Abstract
Introduction and Aim:Co-existence of thyroid disorder and Diabetes Mellitus is no more a coincidence. The cause and impact of thyroid disorder on glucose levels or vice versa is a well -established fact.Hence in this study we wanted to know the glycemic status by estimating fructosamine and glycated hemoglobin of the newly diagnosed thyroid patients without diabetes mellitus. The aim of the study was to estimatefructosamine and glycated hemoglobin levels in newly diagnosed subclinical hypothyroid, clinical hypothyroid and hyper thyroid patients without diabetes mellitus.
 Material and Methods:Twenty cases of subclinical hypothyroid,30 cases of hypothyroid,30 cases of hyperthyroid and 30 healthy participantswere included in the study. Fasting plasma glucose and thyroid profile was estimated in suspected cases of thyroid disorder and participants with fasting plasma glucose (FPG) more than 110 mg/dL were excluded from the study.The participants who were eligible for an inclusion criterion were estimated for fructosamine by nitro bluetetrazolium, (NBT) method andion-exchange high performance liquid chromatography was for glycated hemoglobin.
 Results:In Subclinical hypothyroid group there was a statistically significant increase in the mean fasting plasma glucose, fructosamine and glycated hemoglobin levels when compared with the controls.There was a significant increase in the mean fasting plasma glucose,fructosamine and glycated hemoglobin(HbA1c) levels in clinical hypothyroid group when compared with the controls.Pairwise comparison of FPG (p=0.001), fructosamine (p=0.001) and HbA1c (p=0.001) levels with controls showed a statistically significant difference.In clinical hyperthyroid group the mean FPG and HbA1c levels were high and low fructosamine levels when compared with the controls by one way ANOVA.Pairwise comparison of FPG (p=0.001), fructosamine levels (p=0.001) and HbA1c (p=0.001) levels (p=0.001) with controls showed a statistically significant difference.
 Conclusion: Unidentified hyperglycemia could have an impact on thyroid disorder leading to its complication.Hence a systematic approach to fructosamine testing(monitor the plasma glucose concentration over 2–3 weeks) as a routine test in thyroid disorder patients, needs to be considered.Also the management of hyperglycemia in thyroid patients without diabetes mellitus may prove to be beneficial.
Highlights
Introduction and AimCo-existence of thyroid disorder and Diabetes Mellitus is no more a coincidence
Unidentified hyperglycemia could have an impact on thyroid disorder leading to its complication. a systematic approach to fructosamine testing(monitor the plasma glucose concentration over 2–3 weeks) as a routine test in thyroid disorder patients, needs to be considered. the management of hyperglycemia in thyroid patients without diabetes mellitus may prove to be beneficial
In thyroid dysfunctions the glucose homeostatic balance is broken.Increased concentration of T3 causes protein catabolism and pessimistic nitrogen balance.Circulating sugars mainly glucose and fructose form Advanced Glycation End Products(AGEs) when they come in contact with proteins and lipids.Examples of proteins subject to non-enzymatic glycation are glycated hemoglobin,and Fructosamine.There is a wellrecognised positive association between thyroid disorders and diabetes mellitus.There are lack of studies to correlate the effects of thyroid hormones on glycation.Fructosamine,indicate short term glycemic control. this study was undertaken to estimate the glycated haemoglobin and fructosamine levels in clinical hypo and hyperthyroid patients without diabetes mellitus along with apparently healthy controls
Summary
Introduction and AimCo-existence of thyroid disorder and Diabetes Mellitus is no more a coincidence. The cause and impact of thyroid disorder on glucose levels or vice versa is a well -established fact. in this study we wanted to know the glycemic status by estimating fructosamine and glycated hemoglobin of the newly diagnosed thyroid patients without diabetes mellitus. The aim of the study was to estimatefructosamine and glycated hemoglobin levels in newly diagnosed subclinical hypothyroid, clinical hypothyroid and hyper thyroid patients without diabetes mellitus. Hyperthyroidism, hypothyroidism and subclinical hypothyroidism are sequel of altered biochemical function of thyroid gland [1]. Impact of increased blood glucose along with alteration in the thyroid gland function leads to inflammatory process, leading to mitochondrial dysfunction [4]. .Examples of these glycated proteins are Glycated Haemoglobin, Fructosamine and Glycated Albumin. Thyroid diseases affect Glycated Hemoglobin levels and hematological facts and Glycated albumin levels are affected by albumin turn over but Fructosamine levels are not affected by RBC life span [9]
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