Details
Category: Volume 05 Issue 12 December 2017
Hits: 1161

Title: A Case Control Study of Serum Lipid Level Alterations in Subclinical Hypothyroid Patients

Authors: Naveen Angadi, Yogesh Garg

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i12.144

Abstract

Background: Subclinical hypothyroidism is often associated with increased risk of heart complications and various biochemical abnormalities.

Objectives: The present study was aimed to determine lipid abnormalities in the subclinical hypothyroidism patients.

Methods: The 1-year case–control study included 25 patients diagnosed with subclinical hypothyroidism and 25 euthyroid controls. Patients underwent thyroid and lipid profiling, evaluation of fasting blood sugar levels, complete blood count, and levels of apolipoprotein A and B. Statistical analysis was performed using chi-square test and unpaired t-test. P< 0.05 was considered as statistically significant.

Results: Female preponderance was observed with mean age of 20.46 ± 1.68 and 37.25 ±13.73 years in euthyroid and subclinical hypothyroid group, respectively (P< 0.001). Mean body mass index of the euthyroid and subclinical hypothyroid groups was 21.58 ± 2.8 kg/m2 and 20.46 ± 1.68 kg/m2, respectively (P = 0.033). Thyroid-stimulating hormone (7.89 ± 2.51 vs. 2.07 ± 1.01 µIU/ml; P < 0.001), serum cholesterol (168.08 ± 39.35 vs. 143.68 ± 38.15 mg/dL; P = 0.031) and triglyceride (162.02 ± 71.87 vs 121.48 ± 34.42 mg/dL; P< 0.001) levels were elevated in subclinical hypothyroid group when compared to euthyroid group. In the subclinical hypothyroid group, mean apolipoprotein A levels varied (117.04 ± 19.27 vs 96.48 ± 7.38 mg/dL; P < 0.001); however, apolipoprotein B levels were unaltered.

Conclusion: Alterations in lipid levels were observed in subclinical hypothyroidism patients which could be further established in future studies by the exploration of factors such as detection of autoimmune disorders in larger sample size.

Keywords: Serum cholesterol; Subclinical hypothyroidism; Triglycerides, Thyroid stimulating hormone.

References

  1. Chin K-Y, Ima-Nirwana S, Mohamed IN, Aminuddin A, Johari MH, Ngah WZW. The relationships between thyroid hormones and thyroid-stimulating hormone with lipid profile in euthyroid men. Int J Med Sci 2014:11(4):349-55.
  2. Nelson RH.Hyperlipidemia as a risk factor for cardiovascular disease. Prim Care 2012:40(1):195-211.
  3. World Health Organisation. Cardiovas-cular diseases (CVDs). 2013. Fact Sheet. 317. Last updated on May 2017; http://www.who.int/mediacentre/factsheets/fs317/en/. Accessed on 14 Aug 2017
  4. World Health Organization (2000). The Asia-Pacific perspective: redefining obesity and its treatment. Sydney: Health Communications Australia. http://www.-wpro.who.int/nutrition/documents/docs/Redefiningobesity.pdf. Accessed on 14 Aug 2017
  5. World Health Organization (2006). Global database on Body Mass Index: BMI Classification. http://www.assessmentpsychology.com/icbmi.htm. Accessed on 20 Aug 2017
  6. Nicoloff JT, Spencer CA.The Use and Misuse of the Sensitive Thyrotropin Assays. J Clin Endocrinol Metab 2009:71(3):553-8.
  7. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA 2001:285(19):2486-97.
  8. Kasper DL. Harrison's principles of inte-rnal medicine. 19th Ed / editors, Dennis L. Kasper, MD, William Ellery Channing, Professor of Medicine, Professor of Microbiology, Department of Microbi-ology and Immunobiology, Harvard Medical School, Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts and five others . ed. 1 volume (various pagings), 2015.
  9. Fatourechi V. Subclinical hypothyroidism: an update for primary care physicians. Mayo Clin Proc 2009:84(1):65-71.
  10. Prakash A, Lal AK. Serum lipids in hypothyroidism: our experience. Indian J Clin Biochem 2006:21(2):153-5.
  11. Sangeeta N,Singh YA, Devi OP, Singh RKR, Chubalemla L, Abhishek D, et al.Lipid Profile in Thyroid Dysfunction Patients. JDent MedSci 2016:15(12):39-43
  12. Hennessey JV, Espaillat R (2015). Diagnosis and management of subclinical hypothyroidism in elderly adults: a review of the literature. J Am Geriatr Soc 2015:63(8):1663-73.
  13. Walter KN, Corwin EJ, Ulbrecht J, Demers LM, Bennett JM, Whetzel CA, et al.Elevated thyroid stimulating hormone is associated with elevated cortisol in healthy young men and women. Thyroid Res 2012:5(1):13.
  14. Singh K, Singh S. Alterations in lipid fraction levels in subclinical hypothyro-idism in north Indian population. Indian J Fundam Appl Life Sci 2011:1(2):127-32.
  15. Khan M, Majumder I, Hoque M, Fariduddin M, Mollah F, Arslan M.Lipid profile in hypothyroid patients: a cross sectional Study. Medicine today 2013:25(1):21-4.
  16. Liu XL, He S, Zhang SF, Wang J, Sun XF, Gong CM, et al. Alteration of lipid profile in subclinical hypothyroidism: a meta-analysis. Med Sci Monit 2014:20:1432-41.
  17. Rizos CV, Elisaf MS, Liberopoulos EN. Effects of thyroid dysfunction on lipid profile. Open Cardiovasc Med J 2011:5:76-84.
  18. Saini V, Yadav MA, Arora S, Singh R, Bhattacharjee J. Association between different degrees of hypothyroidism and serum lipids. Internet Journal of Medical Update-EJOURNAL 2012:7(2).
  19. Peppa M, Betsi G, Dimitriadis G. Lipid Abnormalities and Cardiometabolic Risk in Patients with Overt and Subclinical Thyroid Disease. J Lipids 2011:2011:1-9.
  20. Gupta G, Sharma P, Kumar P, Itagappa M. Study on subclinical hypothyroidism and its association with various inflammatory markers. J Clin Diagn Res 2015:9(11): BC04-6.
  21. Jayasingh I, Puthuran P. Subclinical hypothyroidism and the risk of hypercholesterolemia. J Family Med Prim Care 2016:5(4):809.
  22. Talayero BG, Sacks FM. The role of triglycerides in atherosclerosis. Curr Cardiol Rep 2011:13(6):544-52.
  23. Harper CR, Jacobson TA. Using apolipoprotein B to manage dyslipidemic patients: Time for a change? Mayo Clin Proc 2010:85(5):440-5.
  24. Onat A, Can G, Hergenç G, Yazıcı M, Karabulut A, Albayrak S. Serum apolipoprotein B predicts dyslipidemia, metabolic syndrome and, in women, hypertension and diabetes, independent of markers of central obesity and inflamm-ation. Int J Obes 2007:31(7):1119-25.
  25. Barkas F, Elisaf M, Liberopoulos E, Liontos A, Rizos EC. High triglyceride levels alter the correlation of apolipoprotein B with low- and non-high-density lipoprotein cholesterol mostly in individuals with diabetes or metabolic syndrome. Atherosclerosis2016:247:58-63.
  26. Marwaha RK, Tandon N, Garg MK, Kanwar R, Sastry A, Narang A, et al. Dyslipidemia in subclinical hypothyr-oidism in an Indian population. Clin Biochem 2011:44(14-15):1214-7.
  27. Asranna A, Taneja RS, Kulshreshta B. Dyslipidemia in subclinical hypothyroi-dism and the effect of thyroxine on lipid profile. Indian J Endocrinol Metab2013:16 (Suppl 2):S347-9.
  28. Chakera AJ, Pearce SH, Vaidya B. Treatment for primary hypothyroidism: current approaches and future possibilities. Drug Des Devel Ther 2011:6:1-11.

Corresponding Author

Naveen Angadi

Department of Medicine, Jawaharlal Nehru Medical College,

Belgaum 590010, Karnataka, India

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Tel: +919880940984