Analysis and establish a correlation between serum ceruloplasmin, serum apelin level and thyroid profile in patients with hypothyroidism and healthy controls
DOI:
https://doi.org/10.18203/2320-6012.ijrms20223078Keywords:
Hypothyroidism, Apelin, Ceruloplasmin, T3, T4, TSHAbstract
Background: Hypothyroidism is an endocrine disorder resulting from deficiency of thyroid hormone. It is often the primary process in which the thyroid gland produces insufficient amounts of thyroid hormone. It can also be secondary, i.e., lack of thyroid hormone secretion due to the failure of either adequate thyrotropin (TSH) secretion from the pituitary gland or thyrotropin-releasing hormone (TRH) from the hypothalamus (secondary or tertiary hypothyroidism). The patient's appearance may vary from asymptomatic to, rarely, coma with multisystem organ failure (myxoedema coma).
Methods: The present observational descriptive, cross sectional study has been conducted on 120 newly diagnosed Subclinical Hypothyroidism patients of 20-50 years age group of both sex attending the OPD of department of medicine, RVRS medical college and associated group of hospitals, Bhilwara from May 2021 to May 2022. Diagnosis of thyroid disorder has been made according to the criteria recommended by the European thyroid association guidelines-2013. The result has been compared with age and gender matched 120 euthyroid subjects acting as controls. Detailed history of participants including age, history of any medications, addictions has been taken. Written consent from all the subjects has been obtained for the study.
Results: The mean serum FT3 level was found to be slightly decreased in Subclinical hypothyroid subjects (group I) as compared to healthy controls (group II) but the difference was statistically significant (p<0.0001). The mean serum FT4 level was found to be slightly decreased in Subclinical hypothyroid subjects (group I) as compared to healthy controls (group II) but the difference was statistically significant (p<0.0001). A highly significant increase (p<0.0001) in mean serum TSH level has been observed in subclinical hypothyroid subjects (group-I) when compared to controls (group- II). In subclinical hypothyroid subjects, mean serum ceruloplasmin levels were found to be significantly lower in comparison to healthy subjects (p<0.0001).
Conclusions: The overall findings of the present study thus confirm that serum Apelin level is significantly higher in subclinical hypothyroid subjects and serum ceruloplasmin level is significantly lower in the subclinical hypothyroid subjects. However, further experimental and observational studies are needed to illustrate the role of serum ceruloplasmin and serum apelin in subclinical hypothyroidism.
References
Matsuzawa Y. Adipocytokines and metabolic syndrome, Semin Vasc Med. 2005;5:34-8.
Goglia F, Moreno M, Lanni A. Action of thyroid hormones at the cellular level: the mitochondrial target. FEBS Lett. 1999;452:115-20.
Klein I. Thyroid hormone and the cardiovascular system. Am J Med. 1990;88:631-7.
Riis AL, Hansen TK, Moller N, Weeke J, Jorgensen JO. Hyperthyroidism is associated with suppressed circulating ghrelin levels. J Clin Endocrinol Metab. 2003;88:853-7.
Demers LM, Spencer CA. Laboratory Medicine Practice Guidelines: Laboratory Support for The Diagnosis and Monitoring, Thyroid. Clin Endocrinol (Oxf). 2003;13:57-67.
Menendez C, Baldelli R, Camina JP, Escudero B, Peino R, Dieguez C et al. TSH stimulates leptin secretion by a direct effect on adipocytes. J Endocrinol. 2003;176:7-12.
Aragao CN, Souza LL, Cabanelas A, Oliveira KJ, Pazos-Moura CC. Effect of experimental hypoand hyperthyroidism on serum adiponectin. Metabolism. 2007;56:6-11.
Baumgartner C, Blum MR, Rodondi N. Subclinical hypothyroidism: summary of evidence in 2014. Swiss Med Wkly. 2014;144:w14058.
Hollowell JG, Staehling NW, Flanders WD. 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.
Mahanta A, Choudhury S, Choudhury SD. Prevalence of hypothyroidism in Assam: Fetuin-A and hs-CRP levels in subclinical hypothyroidism Int J Health Sci Res. 2020;337(10)6.
Vanderpump MP, Tunbridge WM, French JM, Appleton D, Bates D, Clark F et al et al. The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham survey. Clin Endocrinol (Oxf). 1995;43:55-68.
Huber G, Staub JJ, Meier C: Prospective study of the spontaneous course of subclinical hypothyroidism- prognostic value of thyrotropin, thyroid reserve and thyroid antibodies. J Clin. Endocrinol Metab. 2002;87(7):3221-6.
Surks MI, Ortiz E, Daniels GH: Subclinical thyroid disease-scientific review and guidelines for diagnosis and management. JAMA. 2004;291(2):228-38.
Ladenson PW, Singer PA, Ain KB. American Thyroid Association guidelines for detection of thyroid dysfunction. [published correction appears in Arch Intern Med. 2001;161(2):284
Mc Dermott MT, Ridgway EC. Subclinical hypothyroidism is mild thyroid failure and should be treated. J Clin Endocrinol Metab. 2001;86(10):4585-90.
Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado thyroid disease prevalence study. Arch Intern Med. 2000;160(4):526-34.
Fatourechi V. Subclinical hypothyroidism- an update for primary care physicians. Mayo Clin. Proc. 2009;84(1):65-71.
Hak AE, Pols HA, Visser TJ. Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women-the Rotterdam study. Ann Intern Med. 2000;132(4):270-8.
Libby P. Inflammation in atherosclerosis. Arterioscler Thromb Vasc Biol. 2012;32:2045-51.
Khan MAH, Majumder I, Hoque M, Fariduddin M, Mollah FH, Arslan MI. Lipid profile in hypothyroid patients: a cross sectional study. Med Today. 2013;25(1):21-40.
Kleinz MJ, Davenport AP. Emerging roles of apelin in biology and medicine. Pharmacol Therap. 2005;07:198-211.
Boron WF, Boulpaep EL. Medical Physiology: A Cellular and Molecular Approach. Saunders, Philadelphia. 2003.
Hollowell JG, LaFranchi S, Smallridge RC, Spong CY, Haddow JE, Boyle CA. 2004 Where do we go from here?-summary of working group discussions on thyroid function and gestational outcomes. Thyroid. 2005;15(1):72-6.
Hueston WJ, King DE, Geesey ME. Serum biomarkers for cardiovascular inflammation in subclinical hypothyroidism. Clin Endocrinol. 2005;63(5):582-7.
Sharma R, Sharma TK, Kaushik GG, Sharma S, Vardey SK, Sinha M. Subclinical hypothyroidism and its association with cardiovascular risk factors. Clin Lab. 2011;57:719-24.
Kong WM, Sheikh MH, Lumb PJ. A 6-month randomized trial of thyroxine treatment in women with mild subclinical hypothyroidism. Am J Med. 2002;113(3):264
Ochs N, Auer R, Bauer DC, Nanchen D, Gussekloo J, Cornuz J. Meta-analysis: subclinical thyroid dysfunction and the risk for coronary heart disease and mortality. Ann Intern Med. 2008;148(11):832-45.
Cooper DS. Subclinical hypothyroidism. N Engl J Med. 2001;345(4):260-65.
Arner E, Forrest AR, Ehrlund A. Ceruloplasmin is a novel adipokine which is overexpressed in adipose tissue of obese subjects and in obesity-associated cancer cells. PLOS one. 2014;9(3):e80274.
Baskin HJ, Cobin RH, Duick DS, Gharib H, Guttler RB, Kaplan MM et al. American Association of clinical Endocrinologists medical Guidelines for clinical practice for the Evaluation and Treatment of hyperthyroidism and hypothyroidism. Endocrinol. 2002;8:457-67.
Gurel A, Dogantekin A, Ozkan Y, Aydın S. Serum apelin levels in patients with thyroid dysfunction. Int J Clin Exp Med. 2015;8(9):16394-8.
Masaki T, Chiba S, Yasuda T, Tsubone T, Kakuma T, Shimomura I et al. Peripheral, but not central, administration of adiponectin reduces visceral adiposity and upregulates the expression of uncoupling protein in agouti yellow (Ay/a) obese mice. Diabetes. 2003;52:2266-73.
Bhattacharya A, Saha R, Mondal T, Choudhuri S, Gupta S. Ceruloplasmin and serum MDA levels in hypothyroid patients. Int J Biomed Adv Res. 2014;5(8):369-72.
Lee DK, Cheng R, Nguyen T, Fan T, Kariyawasam AP, Liu Y. Characterization of apelin, the ligand for the APJ receptor. J Neurochem. 2000;74:34-41.
Garg A. Adipose tissue dysfunction in obesity and lipodystrophy. Clin Cornerstone. 2006;8(4):S7-13.
Pucci E, Chiovato L, Pinchera A. Thyroid and lipid metabolism. Int J Obes Relat Metab Disord. 2000;24(2):S109-12.
Gueorguiev M, Goth ML, Korbonits M. Leptin and puberty: A review. Pituitary. 2001;4:79-86.
Korbonits M. Leptin and the thyroid--a puzzle with missing pieces. Clin Endocrinol (Oxf). 1998;49:569-72.
Masaki T, Chiba S, Yasuda T, Tsubone T, Kakuma T, Shimomura I, Funahashi T, Matsuzawa Y, Yoshimatsu H. Peripheral, but not central, administration of adiponectin reduces visceral adiposity and upregulates the expression of uncoupling protein in agouti yellow (Ay/a) obese mice. Diabetes. 2003;52:2266-73.
Rousset S, Alves-Guerra MC, Mozo J, Miroux B, Cassard-Doulcier AM, Bouillaud F et al. The biology of mitochondrial uncoupling proteins. Diabetes. 2004;53:S130-5.
Higuchi K, Masaki T, Gotoh K, Chiba S, Katsuragi I, Tanaka K et al. Apelin, an APJ receptor ligand, regulates body adiposity and favors the messenger ribonucleic acid expression of uncoupling proteins in mice. Endocrinology. 2007;148:2690-7.
Boucher J, Masri B, Daviaud D, Gesta S, Guigné C, Mazzucotelli A et al. Apelin, a newly identified adipokine up-regulated by insulin and obesity. Endocrinology. 2005;146:1764-71.
Zorlu M, Kiskac M, Karatoprak C, Kesgin S, Cakirca M, Yildiz K et al. Assessment of serum apelin and lipocalin-2 levels in patients with subclinical hypothyroidism. Ann Endocrinol (Paris) 2014;75:10-14.
Menendez C, Baldelli R, Camina JP, Escudero B, Peino R, Dieguez C et al. TSH stimulates leptin secretion by a direct effect on adipocytes. J Endocrinol. 2003;176:7-12.
Aragao CN, Souza LL, Cabanelas A, Oliveira KJ, Pazos-Moura CC. Effect of experimental hypo-and hyperthyroidism on serum adiponectin. Metabolism. 2007;56:6-11.
Iglesias P, Alvarez FP, Codoceo R, Diez JJ. Serum concentrations of adipocytokines in patients with hyperthyroidism and hypothyroidism before and after control of thyroid function. Clin Endocrinol (Oxf). 2003;59:621-9.
Riis AL, Hansen TK, Moller N, Weeke J, Jorgensen JO. Hyperthyroidism is associated with suppressed circulating ghrelin levels. J Clin Endocrinol Metab. 2003;88:853-7.
Yu H, Yang Y, Zhang M, Lu H, Zhang J, Wang H et al. Thyroid status influence on adiponectin, acylation stimulating protein and complement C3 in hyperthyroid and hypothyroid subjects. Nutr Metab (Lond). 2006;3:13.
Saito T, Kawano T, Saito T, Ikoma A, Namai K, Tamemoto H et al. Elevation of serum adiponectin levels in Basedow disease. Metabolism. 2005;54:1461-6.
Torun AN, Kulaksizoglu S, Kulaksizoglu M, Pamuk BO, Isbilen E et al. Serum total antioxidant status and lipid peroxidation marker malondialdehyde levels in overt and subclinical hypothyroidism. Clin Endocrinol. 2009;70:469-74.
Das K, Chainy GB. Thyroid hormone influences antioxidant defense system in adult rat brain. Neurochem. Res. 2004;29(9):1755-66.
Resch,U.,Helsel, G., Tatzber, F., Sinzinger, H. Antioxidant status in thyroid disfunction. Clin Chem Lab Med. 2002;40:1132-4.
Baskol G, Atmaca H, Tanrıverdi F, Baskol M, Kocer D, Bayram F. Oxidative Stress and Enzymatic Antioxidant Status in Patients with Hypothyroidism before and after Treatment. Exp Clin Endocrinol Diabetes. 2007;115(8):522-6.
Joshi VR, Mallick AK, Goud MBK, Maradi RC, Reddy MG, Raghavendra T et al. Effect of serum copper concentration and ceruloplasmin on lipid parameters leading to increased propensity to cardiovascular risk. Res J Pharmaceutical Biolog Chem Sci. 2011;2(2):558-63.
