Objective: One most recent study by Onyebuchi et al. showed that Graves' disease has an increased risk of cardiovascular events, and early control of hyperthyroidism improves long-term cardiovascular morbidity and all-cause mortality. It has been known that, treatment with antithyroid drugs is usually accompanied with a certain gain in body weight (BW). However, the serial changes of BW and other cardiometabolic risk factors have never been clearly investigated. The aim of this study was to examine the serial changes of these cardiometabolic risk factors in the clinical course of thionamide treatment for Graves’ disease.
Design: This was a prospective observational study. Patients with newly diagnosed Graves’ disease treated with thionamide were followed up to 12 months. At each visit, anthropometric data, clinical features, biochemistry and thyroid function tests were measured.
Result: A total of 97 subjects (M/F: 29/68) were recruited. After treatment, BW increased by 2.4 ± 3.4%, 6.9 ± 4.6%, 10.0 ± 6.0%, 11.2 ± 6.5% and 12.4 ± 6.9% in males, and 1.7 ± 3.4%, 5.0 ± 4.9%, 5.9 ± 5.6%, 7.0 ± 6.4% and 7.3 ± 6.8% in females, at 1, 3, 6, 9 and 12-month, respectively. Waist circumference and body mass index also increased significantly after treatment in both genders. Furthermore, HDL-Cholesterol decreased significantly after treatment. As for metabolic syndrome components, we found significantly increased percentages of subjects with central obesity, hypertension, and hypertriglyceridemia after treatment. On the contrary, the percentage of hyperglycemia decreased significantly after treatment. Taken together, subjects with metabolic syndrome increased accordingly from 6.3 % to 21.1 % (p = 0.017).
Conclusion: We demonstrated a rapid BW gain as well as deteriorations of cardiometabolic risk factors shortly after thionamide treatment in both genders, which might contribute to increased cardiovascular mortality in Graves’ disease. Further studies are needed to validate this speculation.