Reversal of decreased hepatic lipase and lipoprotein lipase activities after treatment of hypothyroidism.

Plasma lipoprotein concentrations, activities of hepatic lipase and lipoprotein lipase in post-heparin plasma, and the removal rate of exogenous triglyceride were measured in fourteen patients with severe primary hypothyroidism before and after 4 months substitution therapy with 1-thyroxine. Before treatment plasma LDL cholesterol concentrations were markedly increased while HDL cholesterol and plasma triglycerides were in the upper reference range. Thyroxine substitution led to a normalization of LDL cholesterol in all patients. Plasma triglycerides and HDL cholesterol decreased moderately. Hepatic lipase and lipoprotein lipase activities were initially reduced but increased significantly after treatment, by about 170% and 55%, respectively. The increase in hepatic lipase activities was significantly correlated to the increase in serum triiodothyronine levels and also to the reduction in LDL cholesterol concentrations. The decrease in LDL cholesterol was also significantly correlated to the increase in serum triiodothyronine concentration. In two patients initially treated with triiodothyronine, the activity of hepatic lipase, but not that of lipoprotein lipase, increased after 24 and 48 h, while LDL cholesterol levels decreased substantially. We suggest that the reduced activities of hepatic lipase as well as of lipoprotein lipase are important pathogenetic factors for the dyslipoproteinaemia occurring in hypothyroidism and that the low serum triiodothyronine concentration is of major importance for the alterations in lipid transport.