CO-RELATION BETWEEN METABOLIC SYNDROME AND HYPOTHYROIDISM, PATIENTS ATTAINING GENERAL MEDICINE OPD

Abstract

Introduction: Metabolic syndrome (MetS) and hypothyroidism is well-established which is associated with increased risk atherogenic cardiovascular disease. All over the world the prevalence of metabolic syndrome is increasing with evidence of high prevalence in India and other South Asian countries. Metabolic syndrome is define as a group of abnormalities including hypertension, insulin resistance, hyperglycemia, abdominal obesity, increased triglycerides, and decreased high-density lipoprotein cholesterol (HDL-C). Independent Risk factors for cardiovascular diseases (CVD) are both metabolic syndrome and hypothyroidism. Overlap Presence of both conditions may occur in the pathogenic mechanisms of atherosclerotic cardiovascular disease by metabolic syndrome and hypothyroidism. There are many studies which showed that higher TSH (thyroid stimulating hormone) concentrations are related with increased incidence the occurrence of metabolic syndrome. Thyroid dysfunction has been related with atherosclerotic cardiovascular disease. Though, metabolic syndrome and thyroid dysfunction are independent risk factors of atherosclerotic cardiovascular disease.  They also showed that insulin resistant is more susceptible to the increased levels of high LDL-C at increasing TSH levels even within the normal range.

Aim: The main aim of the study is to study thyroid dysfunction in metabolic syndrome.

Material and methods: Total 150 patients were included in this study. Patients with more than 12 year of age were presenting with metabolic syndrome as per IDF criteria. Based on modified Asian NCEP-ATP III panel criteria metabolic syndrome was diagnosed. In all the patients detailed physical examination was done as well as detailed clinical history was noted in each patient and also height, weight, waist circumference and blood pressure was taken. Routine Investigation like blood glucose, triglycerides, high density lipoprotein (HDL) cholesterol, free triiodothyronine (T3), free thyroxine (T4) and thyroid stimulating hormone (TSH) were done on the day of presentation.

Result: Total 150 patients were included in this study. Patients with more than 12 year of age were presenting with metabolic syndrome as per IDF criteria. of these 150 patients, 91 were males and 59 were females. The numbers of male patients were more (60.7%) as compared to females (39.3%). Out of the 91 male patients 42 patients belong to age group 30-40, 70 patients belong to age group 41-50 as well as 54 patients belong to age group 51-60 whereas in female 27 patients belong to age group 30-40, 43 patients belong to age group 41-50 and  64 patients belong to age group 51-60.

Conclusion: In conclusion, prevalence of thyroid dysfunction is seen in 54% of the patients with metabolic syndrome studied. Subclinical hypothyroidism was more common as compared to other thyroid dysfunction. Thyroid function is associated with certain components of metabolic syndrome (waist circumference and HDL cholesterol). Subclinical hypothyroidism one must have a strong suspicion with metabolic syndrome, as the incidence is high in them.

Keywords: Metabolic syndrome, hypothyroid, Thyroid function, Subclinical hypothyroidism