Abstract
The aim was to compare the lipid profile of patients with GD treated with
anti-thyroid drugs (ATDs) using a titration regimen versus a block and replace
regimen. This is an 18-month prospective observational study. In this study were
included 149 medically treated GD patients, aged+>+18 years. Pregnant women
and patients treated with radioactive iodine therapy or partial/total
thyroidectomy were excluded. Patients were divided into 2 subgroups: titration
(A) and block and replace (B) therapy, according to the ATD regimen used.
Thyroid and metabolic profile was measured at baseline and at least one visit
during medical treatment. The whole group included 122 (81.87%) females (F) and
27 (18.12%) males (M), ratio F:M=4.5:1. As expected, at the time of diagnosis,
thyrotoxic patients were with normal lipid profile. During medical treatment, in
patients who achieved euthyroidism, the cholesterol levels increased as follows:
in subgroup A: by 52.9 mg/dl (95% CI: 26.4–79.3), p<0.001 for total
cholesterol (T-C), by 33.3 mg/dl (95% CI: 10.3–56.3), p=0.007 for low-density
lipoprotein cholesterol (LDL-C) and by 11.44 mg/dl (95% CI: 3.08–19.79), p=0.009
for high-density lipoprotein cholesterol (HDL-C); in subgroup B T-C increased by
45.1 mg/dl (95% CI: 22.2–68), p<0.001 and for LDL-C by 33.57 mg/dl (95% CI:
12.72–54.42), p=0.003. No statistically significant increase in triglyceride
levels was determined. Medical treatment of hyperthyroidism due to Graves’
disease increased cholesterol levels regardless of the ATD regimen used.
Keywords
hyperthyroidism - cholesterol - block-replace - titration - Graves’ disease
