Comparison of pre- and post-treatment orexin A levels in patients with subclinical hypothyroidism

Abstract

AimSubclinical hypothyroidism is a clinical condition mostly observed in women, the prevalence of which increases by age. Sleepiness and appetite problems are observed in subclinical hypothyroidism. Orexins play a role in the physiological regulations like the stabilization of cardiovascular functions and the sleep-alert cycle. Similarities in the physiological regulation areas of orexins and the clinical findings of hypothyroidism were influential in the planning of this research. Additionally, homocysteine, which is influential on the cardiovascular system and the plasma level of which changes by eating, was also analyzed. Besides, the change in the lipid profiles of the patients was also observed.MethodsNineteen pre-menopausal female patients (mean age=39.58±12.58, mean BMI=26.7 ± 4.9) included in this study. Following 12 hours fasting blood samples were taken from brachial vein. All patients were given 50 μg/day L-T4. TSH levels were examined in every 4-6 weeks to adjust the L-T4 doses. When euthyroidism was ensured, a re-evaluation was made 4 months later.ResultsPre-treatment plasma orexin A levels of 19 patients with pre-menopausal subclinical hypothyroidism increased significantly following a treatment of L-tiroxin for 4 months (pre-treatment orexin level median=1.20 ng/dL [mean: 1.33 ± 0.28], post-treatment median=1.82 ng/dL [mean: 1.70 ± 0.42], P = 0.007). A significant change in the level of plasma total homocysteine and lipid profile was not detected.ConclusionAdvanced studies are needed to study the physiological effects of orexin levels in cases with subclinical hypothyroidism and the possible benefits in treatment.

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