Title: To study of serum lipid profile alteration in subclinical hypothyroidism patients: A prospective case control hospital based study

Author: Dr Anil Kumar Gupta

 DOI: https://dx.doi.org/10.18535/jmscr/v7i6.140

Abstract

Background: Thyroid hormones have significant effects on the synthesis, mobilization and metabolism of lipids. Hence the present study was planned to determine lipid abnormalities in patients with subclinical hypothyroidism and its interpretation.

Material & Methods: A total of 50 that is, 25 cases of subclinical hypothyroidism and 25 euthyroid controls were selected for the study. Demographic data such as age and sex were recorded. Lipid profile was assessed, which based on NCEP (National Cholesterol Education Program) guidelines and thyroid profile was assessed.

Results: In our study the mean age of cases was 36.54 years and in controls was 24.45 years (p<0.001). BMI was statistical not significant in between groups. It was also observed that among the cases the mean TSH level was significantly high. However no significant difference was noted among cases and controls when fT3 and fT4 were compared. The significant rise was noted in cases with regard to serum cholesterol and triglycerides but no difference between cases and controls when mean HDL and LDL were compared.

Conclusion: We concluded that subjects with laboratory report of hypercholesterolemia and hypertriglyceridemia should be also further examined and tested for serum thyroid hormones measurements.

Keywords: Thyroid hormones, Subclinical hypothyroidism, Lipid profile, TSH level.

References

  1. Ayala A, Danese MD, Ladenson PW. When to treat mild hypothyroidism. Endocrinol Metabol Clin North Am 2000;29:399-415.
  2. Cooper DS. Subclinical hypothyroidism. J Am Med Assoc 1987;258: 246-7.
  3. Danese MD, Landenson PW, Meinert CL and Powe NR. Effect of thyroxine therapy on serum lipoproteins in patients with mild thyroid failure: a quantitative review of the literature. J Clin Endocrinol Metab 2000;85:2993–3001.
  4. Tunbridge WMG, Evered DC, Hall R, Appleton D, Brewis M, Clark F, et al. The spectrum of thyroid disease in a Community: the Whickham survey. Clin Endocrinol 1977;7:481-93.
  5. Unnikrishnan AG, Menon UV. Thyroid disorders in India: An epidemiological perspective. Indian J Endocr Metab 2011;15:78-81.
  6. Bhaskaran S, Kumar H, Nair V, Unnikrishnan RV, Jayakumar C. Subclinical hypothyroidism. Indications for thyroxine therapy. Thyroid Research & Practice 2004;1:10-4.
  7. Caraccio, N., Ferrannini, E. Monzani, F. Lipoprotein profile in subclinical hypothyroidism: response to levothyroxine replacement, a randomized placebo-controlled study. J Clin Endocrinol Metabol 2002;87(4):1533-8.
  8. Kanaya AM, Harris F, Volpato S, Perez-stable EJ, Harris T, Bauer DC. Association between thyroid dysfunction and total cholesterol level in a older Biracial population. Arch. Intern Med 2002;162:773-9.
  9. Vierhapper H, Nardi A, Grosser P, Raber W, Gessl A. Low- density lipoprotein cholesterol in subclinical hypothyroidism. Thyroid 2000; 10(11):981-4.
  10. Hueston WJ, Pearson WS. Subclinical hypothyroidism and the risk of hypercholesterolemia. Ann Fam Med 2004;2:351-5.
  11. Atthans BU, Staub JJ, De-Lechel R. LDL/HDL changes in subclinical hypothyroidism: possible risk factor for coronary heart disease. Clin Endocrinol 1988;28:157-63.
  12. Monzani F, Caraccio N, Kozakowa M, Dardano A, Vittone F, Virdis A, et al. Effect of levothyroxine replacement on lipid profile and intima-media thickness in subclinical hypothyroidism: a double-blind, placebo- controlled study. J Clin Endocrinol Metabol 2004;89:2099-106.
  13. Danese MD, Powe NR, Sawin CT, Ladenson PW. Screening for mild thyroid failure at the periodic health examination: a decision and cost- effectiveness analysis. J Am Med Association 1996;276:285-92.
  14. 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;285:2486–97.
  15. National Committee for Clinical Laboratory Standards. Protection of Laboratory Workers from Occupationally Acquired Infections: Approved Guideline. 2nd, NCCLS Document M29-A2. Wayne, PA: NCCLS; 2001.
  16. Nicoloff JT, Spencer CA. Clinical review 12: The use and misuse of the sensitive thyrotropin assays. J Clin Endocrinol Metab 1990;71(3):553-8.
  17. Bandyopadhyay SK, Basu AK, Pal SK, Roy P, Chakrabarti S, Pathak HS, et al. A study on dyslipidaemia in subclinical hypothyroidism. J Indian Med Assoc 2006;104(11):622-6.
  18. Saini V, Yadav A, Arora S, Singh R, Bhattacharjee J. Association between different degrees of hypothyroidism and serum lipids. Internet J Med Update 2012;7(2):3-8.
  19. Kong WM, Sheikh MH, Lumb PJ, Freedman DB, Crook M, Dore CJ, et al. A six-month randomized trial of thyroxine treatment in women with mild subclincal hypothyroidism. Am J Med 2002;112:348-54.
  20. Squizzato A, Romualdi E, Piantanida E, Gerdes VE, Büller HR, Tanda M, et al. Subclinical hypothyroidism and deep venous thrombosis. A pilot cross-sectional study. Thromb Haemost 2007;97(5):803-6.
  21. Sing K, Sing S. Alterations in Lipid Fraction Levels in Subclinical Hypothyroidism in North Indian Population. Indian J Fundamental Applied Life Sci 2011;1(2):127-32.
  22. Mansourian AR. The State of Serum Lipids Profiles in Sub-Clinical Hypothyroidism: A Review of the Literature. Pak J Biol Sci 2010;13:556- 62.

Corresponding Author

Dr Anil Kumar Gupta

Assistant Professor, Dept. of General Medicine, MSY Medical College & Hospital, Lalpur, Meerut (U.P), India