Thyroid Function Test, C- Reactive Protein And Blood Lipids In Subclinical Hypothyroidism Patients Reporting At Surgical Wards
DOI:
https://doi.org/10.51985/JBUMDC2018005Keywords:
Subclinical hypothyroidism, Dyslipidemia, C-reactive proteinAbstract
ABSTRACT:
Objective: To investigate the thyroid function, C-reactive protein (CRP) and blood lipid profile in the subclinical
hypothyroidism (SH) patients in surgical wards and outpatient department.
Study design: Cross sectional study
Place and Duration: Department of surgery, Isra University Hospital from August 2014 to May 2017.
Materials and Methods: 100 subclinical hypothyroid cases and 100 controls were included according to inclusion
and exclusion criteria. Serum TSH level > 6.2 (μIU /ml) with normal free T4 and T3 was considered as subclinical
hypothyroidism. Venous blood was taken from ante cubital vein, centrifuged and processed. Sera were used for the
assay of thyroid hormones, TSH, blood lipids and C-reactive protein. Data variables were analyzed by Statistix 8.0
(95% confidence interval) (P-value =0.05).
Results: Age in controls and cases was noted as 51.3±12.5 and 50.8±11.95 years respectively. SH cases show serum
T3, T4 and TSH as 0.89±0.18 μg/dl, 4.96±0.85 μg/dl and 11.95±2.85 μU/ml respectively. Serum total cholesterol,
triglycerides and LDLc were raised with concomitant low HDLc in SH cases. C- reactive protein in SH cases was
6.91±3.38 ng/ml compared to controls 2.56±1.51 ng/ml (P=0.0001). Serum TSH showed negative correlation with
HDLc, serum T3 and T4.
Conclusion: The present study reports dyslipidemia with elevated inflammatory marker of C-reactive protein in
subclinical hypothyroid patients.
References
Ufion AA, Zulfiqar B, Hassan A, Habibi R, Boddu P. Subclinical Hypothyroidism and Its Association with increased Cardiovascular Mortality. Cardiol Res Prac 2017; Article ID 7539735:1-5.
Marchiori RC, Pereira LAF, Naujorks AA, Rovaris DL, Meinerz DF, Duarte MMF, et al. Improvement of blood inflammatory marker levels in patients with hypothyroidism under levothyroxine treatment. BMC End Dis 2015; 15 (32):1-9.
Mohamed GA, Elsayed AM. Subclinical hypothyroidism ups the risk of vascular complications in type 2 diabetes. Alexandria J Med 2017; 53; 285–288.
Turemen EE, Cetinarslan B, Sahin T, Canturk Z, Tarkun I. Endothelial dysfunction and low grade chronic inflamma- tion in subclinical hypothyroidism due to autoimmune thyroiditis. Endocr J 2011; 58(5):349-54.
Bilgir O, Bilgir F, Calam M, Calam OG, Yuksel A. Comparison of pre- and post-levothyroxine high-sensitivity c-reactive protein and fetuin-a levels in subclinical hypothyroidism. Clinics 2015;70:97–101
Deshmukh V, Behl A, Iyer V, Joshi H, Dholye JP, Varthakavi PK. Prevalence, clinical and biochemical profile of subclin- ical hypothyroidism in normal population in Mumbai. Indian J Endocrinol Metab 2013; 17(3):454-59.
Shekhar R, Chowdary NVS, Das MC, Vidya D, Prabodh S. Prevalence of subclinical hypothyroidism in coastal Andhra Pradesh. Biomedical Research 2011; 22(4):471-44.
Wang CY, Chang TC, Chen MF. Associations between subclinical thyroid disease and metabolic syndrome. Endocrine J 2012; 59(10):911-17.
Park YJ, Lee EJ, Lee YJ, Choi SH, Park JH, Lee SB, et al. Subclinical hypothyroidism (SCH) is not associated with metabolic derangement, cognitive impairment, depression or poor quality of life (QoL) in elderly subjects. Arch Gerontol Geriatr 2010; 50(3):68-73.
Hak AE, Pols HA, Visser TJ, Drexhage HA, Hofman A, Witteman JC. Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam Study. Ann Int Med 2000; 132(4):270-78.
Libby P. Inflammation in atherosclerosis. Arterioscler Thromb Vasc Biol 2012; 32:2045–51.
Lowe GD. Circulating inflammatory markers and risks of cardiovascular and non- cardiovascular disease. J Thromb Haemost 2005; 3(8):1618-27.
Ridker PM. C- reactive protein - A simple test to help predict r isk of hea r t attack and stroke. Circulation 2003;108(12):81-85.
Yu YT, Ho CT, Hsu HS, Li CI, Davidson LE, Liu CS. Subclinical hypothyroidism [15] is associated with elevated high sensitive C-reactive protein adult Taiwanese. Endocrine 2013; 44(3):716-22.
Chawla R. Practical clinical biochemistry methods and interpretation. Jaypee Brothers India. 3rd Ed 2008: 277- 79
Burtis CA, Ashwood ER, Bruns DE. Teitz fundamentals of clinical chemistry. Saunders An imprint of Elsevier. 6th Ed 2010: 422-24.
Erhardt JG, Estes JE, Pfeiffer CM, Biesalski HK, Craft NE. Combined measurement of ferritin, soluble transferring receptor, retinol binding protein, and C-reactive protein by an inexpensive, sensitive, and simple sandwich enzyme- linked immunosorbent assay technique. J Nutr, 2004; 134(11):3127-32.
Christ-Crain M, Meier C, Guglielmetti M, Huber PR, Riesen W, Staub JJ, Muller B. elevated C-reactive protein and homocysteine values: cardiovascular risk factors in hypothyroidism? A cross-sectional and a double blind, placebo-controlled trial. Atherosclerosis, 2003; 166(2):379- 86.
Calorabo P, Golia E, Yeh ET. Role of C reactive protein in acute myocardial infarction and stroke: possible therapeutic approaches. Curr Pharm Biotechnol. 2012; 13(1):4-16.
Mala S, Kumar S, Piryanka K, Shaikh ZA. Serum inflamma- tory markers in subclinical hypothyroidis. Eur J Pharma Med Res 2017;4(9): 855-859.
Ridker PM, Hennekens CH, Burning JE, Rifai N. C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. New Engl J Med. 2000; 342(12):836-43.
Arikan S, Bahceci M, Tuzcu A, Celik F, Gokalp D. Postprandial hyperlipidemia in overt and subclinical hypothyroidism. Eur J Intern Med. 2012; 23(6):e141-45.
Ujwal Upadya B, Suma MN, Srinath KM, Prashant A, Doddamani P, Sv S. Effect of insulin resistance in assessing the clinical outcome of clinical and subclinical hypothyroid patients. J Clin Diagn Res. 2015; 9(2):1-4.
Sridevi A, Vivekanand B, Giridhar G, Mythili A, Subrahmanyan KA. Insulin resistance and lipid alterations in subclinical hypothyroidism. Indian J Endocrinol Metab, 2012; 16(Suppl 2):S345–46.
Kvetny J, Heldgaard PE, Bladbjerg EM, Gram J. Subclinical hypothyroidism is associated with a lowgrade inflammation, increased triglyceride levels and predicts cardiovascular disease in males below 50 years. Clin Endocrinol (Oxf), 2004; 61(2):232-38.
Erdem TY, Ercan M, Ugurlu S, Balci H, Acbay O, Gundogdu
S. Plasma viscosity, an early cardiovascular risk factor in women with subclinical hypothyroidism. Clin Hemorheol Microcirc, 2008; 38(4):219-25.
Ford ES. Body mass index, diabetes, and c reactive protein among U.S. adults. Diabetes Care, 1999; 22:1971-77.
Ridkar PM, Rifai N, Rose L. Comparison of c reactive protein and low density lipoprotein cholesterol levels in the prediction of first cardiovascular events. N Eng J Med, 2002; 347:1557-65.
Roy S, Banerjee U, Dasgupta A. Effect of Sub clinical hypothyroidism on C reactive protein and ischemia modified albumin. Mymensingh Med J 2015; 24(2):379- 84.
Karoli R, Fatima J, Shukla V, Chandra A, Khanduri S, Rawat
A. hospital based study of carotid intima media thickness and high sensitivity C-reactive protein in young hypothyroid patients. JIACM 2014; 15(2):116-19.
Mahto M, Chakraborthy B, Gowda SH, Kaur H, Vishnoi G, Lali P. Are hsCRP levels and LDL/ HDL Ratio Better and Early Markers to Unmask Onset of Dyslipidemia and In- flammation in Asymptomatic Subclinical Hypothyroidism? Ind J Clin Biochem 2012; 27(3):284–89.
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(9- 10):719-24.
Duntas LH, Wartofsky L. Cardiovascular risk and subclinical hypothyroidism: focus on lipids and new emerging risk factors. What is the evidence? Thyroid 2007; 17(11):1075- 84.
Xiang GD, Pu J, Sun H, Zhao L, Yue L, Hou J. Regular aerobic exercise training improves endothelium-dependent arterial dilation in patients with subclinical hypothyroidism. Eur J Endocrinol 2009; 161(5):755-61
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Copyright (c) 2018 Summaya Qazi, Khalil ahmed Almani, Rizwanullah Junaid Bhanbhro
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