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Objective: Primary hypothyroidism is frequently manifested by weight gain.
Moreover, treatment with L-Thyroxine reverses the weight gain in most subjects
on achieving euthyroid state. However, the characteristic fat distribution contributing
to these changes in body weight is not well documented. Therefore, the presence
of central adiposity was examined in primary hypothyroidism prior to and after
attaining and maintaining euthyroid state following L-Thyroxine therapy. Methods: Waist and hip measurements
were conducted to determine waist: hip ratios in 55 men, ages 39 to 84 years at
diagnosis of primary hypothyroidism established by subnormal Free T4 and
supernormal TSH concentrations and again after their normalization by
L-Thyroxine replacement therapy. The subjects were divided according
to Body Mass Index (BMI-Kg/m2) into 3 groups; hypo T1, 20 men with
BMI < 25; Hypo T2, BMI 25 - 30 and Hypo T3, BMI > 30. 15 euthyroid normal
(N) men matched for age and BMI in each group participated as controls. Results: Mean waist: hip ratio was
significantly higher (p < 0.01) in subjects with primary hypothyroidism
(0.97 + 0.03) than in healthy men (0.92 + 0.02) and declined significantly (p <
0.01) on achieving euthyroidism (0.93 + 0.02). Moreover, waist: hip ratios were
also higher in individual hypothyroid groups; Hypo T1, 0.92 + 0.01 vs. N1, 0.88
+ 0.01; Hypo T2, 0.96 + 0.02 vs. N2, 0.92 + 0.02 and Hypo T3, 1.02 + 0.03 vs.
N3, 0.98 + 0.02 (p < 0.01for all comparisons). Finally, waist: hip ratios
declined significantly in all groups on attaining euthyroidism; Hypo T1, 0.89 +
0.01; Hypo T2, 0.93 + 0.02; Hypo T3, 0.98 + 0.02 (p < 0.01 vs.
pretreatment). Conclusion: Central
adiposity is a definitive clinical manifestation of primary hypothyroidism in
men. Moreover, a significant improvement on achieving euthyroid state following
L-Thyroxine therapy may deem central adiposity to be a major contributor to
changes in body weight in primary hypothyroidism noted at diagnosis and on
attaining and maintaining euthyroid state.