الفهرس 
Evaluation of endothelial function and carotid artery intimamedia thickness in patients with clinical and subclinical hypothyroidism before treatment and after reaching euthyroid state
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Abstract
Background: Hypothyroidism increases the risk of atherosclerosis and cardiovascular disease (CVD). Cardiovascular disease is a leading cause of
morbidity and mortality all over the world. Carotid intima‑media thickness (CIMT)
and flow‑mediated dilation (FMD) have been used as a noninvasive method to detect
atherosclerosis.
Aim of work: To evaluate the effect of levothyroxine replacement on endothelial function and CIMT in patients with clinical or subclinical hypothyroidism patients and its potential role to decelerate atherosclerosis.
Methods: This study included 150 participants who were divided into 3 groups clinical hypothyroid (CH), 50 subclinical hypothyroid (SCH) and 50 euthyroid as controls after measuring the thyroid functions. All subjects were subjected to history, clinical examination, laboratory investigations including lipid profile and anti-TPO, and measurement of CIMT, and FMD. After reaching euthyroid state, lipid profile, CIMT and FMD were reassessed.
Results: CIMT was significantly higher in CH and SCH groups compared to control group (p value <0.001, =0.006 respectively) with significant difference between CH and SCH patients (p value <0.001). FMD was significantly impaired in CH and SCH groups compared to control group (p value <0.001, <0.001 respectively). Treatment with levothyroxine significantly improved lipid profile, FMD, and CIMT in CH and SCH groups
Conclusion: Hypothyroidism hastens atherogenesis by modifying atherosclerotic risk factors and having a direct effect on blood vessels. FMD, and CIMT are noninvasive markers for early detection of atherosclerosis. We observed marked improvement in FMD and CIMT after treatment with LT4. We can suggest that thyroid hormone replacement therapy may help to prevent atherosclerosis in this group of patients.