ASSOCIATION OF SUBCLINICAL HYPOTHYROIDISM WITH METABOLIC SYNDROME: A CROSSSECTIONAL STUDY FROM WESTERN INDIA
Abstract
ABSTRACT
Objective: Metabolic syndrome (MetS) and subclinical hypothyroidism (SCH) both are known to have adverse cardiovascular outcomes. Available
studies have shown variable results on the association of SCH with MetS as well as individual components of MetS. We aimed to study the association
of SCH with MetS and its individual components of MetS.
Methods: This cross-sectional study was carried out in individuals volunteered for health checkup at tertiary care teaching hospital in Western India.
About 60 cases with MetS and 120 controls without having MetS were recruited. Demographic data such as history of diabetes mellitus, hypertension,
dyslipidemia, blood pressure (BP), waist circumference and serum T3, serum T4, thyroid stimulating hormone, fasting blood sugar, fasting lipid
profile, and hemoglobin A1c were collected and statistically analyzed. Statistical analysis was done by using SPSS sav software packages. Chi-square
test was used for the comparison of qualitative data.
Results: SCH was present in 52 (28.9%) among 180 study participants. SCH was present in 35 (58.33%) participants having MetS and in 17 (14.16%)
of controls. There was a strong association between SCH and MetS (p<0.001). Significant association of SCH with diastolic BP (p=0.017) and with
central obesity (p=0.004) was observed but not with high-density lipoprotein, triglyceride, hyperglycemia, systolic BP, total cholesterol, and lowdensity
lipoprotein.
Conclusion: We observed a strong association of SCH with MetS. We also observed significant association of SCH with diastolic BP and with obesity.
The finding of this study indicates the need to screen individuals with MetS for SCH.
Keywords: Central obesity, Diastolic blood pressure, Hypertriglyceridemia, Hypertension, Cardiovascular morbidity, Inflammation, Insulin resistance,
Low-density lipoprotein, High-density lipoprotein.
Â
Downloads
References
REFERENCES
Eckel R. The metabolic syndrome. In: Longo DL, Kasper DL,
Jameson JL, Fauci AS, Hauser SL, Loscalzo J, editors. Harrison’s
Principles of Internal Medicine. 18
ed. USA: The McGraw-Hill; 2012.
p. 1992-7.
th
Uzunlulu M, Yorulmaz E, Oguz A. Prevalence of subclinical
hypothyroidism in patients with metabolic syndrome. Endocr J
;54(1):71-6.
Collet TH, Bauer DC, Cappola AR, Asvold BO, Weiler S, Vittinghoff E,
et al. Thyroid antibody status, subclinical hypothyroidism, and the risk
of coronary heart disease: An individual participant data analysis. J Clin
Endocrinol Metab 2014;99(9):3353-62.
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 Intern Med 2000;132(4):270-8.
Rodondi N, den Elzen WP, Bauer DC, Cappola AR, Razvi S, Walsh JP,
et al. Subclinical hypothyroidism and the risk of coronary heart disease
and mortality. JAMA 2010;304(12):1365-74.
Gencer B, Collet TH, Virgini V, Bauer DC, Gussekloo J, Cappola AR,
et al. Subclinical thyroid dysfunction and the risk of heart failure
events: An individual participant data analysis from 6 prospective
cohorts. Circulation 2012;126(9):1040-9.
Tseng FY, Lin WY, Lin CC, Lee LT, Li TC, Sung PK, et al.
Subclinical hypothyroidism is associated with increased risk for
all-cause and cardiovascular mortality in adults. J Am Coll Cardiol
;60(8):730-7.
Rodondi N, Bauer DC, Cappola AR, Cornuz J, Robbins J, Fried LP,
et al. Subclinical thyroid dysfunction, cardiac function, and the risk
of heart failure. The cardiovascular health study. J Am Coll Cardiol
;52(14):1152-9.
Klein I. Endocrine disorders and cardiovascular disease. In: Mann DL,
Zipes DP, Libby P, Bonow RO, editors. Braun Wald’s Heart Disease:
A Textbook of Cardiovascular Medicine. 10
ed. Philadelphia, PA:
Saunders, Elsevier; 2015. p. 1793-808.
th
Walsh JP, Bremner AP, Bulsara MK, O’Leary P, Leedman PJ,
Feddema P, et al. Subclinical thyroid dysfunction as a risk factor for
cardiovascular disease. Arch Intern Med 2005;165(21):2467-72.
Shantha GP, Kumar AA, Jeyachandran V, Rajamanickam D, Rajkumar K,
Salim S, et al. Association between primary hypothyroidism and
metabolic syndrome and the role of C reactive protein: A cross-sectional
study from South India. Thyroid Res 2009;2(1):2.
Hamdy N, Adly N, Bakr Y, Salem A, Aty SA. Association between
subclinical hypothyroidism and metabolic syndrome. Int J Adv Res
(Indore) 2014;2(6):213-26.
Waring AC, Rodondi N, Harrison S, Kanaya AM, Simonsick EM,
Miljkovic I, et al. Thyroid function and prevalent and incident metabolic
syndrome in older adults: The health, ageing and body composition
study. Clin Endocrinol (Oxf) 2012;76(6):911-8.
Cheserek MJ, Wu G, Shen L, Shi Y, Le G. Evaluation of the relationship
between subclinical hypothyroidism and metabolic syndrome
components among workers. Int J Occup Med Environ Health
;27(2):175-87.
Asranna A, Taneja RS, Kulshreshta B. Dyslipidemia in subclinical
hypothyroidism and the effect of thyroxine on lipid profile. Indian J
Endocrinol Metab 2012;16 Suppl 2:S347-9.
Azam N, Shukla A, Ahmad N, Gupta A. Altered thyroid profile in
metabolic syndrome. Int J Biomed Res 2014;5(11):692-4.
Caraccio N, Ferrannini E, Monzani F. Lipoprotein profile in subclinical
hypothyroidism: Response to levothyroxine replacement, a randomized
placebo-controlled study. J Clin Endocrinol Metab 2002;87(4):1533-8.
Kota SK, Meher LK, Krishna S, Modi K. Hypothyroidism in metabolic
syndrome. Indian J Endocrinol Metab 2012;16 Suppl 2:S332-3.
Chugh K, Goyal S, Shankar V, Chugh SN. Thyroid function tests in
metabolic syndrome. Indian J Endocrinol Metab 2012;16(6):958-61.
Pangaluri R, Akila S, William E. Prevalence of metabolic syndrome
and its components in women with subclinical hypothyroidism. Asian J
Pharm Clin Res 2013;6(4):82-4.
Khan S, Afsana F, Talukder SK, Ashrafuzzaman SM, Pathan F, Latif ZA.
Presence and association of sub clinical hypothyroidism in subjects
with metabolic syndrome. Diabetes Metab Syndr 2011;5(4):183-7.
Wang CY, Chang TC, Chen MF. Associations between subclinical
thyroid disease and metabolic syndrome. Endocr J 2012;59(10):911-7.
Garduño-Garcia Jde J, Alvirde-Garcia U, López-Carrasco G, Padilla
Mendoza ME, Mehta R, Arellano-Campos O, et al. TSH and free
thyroxine concentrations are associated with differing metabolic
markers in euthyroid subjects. Eur J Endocrinol 2010;163(2):273-8.
Posadas-Romero C, Jorge-Galarza E, Posadas-Sánchez R, AcuñaValerio
J, Juárez-Rojas JG, Kimura-Hayama E, et al. Fatty liver
largely explains associations of subclinical hypothyroidism with
insulin resistance, metabolic syndrome, and subclinical coronary
atherosclerosis. Eur J Endocrinol 2014;171(3):319-25.
Knudsen N, Laurberg P, Rasmussen LB, Bülow I, Perrild H, Ovesen L,
et al. Small differences in thyroid function may be important for body
mass index and the occurrence of obesity in the population. J Clin
Endocrinol Metab 2005;90(7):4019-24.
Roos A, Bakker SJ, Links TP, Gans RO, Wolffenbuttel BH. Thyroid
function is associated with components of the metabolic syndrome in
euthyroid subjects. J Clin Endocrinol Metab 2007;92(2):491-6.
Nakajima Y, Yamada M, Akuzawa M, Ishii S, Masamura Y, Satoh T,
et al. Subclinical hypothyroidism and indices for metabolic syndrome
in Japanese women: One-year follow-up study. J Clin Endocrinol
Metab 2013;98(8):3280-7.
Lee YK, Kim JE, Oh HJ, Park KS, Kim SK, Park SW, et al. Serum
Asian J Pharm Clin Res, Vol 9, Issue 4, 2016, 265-269
Gupta et al.
TSH level in healthy Koreans and the association of TSH with serum
lipid concentration and metabolic syndrome. Korean J Intern Med
;26(4):432-9.
Pearce EN. Update in lipid alterations in subclinical hypothyroidism.
J Clin Endocrinol Metab 2012;97(2):326-33.
Lai CC, Tang SH, Pei D, Wang CY, Chen YL, Wu CZ, et al. The
prevalence of subclinical thyroid dysfunction and its association with
metabolic syndrome in Taiwanese elderly. Int J Gerontol 2011;5(1)25-9.
Published
How to Cite
Issue
Section
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.