Lipidogram profiles in patients with Graves' and Basedow's disease with and without orbitopathy

Researchers reported on the pathogenic role of hypercholesterolemia in thyroid orbitopathy (TO) and the use of statins in its prevention and treatment. To confirm these observations, we conducted a prospective study of patients with Graves' and Basedow's disease (GBD) to evaluate the relationship between the presence of TO and levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), and apolipoproteins A1 and B (Apo A1, Apo B), along with the impact of immunosuppressive treatment on the lipid profile.

Forty-seven patients with GBD diagnosed within the past 12 months were eligible for the study. In the GBD group, 31 patients were diagnosed with active TO and qualified for immunosuppressive treatment, while 16 patients did not have TO. TC, TG, HDL-C, and LDL-C levels were measured in serum using enzymatic methods, and Apo A-1 and Apo B levels were determined by immunoturbidimetric methods.

The mean TC concentration in patients with active TO who qualified for immunosuppressive treatment was 207.7 ± 42.7 mg/dL, significantly higher than the values in GBD patients without TO symptoms (191.5 ± 47.8 mg/dL). After completing immunosuppressive treatment, the mean TC concentration increased to 214.3 ± 49.8 mg/dL, remaining significantly higher than before treatment. The mean LDL-C concentration in patients with active TO was 131.6 ± 40.4 mg/dL and was higher, though not significantly, compared to the GBD group without TO symptoms (122.6 ± 49.0 mg/dL). After immunosuppressive treatment, the mean LDL-C levels increased to 142.1 ± 54.5 mg/dL and were also significantly higher than before treatment. Additionally, the mean Apo B concentration in patients with active TO was significantly higher than in patients without TO. After immunosuppressive treatment, the mean Apo B concentration increased and remained significantly higher than before treatment. There was no significant difference in HDL-C, Apo A1, and TG concentrations between the groups with and without TO, nor their levels after immunosuppressive treatment.

The use of statins as adjunctive therapy in GBD patients with active TO qualified for immunosuppressive treatment is reasonable due to the increase in TC, LDL-C, and Apo B levels during treatment, as well as for their pleiotropic effects, including their anti-inflammatory effects.