{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T08:29:04Z","timestamp":1771057744147,"version":"3.50.1"},"reference-count":33,"publisher":"The Endocrine Society","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,9,1]]},"abstract":"<jats:sec><jats:title>Context:<\/jats:title><jats:p>Thyroid dysfunction may have detrimental effects on patient outcomes. Few studies have assessed this issue in patients with secondary hypothyroidism.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective:<\/jats:title><jats:p>Our objective was to test the hypothesis that thyroid hormone status has an impact on cardiovascular risk factors in adult patients with hypopituitarism.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and Setting:<\/jats:title><jats:p>This was a retrospective observational study (1993\u20132012) at a tertiary referral university hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients:<\/jats:title><jats:p>All GH-deficient patients starting GH replacement (1993\u20132009) with measured free T4 (fT4) (n = 208). Baseline fT4 defined patients as TSH-sufficient and TSH-deficient (further divided into tertiles according to baseline fT4; first tertile had lowest fT4).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures:<\/jats:title><jats:p>Anthropometric (body mass index [BMI], waist circumference, total fat (fat mass) and lean body mass [LBM]) and biochemical (lipids and fasting plasma glucose) data were collected at baseline and a median 4.1 years after commencement of GH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>At baseline, fT4 was negatively associated with BMI and waist circumference, but positively with high-density lipoprotein, independent of age, gender, and IGF-I (SD score). Only first-tertile TSH-deficient patients had higher BMI (P = .02), fat mass (P = .03), total cholesterol (P = .05), triglycerides (P &amp;lt; .01), and waist circumference (P = .01), and lower high-density lipoprotein cholesterol (P = .03) as compared with TSH-sufficient patients. At follow-up, IGF-I, LBM, and plasma glucose had increased in all subgroups (P &amp;lt; .01). The change in fT4 (\u0394fT4) (follow-up \u2212 baseline) was negatively correlated to \u0394BMI, \u0394LBM, \u0394total cholesterol, and \u0394low-density lipoprotein cholesterol (all P &amp;lt; .05, adjusted for \u0394IGF-I and \u0394GH and hydrocortisone dose). The negative correlation to \u0394total cholesterol and \u0394low-density lipoprotein cholesterol persisted only in first-tertile TSH-deficient patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion:<\/jats:title><jats:p>This single-center study over a 20-year period has strengthened the importance of improved awareness of thyroid status and optimal thyroid replacement of hypopituitary patients to reduce cardiovascular risks in hypopituitary patients.<\/jats:p><\/jats:sec>","DOI":"10.1210\/jc.2013-1610","type":"journal-article","created":{"date-parts":[[2013,6,25]],"date-time":"2013-06-25T03:57:15Z","timestamp":1372132635000},"page":"3802-3810","source":"Crossref","is-referenced-by-count":49,"title":["Central Hypothyroidism and Its Replacement Have a Significant Influence on Cardiovascular Risk Factors in Adult Hypopituitary Patients"],"prefix":"10.1210","volume":"98","author":[{"given":"M.","family":"Klose","sequence":"first","affiliation":[{"name":"Departments of Medical Endocrinology (M.K., D.M., M.-L.H.-N., O.K., V.G., \u212b.K.R., U.F.-R.), DK-2100 Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Marina","sequence":"additional","affiliation":[{"name":"Departments of Medical Endocrinology (M.K., D.M., M.-L.H.-N., O.K., V.G., \u212b.K.R., U.F.-R.), DK-2100 Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.-L.","family":"Hartoft-Nielsen","sequence":"additional","affiliation":[{"name":"Departments of Medical Endocrinology (M.K., D.M., M.-L.H.-N., O.K., V.G., \u212b.K.R., U.F.-R.), DK-2100 Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O.","family":"Klefter","sequence":"additional","affiliation":[{"name":"Departments of Medical Endocrinology (M.K., D.M., M.-L.H.-N., O.K., V.G., \u212b.K.R., U.F.-R.), DK-2100 Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V.","family":"Gavan","sequence":"additional","affiliation":[{"name":"Departments of Medical Endocrinology (M.K., D.M., M.-L.H.-N., O.K., V.G., \u212b.K.R., U.F.-R.), DK-2100 Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Hilsted","sequence":"additional","affiliation":[{"name":"Clinical Biochemistry (L.H.), Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u212b. 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