The pleiotropic effects of levothyroxine replacement therapy in patients with subclinical hypothyroidism and hypertension
Bibliographic record
Abstract
Background. According to epidemiological studies, the prevalence of subclinical hypothyroidism is about 6 % and it depends on age, gender, region of residence and, at the same time, significantly exceeds the frequency of primary hypothyroidism. Within one year, 5 % of cases of subclinical hypothyroidism turn into the manifested form. Delayed diagnosis of the disease increases the risk of serious complications. It is still controversial whether subclinical hypothyroidism affects blood pressure because of conflicting results in published studies. Thus, the aim of this study was to assess the effects of levothyroxine replacement therapy in patients with subclinical hypothyroidism and hypertension on lipid metabolism, functional state of the endothelium and cognition. Materials and methods. Thirty-one patients with subclinical hypothyroidism and stage 2 hypertension participated in the study, among them 12 (38.71 %) men and 19 (61.29 %) women. The average age of participants was 63.19 ± 1.93 years. The study examined lipid profile, functional state of the endothelium, and cognitive functions based on the results of the Montreal Cognitive Assessment before and after 3 months of additional administration of the levothyroxine replacement therapy at a dose 25–50 µg daily. Results. The lipid analysis revealed a significant decrease in total cholesterol for 10.08 % (5.54 ± 0.17 mmol/L against 6.23 ± 0.25 mmol/L, Р < 0.05), low-density lipoprotein cholesterol for 24.5 % (3.39 ± 0.17 mmol/L against 4.49 ± 0.27 mmol/L, Р < 0.01), triglycerides for 19.42 % (1.66 ± 0.11 mmol/L against 2.06 ± 0.16 mmol/L, Р < 0.05) compared to those at baseline. At the same time, patients with subclinical hypothyroidism and hypertension showed a reliable decrease in atherogenic dyslipidemias, 64.52 against 74.19 %. We also observed a reliable improvement of the functional state of the endothelium: the mean value of the endothelium-dependent vasodilation of the brachial artery increased for 11 % (6.56 ± 0.10 % against 5.91 ± 0.05 %, Р < 0.001). The results of the neuropsychological testing showed a reliable improvement of the cognitive functions among examined patients: the average score on the Montreal Cognitive Assessment raised from 23.77 ± 0.60 at baseline to 26.65 ± 0.47 after three months of taking levothyroxine, Р < 0.001. Conclusions. Levothyroxine replacement therapy in patients with subclinical hypothyroidism and hypertension was followed by a normalization of lipid profile and a decrease in atherogenic dyslipidemias, an improvement of the functional state of the endothelium and state of cognition.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".