DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20162273

A study of lipid profile in patients of subclinical hypothyroidism in rural area of Western Uttar Pradesh, India

Manoj Kumar, Raveendra S. Rajpoot

Abstract


Background: Dyslipidemia is thought to confer risk of cardiovascular disease development. Overt hypothyroidism is associated with lipid abnormalities. However, the relationship between subclinical hypothyroidism (SCH) and pattern of lipid abnormalities is unclear. The aim of this study was to assess lipid abnormalities in patients of subclinical hypothyroidism (SCH) and investigate relationship between lipid level and TSH.

Methods: Serum lipid levels of 87 patients with subclinical hypothyroidism (SCH) and 101 age and sex matched euthyroid controls were evaluated in this cross sectional case control study.

Results: In this study total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) were significantly elevated (p value<0.05) in patients with subclinical hypothyroidism (SCH) as compared to control group. Triglycerides (TG) and very low density lipoprotein cholesterol (VLDL-C) were also high in these patients as compared to control but the difference was not statistically significant. High density lipoprotein cholesterol (HDL-C) was marginally lower in these patients than control.

Conclusions: Total cholesterol (TC) and low density lipoprotein (LDL-C) are higher in patients with subclinical hypothyroidism (SCH) as compared to euthyroid individuals. Other lipid like Triglycerides (TG) and very low density lipoprotein cholesterol (VLDL-C) may be marginally elevated whereas high density lipoprotein cholesterol (HDL-C) may be slightly reduced in these patients as compared to euthyroid individuals. There is also a positive correlation of LDL-C and TC with TSH level. As abnormal lipids are associated with development of cardiovascular diseases, lipid profile in these patients needs careful monitoring.

 


Keywords


Antithyroid peroxidase antibodies, Thyroid stimulating hormone, Free thyroxine, Atherosclerosis, Euthyroid

Full Text:

PDF

References


Cooper DS. Subclinical hypothyroidism. N Engl J Med. 2001;345(4):260-5.

Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, Spencer CA, Braverman LE. Serum TSH, T (4), and thyroid antibodies in the United States population (1988 to 1994). National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab. 2002;87(2):489-99.

Karmisholt J, Andersen S, Laurberg P. Variation in thyroid function tests in patients with stable untreated subclinical hypothyroidism. Thyroid. 2008;18(3):303-8.

Pucci E, Chiovato L, Pinchera A. Thyroid and lipid metabolism. Int J Obesity. 2000;24:S109-12.

Rizos CV, Elisaf MS, Liberopoulos EN. Effects of thyroid dysfunction on lipid profile. Open Cardiovasc Med J. 2011;5:76-84.

Bell RJ, Rivera-Woll L, Davison SL, Topliss DJ, Donath S, Davis SR. Well-being, health-related quality of life and cardiovascular disease risk profile in women with subclinical thyroid disease: a community-based study. Clin Endocrinol (Oxf). 2007;66(4):548-56.

Duntas LH. Thyroid disease and lipids. Thyroid. 2002;12(4):287-93.

Mansourian AR, Ghaemi E, Ahmadi AR, Marjani A, Saifi A, Denosrat SB. Serum lipid levels alterations in subclinical hypothyroidism patients in Gorgan (South east of Caspian sea). J Clin Med Res. 2008;3(4):206-9.

Tuzcu A, Bahceci M, Gokalp D, Tuzun Y, Gunes K. Subclinical hypothyroidism may be associated with elevated high-sensitive c-reactive protein (low grade inflammation) and fasting hyperinsulinemia. Endocr J. 2005;52(1):89-94.

Milionis HJ, Tambaki AP, Kanioglou CN, Elisaf MS, Tselepis AD, Tsatsoulis A. Thyroid substitution therapy induces high-density lipoprotein-associated platelet-activating factor-acetylhydrolase in patients with subclinical hypothyroidism: a potential antiatherogenic effect. Thyroid. 2005;15(5):455-60.

Jung CH, Sung KC, Shin HS, Rhee EJ, Lee WY, Kim BS, et al. Thyroid dysfunction and their relation to cardiovascular risk factors such as lipid profile, hsCRP, and waist hip ratio in Korea. Korean J Intern Med. 2003;18(3):146-53.

Walsh JP, Bremner AP, Bulsara MK, O'Leary P, Leedman PJ, Feddema P, et al. Thyroid dysfunction and serum lipids: a community-based study. Clin Endocrinol (Oxf). 2005;63(6):670-5.

Iqbal A, Jorde R, Figenschau Y. Serum lipid levels in relation to serum thyroid-stimulating hormone and the effect of thyroxine treatment on serum lipid levels in subjects with subclinical hypothyroidism: the Tromso Study. J Intern Med. 2006;260(1):53-61.

WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363(9403):157-63.

Rader DJ, Hobbs HH. Disorders of Lipoprotein Metabolism. In: Longo DL, Fauci AS, Kasper DL, Hauser SL , Jameson JL, Loscalzo J, eds. Harrison's Principles of Internal Medicine 18th ed. New York, NY: McGraw-Hill; 2012;2:3145-61.

Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of preparative ultracentrifuge. Clin Chem. 1972;18:499-502.

Després JP, Golay A, Sjöström L. Effects of rimonabant on metabolic risk factors in overweight patients with dyslipidemia. N Engl J Med. 2005;353:2121-34.

Chiasson JL, Josse RG, Gomis R, Hanefeld M, Karasik A, Laakso M. Acarbose treatment and the risk of cardiovascular disease and hypertension in patients with impaired glucose tolerance. JAMA. 2003;290:486-94.

Kuusi T, Taskinen MR, Nikkila EA. Lipoproteins, lipolytic enzymes, and hormonal status in hypothyroid women at different levels of substitution. J Clin Endocrinol Metab. 1988;66:51-6.

O'Brien T, Dinneen SF, O'Brien PC, Palumbo PJ. Hyperlipidemia in patients with primary and secondary hypothyroidism. Mayo Clin Proc. 1993;68(9):860-66.

Hueston WJ, Pearson WS. Subclinical hypothyroidism and the risk of hypercholesterolemia. Annals of family medicine. 2004;2(4):351-5.

Vierhapper H, Nardi A, Grosser P, Raber W, Gessl A. Low-density lipoprotein cholesterol in subclinical hypothyroidism. Thyroid. 2000;10(11):981-4.

Laway BA, War FA, Shah S, Misgar RA, Kumar Kotwal S. Alteration of Lipid Parameters in Patients With Subclinical Hypothyroidism. Int J Endocrinol Metab. 2014;12(3):e17496.

Asranna A, Taneja RS, Kulshreshta B. Dyslipidemia in subclinical hypothyroidism and the effect of thyroxine on lipid profile. Indian J Endocr Metab. 2012;16(Suppl 2):S347-S349.

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;104:622-4.

Guntaka M, Hanmayyagari B, Rosaline M, Nagesh V. Lipid profile in subclinical hypothyroidism: a biochemical study from tertiary care hospital. CHRISMED J Health Res. 2014;1:266-70.

Marwaha RK, Tandon N, Garg MK, Kanwar R, Sastry A, Narang A, et al. Dyslipidemia in subclinical hypothyroidism in an Indian population. Clin Biochem. 2011;44(14-15):1214-7.

Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado Thyroid Disease Prevalence Study. JAMA 2000;160(4):526.

Lai Y, Wang J, Jiang F, Wang B, Chen Y, Li M, et al. The relationship between serum thyrotropin and components of metabolic syndrome. Endocr J. 2011;58(1):23-30.

Santi A, Duarte MMMF, de Menezes CC, Loro VL. Association of lipids with oxidative stress biomarkers in subclinical hypothyroidism. Endocr J. 2012;2012:856359.