A Comparative Study to Evaluate the Interplay of Lipoprotein (a) With Traditional Lipid Parameters in Overt and Subclinical Hypothyroidism

Introduction: Lipoprotein a {Lp(a)} increases in Nephrotic Syndrome (NS). Although the majority of paediatric NS are steroid sensitive, relpase and steroid dependence are commonly seen in this cases. Lp(a) is an LDL-like lipoprotein that consists of an LDL particle to which the glycoprotein apolipoprotein(a) {apo(a)} is attached. Aim: To evaluate the potential of Lp(a), measured on admission, for the prediction of relapse/steroid dependency. Materials and Methods: Children (n=36) with first episode NS were recruited in this prospective observational case-control study and followed up for one year. They were tested at presentation for Lp(a) (mg/dL) and standard tests such as haemoglobin, albumin, protein, cholesterol, triglyceride, and urine protein. Children received standard therapy for NS, and were followed for a period of one year from diagnosis to record days to initial remission, relapse episodes, steroid dependence etc. Patients were categorised as: no relapse (NR), Infrequent Relapse (IFR), frequent relapse (FR) and Steroid Dependent (SD) as per standard definitions. Fifteen healthy volunteers were also tested for lipid profile and Lp(a) levels. Results: Of 36 cases (median age 3 years, 19 males), there were 15NR, 7IFR, 2FR and 12SD. The mean Lp(a) of the NS group (165.2±120.4 mg/dL) was higher than controls (30.52±21.9 mg/dL) (p<0.0001). All the lipid parameters except HDL-cholesterol were significantly higher in the NS group. Within the NS group, Lp(a) showed significant correlation (Spearman-rho) with albumin (p=0.0062,r=0.47), but no correlation with lipid parameters or urine protein. Comparison of Lp(a)levels in the NS groups revealed that the SD patients had a high Lp(a)(222.0±115.7 mg/dL) compared to NR (129.7±120.1 mg/dL) (p=0.02). Conclusion: Concentration of plasma Lp(a) in patients with SDNS was higher compared to patients who did not suffer any relapse, and this concentration may serve as a marker for prediction of SDNS.

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The effect of ezetimibe monotherapy on lipoprotein-(a) and other lipid parameters

Medeniyet Medical Journal ◽

10.5222/mmj.2015.083 ◽

2015 ◽

Author(s):

Bülent Bilir ◽

Betül Ekiz Bilir ◽

Mümtaz Takır ◽

Yaşar Sertbaş ◽

Can Murat Akıncı ◽

...

Keyword(s):

Lipoprotein A ◽

Lipid Parameters

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Prevalence of sub clinical hypothyroidism and pregnancy outcome: a prospective comparative study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20200909 ◽

2020 ◽

Vol 9 (3) ◽

pp. 1250

Author(s):

Bilal Ur Rehman ◽

Hiba Gull

Keyword(s):

Comparative Study ◽

Pregnant Women ◽

Pregnancy Outcome ◽

Subclinical Hypothyroidism ◽

Apgar Score ◽

Adverse Pregnancy Outcome ◽

Significant Risk ◽

Overt Hypothyroidism ◽

Prospective Comparative Study ◽

Adverse Pregnancy

Background: In pregnancy, subclinical hypothyroidism is more common than overt hypothyroidism, ranging from 15% to 28% in Iodine sufficient region. Evidence suggests that subclinical hypothyroidism is associated with adverse pregnancy outcome. The aim of this study was to find the prevalence of subclinical hypothyroidism in pregnant women and adverse pregnancy outcome.Methods: This hospital based prospective comparative study was conducted over a period of 6 months from 1st July 2018 to 31st December 2018 in department of obstetrics and gynecology SKIMS Soura Kashmir. All the subjects who fulfilled the inclusion criteria and who consented to participate were screened for subclinical hypothyroidism.Results: A total of 175 pregnant women participated in the study and subclinical hypothyroidism was diagnosed in 25 pregnant women (14.2%). Most of our patients were in age group 21 to 30 years (69.1%). Pregnant women with subclinical hypothyroidism had significant risk of preeclampsia (35%) and higher cesarean section rate (29.6%). Neonate of women with subclinical hypothyroidism had higher incidence poor Apgar score, NICU admission.Conclusions: The prevalence of subclinical hypothyroidism is high in pregnant women and the gravity of the complications like pre-eclampsia, neonate with low Apgar score, increased NICU admission, overweight the cost of screening. In this view, we propose screening of all pregnant women in the first trimester for diagnosis.

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Profile of lipoprotein(a) and lipid parameters in acute ischemic stroke

Journal of Stroke and Cerebrovascular Diseases ◽

10.1016/j.jstrokecerebrovasdis.2003.11.005 ◽

2003 ◽

Vol 12 (5) ◽

pp. 248

Author(s):

H. Tandon ◽

O.P. Kalra ◽

G. Singh ◽

J. Gambhir ◽

G. Mehrotra

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Lipoprotein A ◽

Lipid Parameters

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Lipoprotein(a) Concentration in Subclinical Hypothyroidism Before and After Levo-Thyroxine Therapy.

Endocrine Journal ◽

10.1507/endocrj.43.731 ◽

1996 ◽

Vol 43 (6) ◽

pp. 731-736 ◽

Cited By ~ 44

Author(s):

METIN YILDIRIMKAYA ◽

METIN ÖZATA ◽

KURTULUS YILMAZ ◽

CUMHUR KILINÇ ◽

M. ALI GÜNDOGAN ◽

...

Keyword(s):

Subclinical Hypothyroidism ◽

Lipoprotein A ◽

Thyroxine Therapy ◽

Before And After

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Prevalence and association of thyroid disorders with selected risk factors and severity of disease in patients confirmed of Coronary Artery Disease

Bangladesh Journal of Medical Science ◽

10.3329/bjms.v19i4.46625 ◽

2020 ◽

Vol 19 (4) ◽

pp. 678-684

Author(s):

EM Samantha Bardara ◽

Sagarika Ekanayake ◽

Chandanie Wanigatunge ◽

Aruna Kapuruge ◽

GA Sarath Kumara

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Subclinical Hypothyroidism ◽

Bypass Graft ◽

Density Lipoprotein ◽

Lipoprotein Cholesterol ◽

Gensini Score ◽

Anthropometric Data ◽

Artery Disease ◽

Lipid Parameters

Objective: Subclinical hypothyroidism (SCH) has been identified as a risk for atherosclerosis and Coronary Artery Disease (CAD). The aim of this study was to determine the prevalence and association between hypothyroidism or subclinical hypothyroidism (SCH) and lipid parameters, anthropometric data and the severity of coronary artery disease (CAD) in patients awaiting Coronary Artery Bypass Graft Surgery (CABG) from a selected center. Method: A cross sectional analytical study was carried out amony patients awaiting CABG in a selected center. Thyroid profile (enzyme immunoassay method), lipoprotein (a) [Lp(a)], C- reactive protein (CRP) (immunoturbidimetric method) were determined and the Gensini score calculated. Lipid parameters and details of current medication were obtained from the medical records and anthropometric data were measured. Results: From a total of 102 patients 3% were on treatment for hypothyroidism and 15% had subclinical hypothyroidism. A significantly high (p= 0.04) percentage of SCH patients (75%) were dyslipidemic. There were no significant differences observed in lipid profiles and Lp(a) among SCH and euthyroid patients when the total sample or dyslipidemic sample was considered. However, a significantly high percentage (58%, p<0.05) of SCH patients on statins had a higher level of low density lipoprotein cholesterol (LDLc) compared to euthyroid dyslipidemic patients. A significant negative (p< 0.05) correlation was observed between thyroid stimulating hormone concentration and high density lipoprotein cholesterol (r= -0.67) in SCH group. No significant differences were observed in anthropometric data, CRP or Gensini score of SCH and euthyroid patients with CAD. Conclusion: The prevalence of dyslipidemia among SCH patients with CAD was significantly high. The patients suffering from SCH exhibited higher levels of LDLc compared to euthyroid patients from both the total and dyslipidemic groups. SCH patients under statin treatment displayed a higher LDLc suggesting a strong association between coronary artery disease and thyroid disease. Bangladesh Journal of Medical Science Vol.19(4) 2020 p.678-684

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