Abstract
Hypothyroidism resulting from a deficiency of thyroid hormones may be associated with dyslipidaemia. Since altered lipid profile is quite important in predicting CVD risk, therefore the present study aimed to investigate any possible association between the levels of certain lipid indices with thyroid profile and their diagnostic ability of cardiometabolic syndrome in patients with hypothyroidism. A cohort of 40 female patients diagnosed with hypothyroidism was included as cases and thirty age and gender matched healthy females were recruited as controls. Fasting blood samples were collected for analysis of thyroid hormones, cholesterol, triglycerides and high density lipoprotein cholesterol levels by Chemiluminescence immuno-assay, and enzymatic colorimetric methods respectively. Differences in all between groups were tested using parametric independent sample T test. Pearson’s correlation or Spearman rank correlation analysis was done to study the correlations among the parameters as appropriate. Receiver operative characteristic (ROC) curve analysis was performed to study diagnostic utility of parameters.Lipid indices were found to be significantly increased in patients with hypothyroidism when compared to the controls. Castelli risk index-I (CRI-I), CRI-II, atherogenic coefficient (AC) and atherogenic index of plasma (AIP), were found to be significant positively correlated with low density lipoprotein cholesterol (LDL) (r=0.923, p=0.0001, r=0.935, p=0.0001,r=0.970, p=0.0001 and r=0.382, p=0.0001 respectively). The ROC curve analysis of lipid indices for cardiometabolic risk reveals that AUC for CRI-I and AC was high and statistically significant than other lipid parameters.The present study suggests that in addition to routine lipid investigations the inclusion of lipid Indices especially CRI-I, AC, were better indices for screening of early detection of cardiometabolic risk in female patients with hypothyroidism.
Highlights
Hypothyroidism is a clinical syndrome resulting from a deficiency of thyroid hormones
The present study observed that significant higher levels of total cholesterol (TC) and low density lipoprotein cholesterol (LDL) and significant lower levels of HDL cholesterol in hypothyroid patients compared to controls
The present study found that the lipid indices such as Castelli risk index-I (CRI-I), Castelli’s Risk Index-II (CRI-II), atherogenic coefficient (AC) and atherogenic index of plasma (AIP), were found to be significantly positively correlated with Total cholesterol (r=0.865, p=0.0001, r=0.871, p=0.0001, r=1.000, p=0.0001 and r=0.489, p=0.0001 respectively), and LDL (r=0.923, p=0.0001, r=0.935, p=0.0001, r=0.970, p=0.0001 and r=0.382, p=0.0001 respectively), and showed significant negative correlation with HDL cholesterol
Summary
Hypothyroidism is a clinical syndrome resulting from a deficiency of thyroid hormones. It is more frequent with increasing age and in women. Since dyslipidemia is implicated as cardiovascular risk factor, it might be relevant to find out possible correlation between lipid abnormality and the thyroid profile. 2 Evidence suggests that (Framingham study), comparison of certain lipid ratios are extensively more useful as predictors of cardiovascular diseases (CVD) than the individual levels of LDL or HDL cholesterols. 2 lipid ratio defined as Castelli’s Risk Index-II (CRI-II) presented more prognostic value when compared with ordinary LDL or HDL fraction. In a related but different term, another lipid ratio, AIP defined as log(TG/HDL) was proposed as a marker of plasma atherogenicity (Helsinki et al.).
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