• Maja Jazheva Davchevska Health Center of Skopje, Skopje, R. North Macedonia
  • Vesela Maleska Ivanovska Institute of Physiology, Faculty of Medicine, Ss Cyril and Methodius University, Skopje, R. North Macedonia
  • Vesna Velic Stefanovska Institute of Epidemiology, Biostatistics and Medical Informatics, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, R. North Macedonia


TSH, hypothyroidism, cholesterol, triglycerides, LDL


Introduction: Thyroid gland dysfunction is presented as overt or subclinical hypothy­roidism and has repercussions on patient’s lipid profile.

Aims: To present patients lipid status with hypothyroidism versus a control group and to determine an association of thyroid status elements with lipid parameters.

Material and methods: This case-controlled retrospective study included a sample of 82 patients, examined group (N=56), who were divided into two subgroups according to the established TSH level (ТЅН<4ulU/ml and ТЅН>4ulU/ml) and a control group (ТЅН<4ulU/ml) (N=26). We analyzed the parameters of the thyroid function (TSH, FT4, FT3, anti-TPO) and se­lec­ted lipid status parameters (cholesterol, triglycerides, HDL-cholesterol and LDL-cholesterol).

Results: The comparative analysis between the examined and the control group of patients, as well as between the two subgroups, found no significant difference in the lipid pa­ra­meter levels in relation to selected parameters of the lipid status. The performed correlation among the elements of the lipid status with the thyroid parameters determined a significant linear negative weak correlation between the fT4 and cholesterol, and between fT4 and triglycerides.

Conclusion: These three examined groups did not differ in lipid status, although dyslipidemia is an expected finding in untreated hypothyroidism. The statin therapy influenced on reduction of lipid fraction values ​​in all groups. Therefore, in newly diagnosed patients with hypothyroidism and dyslipidemia, before starting statin therapy, levothyroxine is recommended to be initially administered. Even under conditions of concomitant use of statins, cholesterol and triglyceride levels showed a negative correlation with fT4 and anti-TPO.


Abrams JJ, Grundy SM. Cholesterol metabolism in hypothyroidism and hyperthyroidism in man. J Lipid Res 1981; 22(2): 323-38. PMID: 7240961.

Duntas LH, Brenta G. A Renewed Focus on the Association Between Thyroid Hormones and Lipid Metabolism. Front Endocrinol (Lausanne) 2018; 9: 511. doi: 10.3389/fendo.2018.00511. PMID: 30233497; PMCID: PMC6129606.

Rizos CV, Elisaf MS, Liberopoulos EN. Effects of thyroid dysfunction on lipid profile. Open Cardiovasc Med J 2011; 5: 76-84. doi:10.2174/1874192401105010076.

Feingold KR, Brinton EA, Grunfeld C. The Effect of Endocrine Disorders on Lipids and Lipoproteins. [Updated 2020 Mar 9]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000. Available from: https://www.ncbi.nlm.nih.gov/books/NBK409608/.

Satpathy PK, Diggikar PM, Sachdeva V, Laddha M, Agarwal A, Singh H. Lipid profile and electrocardiographic changes in thyroid dysfunction. Med J DY Patil Univ 2013; 6: 250-3

Nakova VV, Krstevska B, Kostovska ES, Vaskova O, Ismail LG. The effect of levothyroxine treatment on left ventricular function in subclinical hypothyroidism. Arch Endocrinol Metab 2018;62(4):392-398. doi: 10.20945/2359-3997000000052. PMID: 30304103.

Teixeira PFDS, Dos Santos PB, Pazos-Moura CC. The role of thyroid hormone in metabolism and metabolic syndrome. Ther Adv Endocrinol Metab 2020; 11: 2042018820917869. doi: 10.1177/2042018820917869. PMID: 32489580; PMCID: PMC7238803.

Tanase DM, Gosav EM, Neculae E, Costea CF, Ciocoiu M, Hurjui LL, et al. Hypothyroidism-Induced Nonalcoholic Fatty Liver Disease (HIN): Mechanisms and Emerging Therapeutic Options. Int J Mol Sci 2020; 21(16): 5927. doi: 10.3390/ijms 21165927. PMID: 32824723; PMCID: PMC7460638.

Brenta G, Fretes O. Dyslipidemias and hypothyroidism. Pediatr Endocrinol Rev 2014; 11(4): 390-9. PMID: 24988692.

Pearce EN. Update in lipid alterations in subclinical hypothyroidism. J Clin Endocrinol Metab 2012; 97(2): 326-33. doi: 10.1210/jc.2011-2532. PMID: 22205712.

Risal P, Maharjan BR, Koju R, Makaju RK, Gautam M. Variation of total serum cholesterol among the patient with thyroid dysfunction. Kathmandu Univ Med J (KUMJ) 2010; 8(30): 265-8. doi: 10.3126/kumj.v8i2.3573. PMID: 21209550.

Huang F, Wu L, Qiu Y, Bu K, Huang H, Li B. The role of free triiodothyronine in high-density lipoprotein cholesterol metabolism. Medicine (Baltimore) 2019; 98(36): e17016. doi: 10.1097/MD.0000000000017016.

Biondi B. Thyroid and obesity: an intriguing relationship. J Clin Endocrinol Metab 2010; 95(8): 3614-7. doi: 10.1210/jc.2010-1245. PMID: 20685890.

Tagami T, Kimura H, Ohtani S, Tanaka T, Tanaka T, Hata S, et al. Multi-center study on the prevalence of hypothyroidism in patients with hypercholesterolemia. Endocr J 2011; 58(6): 449-57. doi: 10.1507/endocrj.k11e-012. Epub 2011 Apr 20. PMID: 21505266.

LEE SL. Hashimoto Thyroiditis: Practice Essentials, Background, Etiology. Available from: https://emedicinemedscapecom/article/120937-overview#a5. 2021.

Mincer DL, Jialal I. Hashimoto Thyroiditis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021.

González-Rodríguez LA, Felici-Giovanini ME, Haddock L. Thyroid dysfunction in an adult female population: A population-based study of Latin American Vertebral Osteoporosis Study (LAVOS) - Puerto Rico site. P R Health Sci J 2013; 32(2): 57-62. PMID: 23781620; PMCID: PMC3804108.

Mendes D, Alves C, Silverio N, Batel Marques F. Prevalence of Undiagnosed Hypothyroidism in Europe: A Systematic Review and Meta-Analysis. Eur Thyroid J 2019; 8(3): 130-143. doi: 10.1159/000499751. PMID: 31259155; PMCID: PMC6587201.



2021-12-27 — Updated on 2021-12-30




Original Articles