Evidence mapPaperPMID 41965091Full record

Trial reportThe Journal of clinical endocrinology and metabolism2026

Levothyroxine treatment response of cardiometabolic biomarkers in older adults with subclinical hypothyroidism.

Linjun Ao, Raymond Noordam, Stella Trompet, Nicolien A van Vliet, Naveed Sattar, Nicolas Rodondi, Elisavet Moutzouri, Sarah Atighetchi, Patricia M Kearney, Terry Quinn and 6 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in The Journal of clinical endocrinology and metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
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

1 citing paper in PubMed.

  1. Trial
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

16 authors.

Linjun AoDepartment of Human Genetics, Leiden University Medical Center, 2300 RC Leiden, the Netherlands.
Raymond NoordamDepartment of Clinical Epidemiology, Leiden University Medical Center, 2300 RC Leiden, the Netherlands.ORCID 0000-0001-7801-809X
Stella TrompetDepartment of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, 2300 RC Leiden, the Netherlands.ORCID 0000-0001-5006-0528
Nicolien A van VlietDepartment of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, 2300 RC Leiden, the Netherlands.
Naveed SattarSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow G12 8TA, UK.ORCID 0000-0002-1604-2593
Nicolas RodondiInstitute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland.
Elisavet MoutzouriInstitute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland.
Sarah AtighetchiInstitute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland.
Patricia M KearneySchool of Public Health, University College Cork, Pw31584 Cork, Ireland.
Terry QuinnSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow G12 8TA, UK.
J Wouter JukemaDepartment of Cardiology, Leiden University Medical Center, 2300 RC Leiden, the Netherlands.
Jacobijn GusseklooDepartment of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, 2300 RC Leiden, the Netherlands.ORCID 0000-0001-7186-8278
Simon P MooijaartDepartment of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, 2300 RC Leiden, the Netherlands.
Ko Willems van DijkDepartment of Human Genetics, Leiden University Medical Center, 2300 RC Leiden, the Netherlands.
Rosalinde K E PoortvlietDepartment of Public Health and Primary Care, Leiden University Medical Center, 2300 RC Leiden, the Netherlands.
Diana van HeemstDepartment of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, 2300 RC Leiden, the Netherlands.ORCID 0000-0001-8526-7748

Funding

China Scholarship Council 202106240064China Scholarship Council 666869European Union 627001001Merck KGaASwiss National Science Foundation 278148Swiss National Science Foundation 320030-172676Swiss National Science Foundation 320030-231242Swiss National Science Foundation SNSF 320030-150025Swiss National Science Foundation SNSF 320033-200606ZonMw
6 · The paper itself

Abstract

contextRandomized controlled trials (RCTs) found no cardioprotective effects of levothyroxine therapy in older adults with subclinical hypothyroidism.

objectiveThe aim of this study was to assess levothyroxine effects on cardiometabolic biomarkers, which may serve as more sensitive treatment indicators.

designPost-hoc analysis using (baseline and 12-month) data from two double-blind RCTs in older adults (≥65 years) with subclinical hypothyroidism. MAIN OUTCOME MEASURE(S): Cardiometabolic biomarkers included seven clinically relevant lipid measures (apolipoprotein B (ApoB), total cholesterol (Total-C), non-high-density lipoprotein cholesterol (non-HDL-C), remnant cholesterol (RC), low-density lipoprotein cholesterol (LDL-C), HDL-C, and triglycerides (TG)) and 167 standardized metabolomic measures from nuclear magnetic resonance. Analyses were additionally stratified by baseline TSH levels.

resultsAmong 286 included participants (48% women; median age 75 [70, 82] years; median baseline TSH 6.44 [5.36, 7.81] mIU/L), 142 were randomized to levothyroxine. Overall, levothyroxine showed no effects on ApoB (-0.03 [95% CI: -0.07, 0.00] g/L), Total-C (-0.17 [-0.34, 0.00] mmol/L), non-HDL-C (-0.15 [-0.31, 0.00] mmol/L), RC (-0.09 [-0.16, -0.01] mmol/L), LDL-C (-0.07 [-0.15, 0.02] mmol/L), and TG (-0.07 [-0.15, 0.01] mmol/L). In participants with baseline TSH ≥10 mIU/L (n = 27), potentially beneficial changes (P < .05, but not significant after multiple-testing correction) were observed for all clinically relevant lipids except HDL-C, as well as for ApoB-containing lipoproteins, VLDL size, and fatty acids.

conclusionIn older adults with subclinical hypothyroidism, levothyroxine treatment showed no effects on cardiometabolic biomarkers, although potentially favorable changes in lipids and lipoproteins were observed for individuals with baseline TSH ≥10 mIU/L.

Indexed as

BiomarkersCardiovascular DiseasesHypothyroidismThyroxineAgedAged, 80 and overAsymptomatic DiseasesDouble-Blind MethodFemaleHumansLipidsMaleTreatment OutcomeBiomarkersLipidsThyroxinecardiometabolic biomarkerslevothyroxinelipidsolder adultssubclinical hypothyroidism

Identifiers

PMID41965091
PMCPMC13466939

What Socratic holds

Textmetadata
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 Socratic graph.