DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20192473

Clinical profile and lipid abnormalities in subclinical and overt primary hypothyroidism

Mrutyunjay B. Hiregoudar, Pradeep Kumar Mohanty, Sagnika Tripaty, Amita Kerketta, Uttam Kumar Soren, Sunil Kumar Sukla

Abstract


Background: Overt and subclinical hypothyroidism, affects metabolism of lipids particularly that of cholesterol, low density lipoprotein and triglyceride. Hypercholesterolemia predisposes to atherosclerosis and thereby increases cardiovascular risks.

Methods: Hundred patients of primary  hypothyroidism of age more than 15 yrs were included. Five milliliters of venous blood was drawn in fasting state and serum obtained; thyroid function test (TFT) and fasting lipid profile were performed. Based on the TFT, patients were categorized as sub clinical or overt hypothyroidism. Clinical data, thyroid and lipid profiles obtained were analyzed and compared using statistical methods.

Results: Seventy patients were females and thirty were males in the ratio of 2.3:1. Most common age group was 51-60years followed by 41-50years. Most common symptom was generalised weakness followed by weight gain, cold intolerance, constipation, hair loss, paraesthesia’s. Most common signs were myxoedema, delayed ankle reflex relaxation, dry and  coarse skin, bradycardia, non-pitting peripheral edema, madarosis, pallor, goiter. Patients with Overt hypothyroidism had significantly higher serum levels of total cholesterol(249.1±31.7 mg/dl), Triglycerides (191.5±68.5 mg/dl) and LDL cholesterol(167.7±31 mg/dl) than the Subclinical hypothyroidism with total cholesterol(202±19.8),triglycerides(155.6±35) and LDL cholesterol(129±21.1) but HDL cholesterol  level remains normal in both overt  (44.0±4.7) and subclinical  (43.1±4.4)hypothyroidism respectively.

Conclusions: Patients with Overt hypothyroidism had significantly higher levels of Total cholesterol, Triglycerides (TG) and LDL cholesterol than the Subclinical hypothyroidism but HDL cholesterol level remains normal in both. So, concomitant estimation of lipid profile in hypothyroidism patients is needed for early intervention and prevention of cardiovascular morbidity and mortality.


Keywords


Cholesterol, Hypothyroidism, Lipid profile, TSH

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References


Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, Spencer CA, Braverman LE. Serum TSH, T4, and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metabolism. 2002 Feb 1;87(2):489-99.

Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado thyroid disease prevalence study. Arch Internal Med. 2000 Feb 28;160(4):526-34.

Vanderpump MPJ, Tunbridge VMG, French TM, Appletant D, Batast D, Clark R, et al. The incidence of thyroid disorders in a community: a twenty year follow up Wickham survey. Clin Endocrinal. 1995;43(1):55-8.

Unnikrishnan AG, Menon UV. Thyroid disorders in India: An epidemiogical perspective. Indian J Endocrinol Metab. 2011;15(6):578-81.

Tunbridge WMG, Evered DC, Hall R, Appleton D, Brewis M, Clark F. The spectrum of thyroid disease in a community: the Wickham survey. Clin Endocrinol. 1977;7(6):481-3.

Teixeira DSP, Reuters SV, Ferreira MM, Almeida PC, Reis AAF, Buescu A, et al. Lipid profile in different degrees of hypothyroidism and effects of levothyroxine replacement in mild thyroid failure. Translation Res. 2010;151(4):224-31.

Muck low JC. Barker DJP. Ankle reflex timing as screening procedure for the detection of hypothyroidism. Brit J Soc Med. 1970;24(1):16-7.

Vasudevan N, Ogawa S, and Pfaff D. estrogen and thyroid hormone receptor interactions: physiological flexibility by molecular specificity. Physiol Rev. 2002;82(4):923-44.

Bahemuka M, Hodkinson HN. Screening of hypothyroidism in elderly In patients. Br Med J. 1975 Jun 14;2(5971):601-3.

Jabbari A, Besharat S, Razavianzadeh N, Moetabar M. Common signs and symptoms in hypothyroidism in central part of Iran. Pak J Med Sci. 2008 Jan 1;24(1):44.

Zulewski H, Mller B, Exer P, Miserez AR, Staub JJ. Estimation of tissue hypothyroidism by a new clinical score: evaluation of patients with various grades of hypothyroidism and controls. J Clin Endocrinol Metab. 1997;82(3):771-6.

Dogra A, Dua A. Cutaneous changes in hypothyroidism. Thyroid Res Pract. 2006 May 1;3(2):45.

Samanta BB. Clinical Profile of Hypothyroidism. Maharashtra Source: Indian Medical Gazette.

Lohano AK, Siaya NN, Samie A. Overt hypothyroidism. Professional Med J. 2014;21(01):75-8.

Sampath S, Singh P, Somani BL, Arora MM, Batra HS, Harith AK, Ambade V. Study of clinicobiochemical spectrum of hypothyroidism. Med J Armed Forces India. 2007 Jul 1;63(3):233-6.

Raju D, Soni S, Chaurasia A, Baghel PK, Jatav OP, Jain MK. Study of clinical profile of hypothyroidism.

Haritha S, Sampath KK. Skin manifestations of hypothyroidism-A clinical study. IOSR J Dent Med Sci. 2013;7(2):58-60.

Prakash A, Lal AK. Serum lipids in hypothyroidism: our experience. Indian J Clin Biochem. 2006 Sep 1;21(2):153-5.

Tagami T, Tamanaha T, Shimazu S, Honda K, Nanba K, Nomura H, et al. Lipid profiles in the untreated patients with Hashimoto thyroiditis and the effects of thyroxine treatment on subclinical hypothyroidism with Hashimoto thyroiditis. Endocr J. 2010;57(3):253-8.

Saini V, Yadav MA, Arora S, Singh R, Bhattacharjee J. Association between different degrees of hypothyroidism and serum lipids. Internet J Med Update-E J. 2012;7(2):3-8

Regmi A, Shah B, Rai BR, Pandeya A. Serum lipid profile in patients with thyroid disorders in central Nepal. Nepal Med Coll J. 2010;12(4):253-6.