METABOLIC SYNDROME AND HYPOTHYROIDISM

Abstract

Metabolic syndrome (MetS) and hypothyroidism are well known atherogenic cardiovascular disease. Considerable overlap occurs in the pathogenic mechanisms of atherosclerotic cardiovascular disease by metabolic syndrome and hypothyroidism. This cross sectional study assesses thyroid function in patients with metabolic syndrome and to investigate the association between hypothyroidism and metabolic syndrome.

MATERIAL AND METHODS: We included the patients who fulfilled the National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP) III criteria [three out of five criteria positive, namely, blood pressure ?130/85 mm Hg or on antihypertensive medications, fasting plasma glucose >100 mg/dl or on anti-diabetic medications, fasting triglycerides >150 mg/dl, high density lipoprotein cholesterol (HDL-C) <40 mg/dl in males and <50 mg/dl in females, waist circumference >102 cm in men and 88 cm in women] were included in the study group[i]. We exclude the patients receiving medication that may alter thyroid functions or lipid levels, pregnant women, patients with liver or kidney disorder and patients with a cardiovascular disease, corticosteroid use, active liver disease, and renal dysfunction. Patients on weight loss therapies or steatogenic drugs, and known HIV-positive cases were excluded from the study.

RESULTS: A total of 200 patients were included in the study of which 100 were patients with MetS and 100 were control. Statistically significant difference was observed in all the characteristics except FT4 levels of metabolic syndrome patients and control group. BMI, waist circumference, mean systolic and diastolic blood pressure, fasting blood sugar, total cholesterol, LDL, triglycerides, and TSH were significantly higher in the study group compared to the control group. HDL was significantly lower in the study group. Of the 100 MetS patients, overt hypothyroidism was reported in 18 (18%) patients and overt hyperthyroidism in 2 (2%) patients. Subclinical hypothyroidism, overt hypothyroidism, and subclinical hyperthyroidism were reported in 7%, 2%, and 1 % patients with newly diagnosed TD, respectively. Total number of TD patients was 28(28%).

CONCLUSION: There was a high prevalence of TD in patients with MetS, so there is a positive relation between thyroid hormone status and MetS. Hypothyroidism was the most common TD in patients with MetS.  It is advisable to assess the thyroid function in all patients with MetS.