DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20195705

Evaluation of serum lipid profile in female patients with hypothyroidism: a rural based study

Shilpa R., K. Mallikarjuna Swamy

Abstract


Background: Hypothyroidism is the most common of thyroid disorders in India affecting one in ten adults and more so in women than men by 6 to 8 times with overall prevalence accounting to 11%.

Methods: This hospital based prospective study was conducted in the outpatient ENT Department of district hospital, Koppal Institute Of Medical Sciences, Koppal, Karnataka between January to June 2019 which involved total 60 Female patients out of which 20 patients were euthyroid controls and the remaining 40 patients were having one or more clinical manifestations of hypothyroidism who were divided into group A (n=20, thyroid stimulating hormone (TSH) between 5 and 10 mIU/ml) and group B (n=20, TSH >10 mIU/ml) based on TSH values. All 60 patients were in the age group of 35 to 55 years with a mean age of 42 years. Objective of study were to estimate serum lipids in female patients clinically diagnosed with hypothyroidism, to quantify the effect of lipid lowering drug and L-thyroxine therapy on TSH and serum lipid profiles.  

Results: Mean total cholesterol, low-density lipoprotein cholesterol and triglycerides level in cases was higher than controls whereas high-density lipoprotein cholesterol was found significantly decreased in cases compared to controls.

Conclusions: In hypothyroid patients with TSH <10 mIU/ml, Lipid lowering drug seemed to be sufficient to treat dyslipidemia. While in all hypothyroid patients with TSH >10 mIU/ml, it’s imperative to institute L-thyroxine therapy for restoration of TSH and altered lipids back to normal levels.

 


Keywords


Hypothyroidism, Serum lipid profile, High density lipoprotein, Low density lipoprotein

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References


Shekar A, Singh HK, Chandra S, Shaifali I, Mehra D. Effect of Levothyroxine Therapy on Hypothyroidism-induced Dyslipidemia. Int J Adv Integ Med Sci. 2017;2(3):107-10.

Ahmad N, Panthari M, Gupta A, Chandra P, Nafees S. Prevelance of hypothyhroidism among patients of Meerut, Uttar Pradesh- a hospital based study. Int J Med Sci Public Health. 2013;2(3):39-49.

Surks MI, Ocampo E. Subclinical thyroid disease. Am J Med. 1996;100:217-23.

Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado thyroid disease prevalence study. Arch Intern Med. 2000;160:526-34.

Fauci AS, Kasper DL, Longo DL. Harrison’s principles of internal medicine. Chapter: Disorders of thyroid gland. 17th ed. New York: McGraw Hill; 2008: 2224-2247.

Duntas LH. Thyroid disease and lipids. Thyroid 2002;12(4):287-93.

Friis T, Pedersen LR. Serum lipids in hyper and hypothyroidism before and after treatment. Clin Chim Acta. 1987;162(2):155-63.

Canaris GJ, Manowitz NR, Mayor G, Ridgway C. The Colorado thyroid disease prevelance study. Arch Intern Med. 2000;160(4):526-34.

Jung CH, Sung KC, Shin HS, Rhee EJ, Lee WY, Kim BS, et al. Thyroid dysfunction and their relation to cardiovascular risk factors such as lipid profile, hsCRP, and waist hip ratio in Korea. Korean J Intern Med. 2003;18(3):146-53.

Walsh JP, Bremner AP, Bulsara MK, O'Leary P, Leedman PJ, Feddema P, et al. Thyroid dysfunction and serum lipids: a community-based study. Clin Endocrinol (Oxf). 2005;63(6):670-5.

Iqbal A, Jorde R, Figenschau Y. Serum lipid levels in relation to serum thyroid-stimulating hormone and the effect of thyroxine treatment on serum lipid levels in subjects with subclinical hypothyroidism: the Tromso Study. J Intern Med. 2006;260(1):53-61.

Ginsberg HN, Goldberg IJ. Disorder of lipoprotein metabolism. In: Harrison’s principles of Internal Medicine. New York: McGraw Hill; 2001: 2252.

Singh K, Singh S. Alteration in lipid fractions in subclinical hypothyroidism in North Indian population. Indian J Fundam Appl Life Sci 2011;1(2):127-32.

Bandyopadhyay SK, Basu AK, Pal SK, Roy P, Chakrabarti S, Pathak HS, et al. A study on dyslipidemia in subclinical hypothyroidism. J Indian Med Assoc. 2006;104(11):622-6.

Efstathiadou Z, Bitsis S, Milionis HJ, Kukuvitis A, Bairaktari ET, Elisaf MS, et al. Lipid profile in subclinical hypothyroidism: is L-thyroxine substitution beneficial. Eur J Endocrinol. 2001;145(6):705-10.

Danese MD, Ladenson PW, Meinert CL, Powe NR. Clinical review 115:effect of thyroxine therapy on serum lipoproteins in patients with mild thyroid failure: a quantitative review of the literature. J Clin Endocrinol Metab. 2000;85(9):2993-3001.

Laway BA, War FA, Shah S, Misgar RA, Kumar Kotwal S. Alteration of lipid parameter in patients with subclinical hypothyroidism. Int J Endocrinol Metab Res. 2013;7(2):779-88.

Das AK, Ahmad N, Gupta A. Dyslipidemia and hypothyroidism in population of east Medinipur, West Bengal. J Med Sci Clin Res. 2014;2(5):1049-53.

Saxena A, Kapoor P, Saxena S, Kapoor AK. Effect of levothyroxine therapy on dyslipidemia in hypothyroid patients. Internet J Med Update. 2013;8(2):39-49.

Sharma P, Patgiri D, Goyal S, Sharma G, Pathak MS. Hypithyroidism causing dyslipidemia in both subclinical and overt hypothyroidism. Indian J Basic Appl Med Res. 2013;7(2):779-88.

Monzani F, Carracio N, Koza Kowa M, Dardano A, Vittone F, Virdis A, et al. Effect of levothyroxine replacement on lipid profile and intima media thickness in subclinical hypothyroidism : a double blind, placebo-controlled study. J Clin Endocrinol Metab. 2004;89(5):2009-106.

Akbar DH, Ahmed MM, Hijazi NA. Subclinical hypothyroidism in elderly women attending an outpatient clinic. Med Sci Monit. 2004;37(5):725-30.

Ineck BA, Ng TM. Effects of subclinical hypothyroidism and its treatment on serum lipids. Ann Pharmacother. 2003;37(5):725-30.

Meier C, Staub JJ, Roth CB. TSH controlled L-thyroxine therapy reduces cholesterol levels and clinical symptoms in subclinical hypothyroidism : a double blind, placebo controlled trial (Basel Thyroid Study). J Clin Endocrinol Metab. 2001;86(10):4860-6.

Caron P, Calazel C, Parra HJ, Hoff M, Louvet JP. Decreased HDL cholesterol in subclinical hypothyroidism: the effect of L- thyroxine therapy. Clin Endocrinol. 1990;33(4):519-23.

Miura S, Itaka M, Yoahimura H, Kitahama S, Fukasawa N, Kawakami Y, et al. Disturbed lipid metabolism in patients with subclinical hypothyroidism: effect of L- thyroxine therapy. Intern Med. 1994;33(7):413-7.

Arsanna A, Taneja RS, Kulshreshta B. Dyslipidemia in subclinical hypothyroidism and the effect of thyroxine on lipid profile. Indian J Endocrinol Metab. 2012;16(2):347-9.

Tanis BC, Westerndrop GJ, Smelt HM. Effect of thyroid substitution on hypercholesterolemia in patients with subclinical hypothyroidism: a reanalysis of intervention studies. Clin Endocrinol (Oxf). 1996;44(6):643-9.