Alterations of serum cholesterol levels are well recognized findings in hypothyroidism
and hyperthyroidism. It remains unclear, whether thyroid hormones may affect serum
concentrations of cholesterol through changes in the activity of cholesterol 7α-hydroxylase,
the rate-limiting enzyme in the catabolic conversion of cholesterol to bile acids.
We determined serum concentrations of the bile acid precursor 7α-hydroxy-4-cholesten-3-one,
which reflects cholesterol 7α-hydroxylase activity in the liver, in 19 patients with
hypothyroidism and in 10 patients with hyperthyroidism before and after treatment,
respectively. In patients with hypothyroidism, serum concentrations of cholesterol
and LDL-cholesterol decreased by 33% (p < 0.0005) and 39% (p < 0.0005), respectively,
after replacement therapy with thyroid hormones. In contrast, serum concentrations
of 7α-hydroxy-4-cholesten-3-one (21.7 ± 15.8 ng/ml vs 24.5 ± 18.1 ng/ml before treatment,
n.s.) as well as serum HDL-cholesterol were unchanged during substitution therapy.
In patients with hyperthyroidism, serum concentrations of cholesterol and LDL-cholesterol
increased by 27% (p < 0.01) and 39% (p < 0.01) after antithyroid treatment, respectively.
Again, serum concentrations of 7α-hydroxy-4-cholesten-3-one did not change significantly
during treatment (15.8 ± 12.6 ng/ml vs 14.7 ± 8.1 ng/ml before treatment, n.s.). These
findings indicate that in humans, thyroid hormones influence serum lipid concentrations
by other mechanisms than by affecting the activity of cholesterol 7α-hydroxylase.
Key words
Cholesterol 7α-Hydroxylase - Hypothyroidism - Hyperthyroidism
