (0.4–2.0 mU/l), the second in upper-normal (2.1–4.0 mU/l) range. We analyzed the results of lipid profile data, CRP and HCY levels at baseline and in 3 months. With a small-dose changes we cross the groups to compare the results. Patients in upper-normal range group had significantly higher levels of total cholesterol (p = 0.002), LDL-C (p = 0.02), triglycerides (p = 0.03) at baseline. After decreasing the dose of L-T4 in group with low-normal TSH range there were no significant difference in levels of total cholesterol and triglycerides. After dose-changing the level of LDL-C was significantly higher in group with upper-normal TSH range (p = 0.02). After increasing the L-T4 dose in group with upper-normal TSH range we didn't find any significant differences in lipid profile level, but the early predictors of endothelium dysfunction were sig-nificantly lower in group with low-normal TSH range: CRP (p = 0.004), HCY (p =0.05). Conclusion: Small-changes in L-T4 dose which help to achieve the low-normal TSH range leads to significantdecrease in levels of early predictors of en-dothelium dysfunction – C-reactive protein and homocysteine.

Lipid profile and early predictors of endothelian dysfunction in hypothyroidism against the TSH level within reference range