Thyroid hormones modulate uric acid metabolism in patients with recent onset subclinical hypothyroidism by improving insulin sensitivity

This report was designed to evaluate the influential role of levothyroxine (L-T4) replacement therapy on circulating levels of UA in patients with recent onset post-thyroidectomy subclinical hypothyroidism. Circulating levels of thyroid hormones, UA and other metabolic parameters were assessed in 155 recently thyroidectomized patients (131 females, mean age 51.1  ± 12.7 years) at baseline (5–7 day after surgery) and after 2 months under replacement therapy with L-T4. At baseline, circulating levels of thyroid hormones were indicative of a subclinical hypothyroidism (TSH 8.2 ± 5.1 mU/mL, FT3 2.1 ± 0.7 pg/mL, FT4 9.2 ± 3.4 pg/mL). The mean serum UA concentration was 5.0 ± 1.3 mg/dL, while the prevalence of hyperuricemia, defined by serum UA levels >  6 mg/dL, was 22.6%. Serum UA levels at baseline were significantly correlated with HOMA-IR index (r = 0.475,p <  0.0001). After 2 months under the replacement therapy with L-T4, both serum UA levels (− 1.2 ± 0.9 mg/dL,p <  0.0001 vs. baseline) and HOMA-IR (− 0.3 ± 1.5 mmol/L,p = 0.0328 vs. baseline) significantly decreased. Multivariate regression analysis revealed that changes in HOMA-IR explained 23% of the variations of serum UA levels under L-T4 replacement therapy (β = 0.295,p <  0.0001,R2 = 0.230). Our study suggests that thyroid hormones could modulate UA metabolism in patients with recent onset subclinical hypothyroidism lik...
Source: Internal and Emergency Medicine - Category: Emergency Medicine Source Type: research