Comparative Study of Hypothyroidism with Cardiometabolic Risk

T Sudhakar¹, Sabitha Kandi², B Venugopal², K. Bhagwan Reddy³ and K V Ramana^4,

¹Lab incharge, Apollo Reach Hospital, Karimnagar, Telangana, India

²Department of Biochemistry, Chalmeda Ananda Rao Institutue of Medical sciences, Karimnagar, Telangana, India

³Department of Biochemistry, Prathima Institute of Medical sciences, Karimnagar, Telangana, India

⁴Department of Microbiology, Prathima Institute of Medical sciences, Karimnagar, Telangana, India

Cite this paper:
T Sudhakar, Sabitha Kandi, B Venugopal, K. Bhagwan Reddy and K V Ramana. Comparative Study of Hypothyroidism with Cardiometabolic Risk. American Journal of Cardiovascular Disease Research. 2015; 3(1):1-4. doi: 10.12691/ajcdr-3-1-1

Abstract

Hypothyroidism is a thyroid deficient state which shows its influence on other metabolic pathways whereas sub-clinical hypothyroidism (SCH) is a condition where there is decreased secretion of Thyroid Stimulating Hormone (TSH) with no significant clinical symptoms. Thyroid hormones (T_3, T₄ and TSH) play an effective role in various aspects of metabolism, development and differentiation of cells. In the present study which included 558 male subjects who came for regular health checkup, 68 (12.18%) were newly diagnosed as suffering from hypothyroidism and among them, 27 (4.83%) had altered lipid parameters. The presenting symptoms included unknown cause of fatigue and weight gain. The atherogenic lipid abnormalities in subjects with hypothyroidism in Indians should be interpreted with paramount importance as there is unexpected improvement or worsening of their lipid profile which may be influenced by abnormal thyroid hormone secretion. The altered lipid profile is seen in conditions where TSH is more than 10 mIU/ml which can result in increased risk of cardiac diseases and altered hemodynamic states. Alcoholism, smoking, sedentary life style, genetic predisposition and stress are added factors to earlier onset of SCH. The important aspects in management of thyroid diseases include the public health awareness, regular screening for the presence of dyslipedemia and thyroid function tests.

Keywords:
subclinical hypothyroidism (SCH) altered lipid parameters in hypothyroidism cardiometabolic risk in hypothyroidism

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References:

[1]	B. Biondi and I. Klien. Hypothyroidism as a risk factor for cardiovascular disease. Endocrine vol. 24, No: 1, 2004: 1-13.
[2]	X. Zhu and S Y Chang. New insight into regulation of lipid metabolism by thyroid hormone. Current opinion in endocrinology, diabetes & obesity. 2010; vol. 17: No. 5: 408-413.
[3]	B.Biondi and G J Kahaly. Cardiovascular involvement in patients with different causes of hyperthyroidism. Nature reviews endocrinology. 2010: Vol. 6; No. 8: 431-433.
[4]	I. Klein and K Ojamaa. Thyroid hormone and the cardiovascular system. The New England Journal of medicine. 2001; Vol. 344: No. 7: 501-509.
[5]	S Fazio, E H Palmeiri, G Lambardi, B Biondi. Effects of thyroid hormone on the cardiovascular system. Recent Progress in Hormone, Research. 2004; Vol. 59, 31-50.
[6]	Ambika Gopal Krishna & Usha Menon. Thyroid disorders in India: An epidiological prospective. Indian journal of endocrinology metabolism. 2011; 15 (suppl) S78-S81.
[7]	P M Yen. Physiological & Molecular basis of thyroid hormone action. Physiol Rev. 2001; 81: 1097-1142.
[8]	Braverman L E, Ingbar S H, Starling K. Conversion of thyroxine (T4) to T3 in athyreotic human subjects. J Clin Invest. 1970; 49: 855-864.
[9]	Fauci AS, Kasper DL, Longo DL, Braunwald E, Hauser SL, et al,. Harrisons Principles of internal medicine. Chapter; Disorders of thyroid gland. 17th edition. Mc Graw Hill. 2008: 2224-2247.
[10]	Gray R S, Irvine W J and B F Clarke. Screening for thyroid dysfunction in diabetes. Br Med J. Dec 1; 1979: 2 (6202): 1439.
[11]	Ayala AR, Danese MD, Ladenson PW. When to treat mild hypothyroidism. Endocrinology Metab Clin Nano. 2009; 29; 399-415.
[12]	Tunbridge WM, Everes DC, Hall R, Appleton D, Brewis M et al.,. The spectrum of thyroid disease in a community; The Wickham survey. Clin Endocrinology (oxf). 1977:7; 481-93.
[13]	Sawin CT, C aslelli WP, Hashman JM, Mc Namara P. Bacharach P. The aging thyroid def in Farmingham study. Arch Inten Med. 1985; 145: 1396-88.
[14]	Geul WK, Van Sluisveld II, Grobbee DE, Docter R, deBruyun AM, Hooykoas et al.,. The importance of thyroid microsomal antibodies in development of elevated serum TSH in middle age women. Association with serum lipids. Clin Endocrinol (oxf). 1993; 39: 275-80.
[15]	Vanderpump MP, Tunbridge WM, Appleton D, French JM, Bates D, Clarke F et al.,. The incidence of thyroid disorders in community, a 20 year follow up of the Wickham survey. Clin Endocrinol. 1995; 43: 55-68.
[16]	Vashali Deshmukh, Anish behl, Vagesh Iyer, Harish Joshi, Jayasree P Dholye, Prema K Varthakavi. Prevalence, clinical and biochemical profile of subclinical hypothyroidism in normal population in Mumbai. Indian Journal of Endocrinology & Metabolism. 2013; vol. 17: 3: 454-459.
[17]	Shurty Mohanty, W AMruthlal, G C Reddy, G Kusumanjali, A S Kanaga Sabapathy & Pragna Rao. Diagnostic strategies for SCH; Indian Journal of Biochem. 2008/23 (3). 279-282.
[18]	Athans BU, Staub JJ, Ryff deleche A, Oberhansti A, Stahetin HB. LDL?HDL changes in subclinical hypothyroidism; possible risk factors for coronary heart disease. Clin Endocrinol (oxf). 1988; 28: 157-63.
[19]	Hooggendoorn EH, Hermus A R, De Vegt F, Ross H A, Verbek AL, Kiemency L A et al.,. Thyroid functions & prevelance of anti TPO antibodies in a population with borderline sufficient iodine intake; influence of age & sex. Clin Chem, 2006; 52: 104-11.
[20]	Hollowell J G, Staehling N W, Flanders WD, Hannon W H, Gunta E W, Spencer C A, et al.,. Serum TSh. T4 & Thyroid antibodies in the United States population (1988 to 1994); national Health & Nutrition Examinations survey (NHANES III). J Clin Endocrinol Metab. 2002; 87: 489-99.
[21]	Bemben D A, Hamm R M, Morgan L, Winn P Davis A, Barton E. Thyroid disease in the elderly part-2 predictability of SCH. J Fam Pract. 1994; 38: 583-8.
[22]	Ambika GopalKrishna Unni Krishnan, Sanjay Kaha, Rakesh kumar Sahay, Ganapqthi Bentwal, Mathew John, Neeraj Tewari; prevalence of hypothyroidism in adults; An epidemiological study in 8 cities of India. 2013; vol. 17: 4: 647-652.
[23]	Garduno Gariera J D E, Alvirde Gareera U, Lopez Carrasco G et al.,. TSH and free thyroxine concentration are association with differing metabolic markers in euthyroid subjects. Eur J Endolog. 2010; 163: 273-8.
[24]	Spencer CA. Clinical uses and limitations of rapid TSH assays. Medical Laboratoey Products. 1988; 17-9.
[25]	Mao YS, Liu ZM, Chen LX et al.,. Ningbo thyroid dysfunction prevalence study; cross sectional survey in an employees-cohort. Clin Med J (Eng) 2010; 123; 1673-8.
[26]	Sgarbi JA, Matsumma LK, Kasamatsu TS et al.,. Subclinical thyroid dysfunction are independent risk factor for mortality in a 7.5 year follow up; The Japanese-Brazilian thyroid study. Eur J endocrinology. 2010; 162; 569-77.
[27]	Kung A W, Janus ED. Thyroid dysfunction in ambulatory elderly Chinese subjects in an area of borderline iodine intake. Thyroid. 1996: 6: 111-.
[28]	Staub J, Athans BU, Eugler H nRy7ff AS, Trabucco P, Marquardt K et al.,. Spectrum of subclinical and overt hypothyroidism. Effect on thyrotropin Prolactin & thyroid reserve and metabolic impact on peripheral target tissue. Am J Med. 1992; 92; 631-42.
[29]	Hak AE, Pols HA, Visser TJ, Drexhage HA, Hofman A, Witterman JC. Subclinical hypothyroidism is an independent risk factor for atherosclerosis and MI in elderly women: The Rotterdam study. Ann Intern Med. 2000; 132: 270-8.
[30]	Canaris G J, Manowitz N R, Mayor G, Ridgway EC. The Colorado disease prevalence study. Arch Intern Med; 2000; 160; 526-34.
[31]	DR Pradeep Sharma, DR Dibyaratha Palgiri, DR Sapna Goyal, DR Geeta Sharma, DR M S Pathak. Hypothyroidism causing dyslipidemia in both subclinical & overt hypothyroidism: Indian Journal of Basic & applied medical research. 2013; 7; vol. 2, 779-88.
[32]	Kuldip Singh, Saranpal Singh. Alteration in lipid fraction in SCH in northern Indian population. Indian Journal of Fundamental & Applied Life Sciences. 2011; 1; 127-32.