THYROID FUNCTION IN POSTMENOPAUSAL WOMEN IN WESTERN INDIA AND ITS IMPACT ON MENOPAUSAL SYMPTOMS, BMI, GLYCEMIC, LIPID AND CARDIAC PROFILE

Abstract

Background Menopause is characterized by estrogen deciency and appearance of variety of menopausal symptoms like lethargy, hotushes, anxiety, sexual problems, tiredness, insomnia, weight gain and mood swings. Many of these symptoms are similar to symptoms of thyroid dysfunction and hence there is likelihood of symptoms of thyroid dysfunction in this age group being misinterpreted as menopausal symptoms and thyroid dysfunction remaining undetected. If thyroid dysfunction remains undetected and untreated, it can lead to health hazards like hyperlipidemia, atherosclerosis and heart disease.2Presently there are no clear cut guidelines about screening menopausal patients for thyroid function and existing studies on screening of menopausal women for thyroid disorders are not conclusive. Therefore this study was undertaken to look at thyroid functions in postmenopausal women and impact of thyroid dysfunction on their cardiovacular health through its action on their glycemic status, BMI and lipid prole. Aims And Objectives 1. To assess the basic thyroid functions in postmenopausal women. 2. To evaluate the effect of abnormal thyroid function on glycemic status, lipid prole, body weight and BMI in postmenopausal women. 3. To look for association of severity of menopause symptoms with the degree of thyroid dysfunction in postmenopausal women. Materials And Methods A cross-sectional observational study was carried out in the indoor and outdoor sections of Department of Medicine at SSG Hospital Vadodara for a period of one year from March 2015 to Feb 2016 in which 130 patients were enrolled. All patients were subjected to a standardized interview in which their symptoms were graded on the basis of the Simplied Menopausal Index , their BMI was calculated from their height and weight and investigations (Fasting thyroid prole, fasting blood sugar, fasting lipid prole, ECG) were carried out. Association between abnormalities in thyroid prole and severity of menopausal symptoms as well as abnormalities in BMI , fasting blood sugar, lipid prole and ECG were analyzed using appropriate statistical tests (Odd's ratio). A P value<0.05 was considered statistically signicant. Thyroid dysfunction is Conclusion common in postmenopausal females and the symptoms of the two entities overlap but with a higher intensity in the former and the simplied menopausal index score can be used as an efcient tool to further increase the index of suspicion for thyroid dysfunction in postmenopausal women. Abnormal thyroid function is statistically associated with BMI with higher prevalence of hypothyroidism in overweight, preobese and obese postmenopausal subjects and hyperthyroidism in underweight postmenopausal subjects. Abnormal thyroid function is statistically associated with abnormal glucose metabolism with higher prevalence of fasting hyperglycemia at either end of the spectrum of thyroid disorders. Abnormal thyroid function is statistically associated with Dyslipidemia in the form of raised total cholesterol, LDL cholesterol and serum triglycerides with no signicant association with HDL cholesterol in postmenopausal women. There is no statistically signicant association between thyroid dysfunction and ischemic heart disease