Impact of Graves' hyperthyroidism treatment on lipid profiles and cholesterol dynamics: a prospective observational study.

IF 4.6 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Therapeutic Advances in Endocrinology and Metabolism Pub Date : 2025-09-09 eCollection Date: 2025-01-01 DOI:10.1177/20420188251372381

Tomoko Nagamine, Kyoko Tanimura-Inagaki, Mototsugu Nagao, Shunsuke Kobayashi, Yuki Shuto, Hideki Tamura, Mikiko Okazaki-Hada, Izumi Fukuda, Hitoshi Sugihara, Shinichi Oikawa, Masato Iwabu

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Abstract

Background: The impact of Graves' hyperthyroidism treatment on lipid metabolism remains unclear. This prospective observational study aimed to clarify the changes in lipid profiles and associated metabolic pathways, including cholesterol synthesis, absorption, and low-density lipoprotein (LDL) receptor regulation, following treatment.

Methods: Seventeen patients newly diagnosed with Graves' hyperthyroidism were enrolled and followed for 6 months after achieving euthyroid status. Serum lipids (total cholesterol, LDL-cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides), apolipoproteins, non-cholesterol sterols (markers of cholesterol synthesis and absorption), proprotein convertase subtilisin/kexin type 9 (PCSK9), and lipoprotein lipase (LPL) levels were measured at baseline, at euthyroid status (Eu-0M), and 6 months after euthyroid status (Eu-6M).

Results: After treatment, serum total cholesterol, LDL-C, and HDL-C levels increased rapidly compared to baseline, while triglyceride levels showed a delayed but significant increase at Eu-6M. Levels of apolipoprotein (apo) AI, AII, B, and CIII increased significantly after treatment, whereas apo B-48 increased only at Eu-6M, and apo CII and apo E remained unchanged. Markers of cholesterol synthesis (lathosterol) and absorption (sitosterol, campesterol, and cholestanol) increased significantly after treatment, indicating enhanced cholesterol metabolism. Circulating PCSK9 levels increased significantly and remained elevated, while LPL levels did not change significantly.

Conclusion: Treatment of Graves' hyperthyroidism rapidly increases cholesterol levels through enhanced cholesterol synthesis and absorption, possibly mediated by increased circulating PCSK9.

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Graves甲亢治疗对血脂和胆固醇动态的影响：一项前瞻性观察研究。

背景：Graves甲亢治疗对脂质代谢的影响尚不清楚。这项前瞻性观察性研究旨在阐明治疗后脂质谱和相关代谢途径的变化，包括胆固醇合成、吸收和低密度脂蛋白（LDL）受体调节。方法：选取17例新诊断为Graves甲亢的患者，在甲状腺功能恢复正常后随访6个月。在基线、甲状腺功能正常状态（Eu-0M）和甲状腺功能正常后6个月（Eu-6M）测量血脂（总胆固醇、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、甘油三酯）、载脂蛋白、非胆固醇固醇（胆固醇合成和吸收的标志物）、蛋白转化酶枯草杆菌素/酮蛋白9型（PCSK9）和脂蛋白脂肪酶（LPL）水平。结果：治疗后，血清总胆固醇、LDL-C和HDL-C水平较基线迅速升高，而甘油三酯水平在Eu-6M时出现延迟但显著升高。治疗后载脂蛋白（apo） AI、AII、B和CIII水平显著升高，而载脂蛋白B-48仅在Eu-6M时升高，载脂蛋白CII和载脂蛋白E保持不变。治疗后胆固醇合成（胆甾醇）和吸收（谷甾醇、油菜甾醇和胆固醇）标志物显著增加，表明胆固醇代谢增强。循环PCSK9水平显著升高并保持在高位，而LPL水平无显著变化。结论：Graves甲亢的治疗通过增强胆固醇的合成和吸收迅速提高胆固醇水平，这可能是由循环PCSK9升高介导的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Therapeutic Advances in Endocrinology and Metabolism Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

7.70

自引率

2.60%

发文量

审稿时长

8 weeks

期刊介绍： Therapeutic Advances in Endocrinology and Metabolism delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of endocrinology and metabolism.