Abstract
Overt hypothyroidism(HO) defined as high Thyroid Stimulating Hormone (TSH) levels with low levels of free thyroxine (FT4) and / or free triiodothyronine (FT3). Hypothyroidism is associated with an increased risk for atherosclerotic cardiovascular disease. Serum Homocysteine (Hcy) is a independent risk factor for atherosclerosis and cardiovascular diseases. Elevated plasma homocysteine levels have been reported in overt hypothyroidism. : To study levels of Hcy in relation to TSH, FT4 and FT3 levels in overt hypothyroid patients compared to control groups and correlation between Hcy and thyroid hormones. This study included 50 female overt hypothyroid cases with age group between 18-50 years and 50 healthy females controls with same age group. Serum homocysteine was estimated by Homocysteine Enzyme Assay in Cobas Integra 400 plus. TSH, FT4 & FT3 estimated by CLIA method using Beckman coulter Access 2. Parameters of cases and controls are compared using unpaired ‘t’ test and the association between parameters is assessed by using Pearson’s correlation. There is a significant increase in Serum Hcy levels 19.24 ± 7.15 μmol/L and TSH levels 30.91 ± 10.21 µIU/ml respectively (p value <0.0001) and significant decrease in FT4 and FT3 levels (p <0.0001). Hcy was positively correlated with TSH and negatively correlated with FT4 and FT3. Thus, from our study we can conclude that serum Hcy levels can be used as a marker, which points towards the possible risk factor for atherosclerosis and cardiovascular diseases in Overt hypothyroid patients.
Highlights
Hypothyroidism is a clinical syndrome resulting from a deficiency of thyroid hormones, which in turn results in a generalized slowing down of metabolic process.[1]
Homocysteine in plasma is an independent risk factor for cardiovascular disease. 5,6 Homocysteine (Hcy) is a sulfhydryl-containing amino acid is synthesised during the conversion of methionine to cysteine.[2]
7 Hyperhomocysteinemia induces endothelial injury, oxidative stress, smooth muscle hypertrophy and oxidation of LDL-Cholesterol and the process of atherosclerosis and cardiovascular diseases.Increased tHcy levels might be the result of two mechanisms either increased tHcy formation or decreased renal tHcy clearance due to direct effect of the thyroid hormones on the tHcy metabolism in the liver and clearance in the kidney
Summary
Hypothyroidism is a clinical syndrome resulting from a deficiency of thyroid hormones, which in turn results in a generalized slowing down of metabolic process.[1]. 7 Hyperhomocysteinemia induces endothelial injury, oxidative stress, smooth muscle hypertrophy and oxidation of LDL-Cholesterol and the process of atherosclerosis and cardiovascular diseases.Increased tHcy levels might be the result of two mechanisms either increased tHcy formation or decreased renal tHcy clearance due to direct effect of the thyroid hormones on the tHcy metabolism in the liver and clearance in the kidney.
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