scholarly journals The Clinical Implications of Thyroid Hormones and its Association with Lipid Profile: A Comparative Study from Western Nepal

1970 ◽  
Vol 1 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Ankush Mittal ◽  
Brijesh Sathian ◽  
Arun Kumar ◽  
Nishida Chandrasekharan ◽  
Sanjeev Dwedi

BackgroundThyroid dysfunction is one of the major public health problems in Nepal. Laboratory tests facilitate early diagnosis before clinical features are obvious, increased sensitivity carries the price of decreased diagnostic specificity. Laboratory tests coupled with supportive clinical findings are frequently used to diagnose thyroid dysfunction. Historically, hypercholesterolemia and raised serum low density lipoprotein (LDL) cholesterol levels have been found to be associated with subclinical hypothyroidism. Therefore, assessment of altered lipid profile plays a supportive role in diagnosis of thyroid dysfunction. The aim of our study was to find out the variations of thyroid hormones and lipid profile in hyperthyroidism and hypothyroidism with their clinical implications.Materials and Methods  It was a hospital based retrospective study carried out from the  data  retrieved  from  the  register  maintained  in  the Department of Biochemistry of the Manipal Teaching Hospital, Pokhara, Nepal between 1st July, 2009 and 30th June, 2010. The variables collected were age, gender, T4, T3, TSH, fT4, total cholesterol and triglyceride levels. Descriptive statistics and testing of hypothesis were used for the analysis of data.Results122 out of the 365 subjects selected for the study had some form of thyroid disorder. Of the 122 cases, 40 had hyperthyroidism, 42 had hypothyroidism and the remaining 40 were diagnosed to have subclinical hypothyroidism.  The frequency of thyroid disorders was much higher in females as compared to their male counterparts. The mean value of each variable in cases, except for age, was statistically significant as compared to controls (p=0.001). Elevated levels of total T3 (CI 2.14 to 2.59), T4 (CI 13.00 to 15.30) and fT4 (CI 2.51 to 2.81) associated with decreased TSH levels (CI 0.29 to 0.35) were found in cases of hyperthyroidism. The TSH values (CI 17.05 to 22.85) were markedly increased while T4 and T3 values were found to be less than the reference range in cases of hypothyroidism. There was significant increase in the mean concentration of total cholesterol (CI 268.83 to 289.79) and triglycerides (CI 154.81to 182.05) in cases of hypothyroidism. The fT4 (CI 1.08 to 1.22) levels were in reference range and TSH levels (CI 9.59 to 10.50) were moderately raised in cases of subclinical hypothyroidism.ConclusionThyroid dysfunction is common across all age groups and shows a strong female preponderance in Pokhara valley. It necessitates the measurement of thyroid hormones in women after the age of 50, in pregnancy and after delivery, and in women and men with hypercholesterolemia. Therefore, timely screening and check ups are necessary in order to curtail the problem of undiagnosed cases, giving specific consideration to patients who have high artherogenic profile. This will reduce the risk of future negative health events in older adults.Key Words: Thyroid hormones; Hyperthyroidism; Hypothyroidism; Lipid profile; NepalDOI: 10.3126/nje.v1i1.4102Nepal Journal of Epidemiology 2010;1 (1):11-16

2020 ◽  
Author(s):  
Ashkan Habib ◽  
Asadollah Habib

Abstract Background: Correlation of higher levels of TSH and dyslipidemia in children is controversial. This study was designed to assess the relation between lipid profile components and TSH levels in children. Method: This cross-sectional study was performed in a growth assessment clinic in Shiraz. Children aged between 2 to 18 years that came to the clinic from January till April 2018 were considered. TSH levels equal or above 5 and lower than 10 mIU/L with normal FT4 were considered as subclinical hypothyroidism. Results: 666 children were euthyroid while 181 had subclinical hypothyroidism. Mean total cholesterol in euthyroid children was 160.50 ± 29.070 mg/dl and in SH group 161.39 ± 28.694 mg/dl (P=0.713). Mean LDL-C in euthyroid children was 90.96 ± 24.996 mg/dl and in SH group 89.10 ± 23.852 mg/dl (P=0.369). Mean HDL-C in euthyroid children was 47.94 ± 10.560 mg/dl and in SH group 49.04 ± 10.361 mg/dl. (P=0.211). Mean non HDL-C in euthyroid children was 112.56 ± 27.696 mg/dl and in SH group 112.35 ± 28.136 mg/dl. (P=0.929). Mean triglyceride in euthyroid children was 104.98 ± 54.934 mg/dl and in SH group 113.83 ± 91.342 mg/dl (P=0.215). There was no significant difference in mean serum total cholesterol, LDL, HDL, non-HDL and triglyceride levels between euthyroid and subclinical hypothyroid. Adjusted correlation was not significant between TSH levels and any lipid profile component. Conclusion: By comparing the results of this study with other studies, it is evident that lipid disorder in subclinical hypothyroid children does not have a specific pattern.


Author(s):  
I. A. Tsanava ◽  
S. V. Bulgakova ◽  
A. V. Melikova

Manifest hypothyroidism occurs in more than 5 % of the population, while prevalence of subclinical hypothyroidism is much higher and reaches 15 %. In the practice of an endocrinologist, in most cases, the diagnosis and treatment of manifest hypothyroidism does not raise questions, while subclinical changes in thyroid hormones quite often generate a lot of discussions. The generally accepted reference range for TSH up to 4.50 μIU / ml is in conflict with data showing that more than 95 % of healthy people with euthyroidism have serum TSH levels up to 2.5 μIU / ml. At the same time, a lot of data has been accumulated on the effect of even slightly altered levels of thyroid hormones and TSH on various tissues, organs and systems of the body, especially on the cardiovascular, nervous and reproductive systems. This review analyzes the results of studies aimed at studying the relationship of subclinical hypothyroidism with cardiovascular and metabolic disorders, cognitive disorders, pathology of pregnant women.


2018 ◽  
Vol 5 (4) ◽  
pp. 978
Author(s):  
Tumbanatham A. ◽  
Jayasingh K. ◽  
Varun Vijayan Vijayan

Background: Subclinical hypothyroidism (SH) is characterized by elevated levels of serum thyroid stimulating hormone in the presence of normal thyroxin levels. Subclinical hypothyroidism is often associated with elevated total cholesterol and other lipid profile parameters. This study was done to evaluate the lipid metabolism in subclinical hypothyroidism.Methods: This case control study was done to compare the lipid profile parameters between subclinical and overt hypothyroidism cases attending the outpatient facility of our tertiary care hospital of our medical college in Puducherry. Newly diagnosed cases of hypothyroidism were selected by convenient sampling. A total of 37 SH cases and 31 overt hypothyroidism cases were included. Blood samples were drawn to measure lipid profile. A 2D echocardiogram was done to evaluate cardiac function. Ultrasonogram was done to evaluate fatty liver.Results: The mean age of the participants in the subclinical hypothyroidism group was 34.2±12.2 years while in the clinical hypothyroidism group was 35.7±9.8 years. About 13.5% of the participants in subclinical hypothyroidism group and 12.9% of the participants in clinical hypothyroidism had fatty liver in ultrasound. A significant difference was observed in the mean values of total cholesterol, triglycerides and LDL levels between clinical and subclinical hypothyroidism.Conclusions: This study highlights the need for screening of subclinical hypothyroidism in order to prevent the incidences of cardiovascular complications and other diseases like metabolic syndrome.


2017 ◽  
Vol 4 (5) ◽  
pp. 1333
Author(s):  
Abhishek Gupta ◽  
Kuldeep K. ◽  
S. K. Virmani ◽  
Mayank Arora

Background: Thyroid hormones play a very important role in regulating metabolism, development, protein synthesis, and influencing other hormone functions. CKD has been known to affect the pituitary-thyroid axis and the peripheral metabolism of thyroid hormones. We aimed to study the thyroid dysfunction in patients of chronic kidney disease for the prevalence of subclinical hypothyroidism.Methods: This cross-sectional study was conducted at Chhatrapati Shivaji Subharti Hospital and Medical College, Meerut, Uttar Pradesh, India, over a 2 year period. The study group comprised 100 patients with Chronic kidney disease. Free thyroxine (fT3, fT4) and thyroid-stimulating hormone (TSH) were measured. Patients with family history of thyroid disorder or past history of any medication for thyroid disease or history of any surgery or any radiological intervention to thyroid gland were excluded from the study.Results: Of 100 CKD patients, 25 were found to have subclinical hypothyroidism (SCH) and 75 were euthyroid. The mean age in patients with SCH was 47.72±10.09 and in euthyroid patients was 46.11±14.332. 12 males (48%) and 13 females (52%) patients were found to have subclinical hypothyroidism and 49 male (65%), 26 female (35%) patients were euthyroid. Prevalence of SCH was 25% with a mean TSH level of 8.68± 1.84.Conclusions: We observed a high prevalence of SCH in our CKD patients. SCH is an additional risk factor in CKD patients and the present study finds thyroid dysfunction being SCH to be very common in CKD patients and reveals significant association between CKD progression and thyroid dysfunction.


2017 ◽  
Vol 10 (2) ◽  
pp. 126-129
Author(s):  
Irena I. Gencheva-Angelova ◽  
Adelaida L. Ruseva ◽  
Juli I.Pastuhov

Summary Significant losses of functional proteins such as hormones and hormone-binding proteins are seen in patients suffering from proteinuria. Studies have reported loss of thyroid hormones and thyroxine-binding globulin in the urine. There is evidence that subclinical hypothyroidism is six times more common in patients with proteinuria than in healthy people. The parameters of the effect of proteinuria on thyroid function have not been fully studiedyet.We investigated 74 patients with qualitatively established proteinuria, of whom 34 men and 40 women, without diagnosed thyroid disease. The average age of the patients was 60.9 years. We tested 20 free controls for free thyroxine (FT4), thyroid stimulating hormone (TSH), creatinine and albumin in serum, and the quantity of urine protein. The mean results found for TSH were higher in the patients with proteinuria than in those of the controls (2.719 mU/l vs 1.78 mU/l). For FT4, the mean result in the patients with proteinuria was 17.04 pmol/l vs 16.39 pmol/l. in the controls. A correlation was sought between TSH and FT4 levels and all the laboratory parameters we tested. Patients with proteinuria had higher TSH levels, probably due to the loss of thyroid hormones in the urine. However, these losses cannot lead to clinically proven hypothyroidism.


1998 ◽  
pp. 141-145 ◽  
Author(s):  
G Michalopoulou ◽  
M Alevizaki ◽  
G Piperingos ◽  
D Mitsibounas ◽  
E Mantzos ◽  
...  

OBJECTIVE: The association between established hypothyroidism and high cholesterol levels is well known. The aim of the present study was to investigate the effect of thyroxine (T4) administration on cholesterol levels in hypercholesterolemic subjects with TSH levels within the normal range ('high-normal' TSH compared with 'low-normal' TSH). DESIGN AND METHODS: We determined TSH levels in 110 consecutive patients referred for hypercholesterolemia (serum cholesterol >7.5 mmol/l). Those with 'high-normal' TSH (2.0-4.0 microU/ml) as well as those with 'low-normal' TSH (0.40-1.99 microU/ml) were randomly assigned to receive either 25 or 50 microg T4 daily for two months. Thus, groups A and B (low-normal TSH) received 25 and 50 microg T4 respectively and groups C and D (high-normal TSH) received 25 and 50 microg T4 respectively. Serum T4, tri-iodothyronine (T3), TSH, free thyroxine index, resin T3 uptake and thyroid autoantibodies (ThAab) as well as total cholesterol, high and low density lipoprotein cholesterol (HDL, LDL), and triglycerides were determined before and at the end of the two-month treatment period. RESULTS: TSH levels were reduced in all groups. The most striking effect was observed in group D (TSH levels before: 2.77+/-0.55, after: 1.41+/-0.85 microU/ml, P < 0.01). Subjects in groups C and D had a higher probability of having positive ThAabs. A significant reduction in total cholesterol (P < 0.01) and LDL (P < 0.01) was observed after treatment only in group D. In those subjects in group D who were ThAab negative, there was no significant effect of thyroxine on cholesterol levels. CONCLUSIONS: Subjects with high-normal TSH levels combined with ThAabs may, in fact, have subclinical hypothyroidism presenting with elevated cholesterol levels. It is possible that these patients might benefit from thyroxine administration.


Homeopathy ◽  
2021 ◽  
Author(s):  
Luiz Carlos Esteves Grelle ◽  
Luiz Antonio Bastos Camacho

Abstract Background Subclinical hypothyroidism (SCH) is a common clinical problem. Controversy surrounds the definition, clinical importance, and need for prompt diagnosis and treatment of the mild form of SCH. Aim The aim of the study was to analyze the evolution of serum thyroid stimulating hormone (TSH) levels after a therapeutic homeopathic intervention in women older than 40 years with SCH. Methods This study is a retrospective series of 19 cases of SCH, with serum TSH levels between 5 and 10 mIU/L, treated exclusively with homeopathic medicines prescribed on an individualized basis. Results Nineteen patients were included according to the inclusion and exclusion criteria. Their mean age was 56 years, they were followed for a mean duration of 69 months, the mean number of serum TSH level measurements was 18, and the intervention was successful for 13 patients. Conclusion The homeopathic therapeutic intervention was successful in 68% of the patients, with serum TSH levels back within the normal range (0.5–5.0 mIU/L).


2017 ◽  
Vol 31 (2) ◽  
pp. 86-89
Author(s):  
Farzana Deeba ◽  
Parveen Fatima ◽  
Jesmine Banu ◽  
Shakeela Ishrat ◽  
Nurjahan Begum ◽  
...  

Objective(s): Aim of this study was to find out the prevalence of hypothyroidism in infertile women as well as to assess their response to treatment.Materials and methods: This descriptive study was conducted in Infertility unit of Department of Obstetrics and Gynecology, Bangabandhu Sheikh Mujib Medical University, Bangladesh, a tertiary care centre from January 2014 to December 2014. Four hundred women who visited infertility clinic of the department for fertility treatment were the target population for this study. Routine investigations such as CBC, Blood sugar 2 hours postparandial or GTT, TSH and Prolactin was done. Subclinical hypothyroidism was diagnosed when there was increased TSH and normal FT4. Hypothyroid patients were given Levothyroxin depending upon TSH levels and continued until end of the study. Patients were followed up for six months even if pregnancy was attained.Results: Out of 400 women 55% were primary and 45% were secondary subfertility. Mean duration of infertility was 4.5 ± 1.2 years. Ninety two (23%) patients were hypothyroid. Among them 66 (16.5%) were subclinical hypothyroid and 26 (6.5%) were frank hypothyroid. The mean TSH levels were 7.34 ± 2.13 ìIU/ml, and the mean PRL levels were 52.46 ± 11.17 ng/ml. Out of 92 infertile women diagnosed as hypothyroidism 75 (81.52%) women conceived after treatment with drugs for hypothyroidism (dose depending upon severity of hypothyroidism, i.e. TSH levels). More than 90% women had regular ovulation for consecutive three cycles after initiation of treatment.Conclusion: The normal TSH levels are the pre-requisite for fertilization. The decision to initiate thyroid replacement therapy in both clinical and subclinical hypothyroidism at early stage is justified in infertile women.Bangladesh J Obstet Gynaecol, 2016; Vol. 31(2) : 86-89


2014 ◽  
Vol 3 (1) ◽  
pp. 7-12 ◽  
Author(s):  
Indrawati Wurdianing ◽  
SA Nugraheni ◽  
Zen Rahfiludin

Background: Lipid profile effects is a risk factor for Coronary Heart Disease. Soursop leaves (Annona muricata L) isa traditional medicine plant containing metabolic compounds that contribute to the improvement of the lipid profile.Objective: To determine the effects of soursop leaves extract on lipid profile (total cholesterol, LDL cholesterol, HDLcholesterol and triglyceride).Methods: An experimental study using randomized pre-posttest with control group design. Sample consisted of 28 maleWistar rats, were divided into four groups. The control group (K) was only given High Fat High Cholesterol (HFHC)diet and treatment groups (P1, P2, P3) were given a HFHC diet plus Annona muricata L extract with doses of 100, 200and 300 mg/kgBB per day for 28 days respectively. Data were analyzed by Wilcoxon test, Kruskal-Wallis and MannWhitney.Results: The mean total cholesterol level significantly decreased in the treatment group P1 (p = 0.028) from 60.7 mg/dl(47.6-75.3) to 45.5 mg/dl (38.4-62.4). Mean HDL cholesterol level significantly increased in the treatment group P2(p=0.043) from 26.0 mg/dl (19.7-35.3) to 27.9 mg/dl (18.8-38.0). The mean levels of LDL cholesterol and triglyceridedecreased but not significantly.Conclusion: The administration of Annona muricata L extract can decrease total cholesterol and increase HDLcholesterol significantly.


2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Minghua Liu ◽  
Yanyan Hu ◽  
Guimei Li ◽  
Wenwen Hu

Objective. The follow-up of GH levels in short-stature children with pituitary hyperplasia secondary to primary hypothyroidism (PPH) is reported in a few cases. We aimed to observe changes in GH secretion in short-stature children with PPH. Methods. A total of 11 short-stature children with PPH accompanied by low GH levels were included. They received levothyroxine therapy after diagnosis. Their thyroid hormones, IGF-1, PRL, and pituitary height were measured at baseline and 3 months after therapy. GH stimulation tests were performed at baseline and after regression of thyroid hormones and pituitary. Results. At baseline, they had decreased GH peak and FT3 and FT4 levels and elevated TSH levels. Decreased IGF-1 levels were found in seven children. Elevated PRL levels and positive thyroid antibodies were found in 10 children. The mean pituitary height was 14.3±3.8 mm. After 3 months, FT3, FT4, and IGF-1 levels were significantly increased (all p<0.01), and values of TSH, PRL, and pituitary height were significantly decreased (all p<0.001). After 6 months, pituitary hyperplasia completely regressed. GH levels returned to normal in nine children and were still low in two children. Conclusion. GH secretion can be resolved in most short-stature children with PPH.


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