Evidence map›Paper›PMID 29061604›Full record

SynthesisBMJ open2017

Effect of levothyroxine on the progression of carotid intima-media thickness in subclinical hypothyroidism patients: a meta-analysis.

Tong Zhao, Baomin Chen, Yingying Zhou, Xinyi Wang, Yuanyuan Zhang, Haoyu Wang, Zhongyan Shan

Open access · goldAbstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 2 pooled it
3.2field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 51 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Review
  5. Article
  6. Review
  7. Article
  8. Review
  9. Review
  10. Review
  11. Review
  12. Article
  13. Review
  14. Review
  15. Article
  16. Article
  17. Article
  18. Review
  19. Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Tong ZhaoDepartment of Endocrinology and Metabolism, Institute of Endocrinology, First Affiliated Hospital, Chinese Medical University, Shenyang, Liaoning, China.
Baomin ChenDepartment of Liver and Gall Surgery, First Affiliated Hospital, Chinese Medical University, Shenyang, Liaoning, China.
Yingying ZhouDepartment of Endocrinology and Metabolism, Institute of Endocrinology, First Affiliated Hospital, Chinese Medical University, Shenyang, Liaoning, China.
Xinyi WangDepartment of Endocrinology and Metabolism, Institute of Endocrinology, First Affiliated Hospital, Chinese Medical University, Shenyang, Liaoning, China.
Yuanyuan ZhangDepartment of Endocrinology and Metabolism, Institute of Endocrinology, First Affiliated Hospital, Chinese Medical University, Shenyang, Liaoning, China.
Haoyu WangDepartment of Endocrinology and Metabolism, Institute of Endocrinology, First Affiliated Hospital, Chinese Medical University, Shenyang, Liaoning, China.
Zhongyan ShanDepartment of Endocrinology and Metabolism, Institute of Endocrinology, First Affiliated Hospital, Chinese Medical University, Shenyang, Liaoning, China.
First Hospital of China Medical University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSubclinical hypothyroidism (SCH) has been associated with increased carotid intima-media thickness (C-IMT) in recent studies, but the effects of levothyroxine (L-T4) therapy on C-IMT in SCH patients are still controversial.

aimTo evaluate the effect of L-T4 therapy on endothelial function as determined by C-IMT in patients with SCH.

methodsBeforeJuly 2016, we searched the PubMed, Embase, Cochrane Library and Google Scholar databases, selecting published randomised controlled trials (RCTs) and self-controlled trials for the meta-analysis.

resultsThree RCTs with 117 patients were considered appropriate for the meta-analysis. The results of the meta-analysis indicated that L-T4 significantly decreased the development of C-IMT (weighted mean difference (WMD) -0.05 mm, 95% CI -0.08 to -0.01 mm; p=0.025). We also analysed nine studies (self-controlled trials) with 247 patients and extracted the IMT of SCH patients before and after L-T4 treatment. After L-T4 therapy, the pooled estimate of the WMD of decreased C-IMT was -0.04 mm (95% CI -0.07 to -0.02 mm; p=0.05). Subgroup analysis showed that L-T4 therapy was associated with a decrease in C-IMT among patients of mixed genders (WMD -0.03 mm, 95% CI -0.06 to -0.01 mm; p=0.145). L-T4 therapy was associated with a decrease in C-IMT among female patients (WMD -0.07 mm, 95% CI -0.14 to -0.01; p=0.186). Longer treatment (>6 months) also resulted in a significant decrease in C-IMT (WMD -0.05 mm, 95% CI -0.08 to -0.02; p=0.335).

conclusionThis meta-analysis indicates that L-T4 treatment of SCH patients can reduce C-IMT, possibly as a result of the reduction of total cholesterol, triglyceride, low density lipoprotein, systolic blood pressure, diastolic blood pressure, lipoprotein(a), and flow-mediated dilatation. Decreased C-IMT was observed in SCH patients after long-term (>6 months) L-T4 treatment. RCTs with larger samples are needed to verify these observations.

Indexed as

Carotid Intima-Media ThicknessBlood PressureHumansHyperlipidemiasHypertensionHypothyroidismRandomized Controlled Trials as TopicThyroxineTriglyceridesThyroxineTriglyceridescardiovascular riskcarotid intima-media thicknesssubclinical hypothyroidismthyroxin

Identifiers

PMID29061604
PMCPMC5665330
OpenAlexW2766151448

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.