{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T17:17:00Z","timestamp":1793812620045,"version":"4.6.1"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,4,24]],"date-time":"2017-04-24T00:00:00Z","timestamp":1492992000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100006765","name":"Chinese Medical Association","doi-asserted-by":"publisher","award":["15010010589"],"award-info":[{"award-number":["15010010589"]}],"id":[{"id":"10.13039\/501100006765","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Dyslipidaemia is common in patients with subclinical hypothyroidism (<jats:styled-content style=\"fixed-case\">SCH<\/jats:styled-content>). To date, there is no universal agreement regarding the lipid\u2010lowering effect of substitution treatment with L\u2010T4 in patients with <jats:styled-content style=\"fixed-case\">SCH<\/jats:styled-content>. We aimed to clarify the effect by conducting this systematic review and meta\u2010analysis of randomized controlled trials (<jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>We systematically searched PubMed, the Cochrane Library, ClinicalTrials.gov and <jats:styled-content style=\"fixed-case\">EMBASE<\/jats:styled-content> for <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s comparing substitution treatment to placebo treatment or observation. We focused on the primary outcomes of changes from baseline of total, low\u2010density lipoprotein and high\u2010density lipoprotein cholesterol (<jats:styled-content style=\"fixed-case\">TC<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> LDL<\/jats:styled-content>\u2010C and <jats:styled-content style=\"fixed-case\">HLD<\/jats:styled-content>\u2010C) and triglycerides. Subgroup analyses were performed, assessing the effect of treatment duration, disease severity and ethnicity on the occurrence of discrepancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twelve trials, with 940 participants, were eligible for analysis. Compared with the control group, levothyroxine substitution yielded a mean reduction in <jats:styled-content style=\"fixed-case\">TC<\/jats:styled-content> (\u22120.29\u00a0mmol\/L, [\u22120.42 to \u22120.16]) and <jats:styled-content style=\"fixed-case\">LDL<\/jats:styled-content>\u2010C (\u22120.22\u00a0mmol\/L, [\u22120.36 to \u22120.09]), with no significant effects on <jats:styled-content style=\"fixed-case\">HDL<\/jats:styled-content>\u2010C (\u22120.04\u00a0mmol\/L, [\u22120.08 to 0.01]) or triglycerides (\u22120.04\u00a0mmol\/L, [\u22120.08 to 0.00]). Trials in which only patients with mild <jats:styled-content style=\"fixed-case\">SCH<\/jats:styled-content> (thyrotropin &lt;10\u00a0mIU\/L) were enrolled showed equivalent effects. The lowering effects were weaker, but still significant, in long\u2010term treatment (&gt;6\u00a0months) compared with short\u2010term treatment (\u22646\u00a0months) for <jats:styled-content style=\"fixed-case\">TC<\/jats:styled-content> (\u22120.19\u00a0mmol\/L [\u22120.35, \u22120.03] vs \u22120.50\u00a0mmol\/L [\u22120.68, \u22120.31], <jats:italic>P<\/jats:italic>=.047) and <jats:styled-content style=\"fixed-case\">LDL<\/jats:styled-content>\u2010C (\u22120.09\u00a0mmol\/L [\u22120.16, \u22120.02] vs \u22120.46\u00a0mmol\/L [\u22120.68, \u22120.25], <jats:italic>P<\/jats:italic>=.006).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Levothyroxine treatment has clear benefits on <jats:styled-content style=\"fixed-case\">TC<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">LDL<\/jats:styled-content>\u2010C in <jats:styled-content style=\"fixed-case\">SCH<\/jats:styled-content> patients, including those with mild <jats:styled-content style=\"fixed-case\">SCH<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.13338","type":"journal-article","created":{"date-parts":[[2017,3,25]],"date-time":"2017-03-25T10:38:06Z","timestamp":1490438286000},"page":"1-9","source":"Crossref","is-referenced-by-count":57,"title":["The lipid\u2010lowering effect of levothyroxine in patients with subclinical hypothyroidism: A systematic review and meta\u2010analysis of randomized controlled trials"],"prefix":"10.1111","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1625-5748","authenticated-orcid":false,"given":"Xiang","family":"Li","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism Shandong Provincial Hospital affiliated to Shandong University  Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yupeng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism Shandong Provincial Hospital 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