Spectrum of Lipid Abnormality among Thyroid Disorder Patients in Ucms-Th, South Western Region

Abstract

INTRODUCTION:Hypothyroidism is the most common cause of secondary dyslipidemia. Thus, thyroid function test should be carried out before starting any hypolipidemic drugs. Even among thyroid disorder, hypothyroidism is more associated with cardiovascular and associated problems and if not detected earlier, it leads to severe clinical consequences. Our study assesses the frequency and spectrum of dyslipidemia in various types of thyroidal illness in the population residing in south western part of Nepal. MATERIALS AND METHODS:This is a cross sectional study carried out in suspected thyroid disorder patients (n=276) and categorized as Euthyroidism (n=55), Subclinical Hypothyroidism (n=89), Primary Hypothyroidism (n=122) and Primary Hyperthyroidism (n=10) patients and to see the association with lipid profiles in the Department of Biochemistry, Universal College of Medical Sciences Teaching Hospital, Bhairahawa Nepal. Serum fT / fT4 and TSH estimations were carried out by competitive 3 ELISA method and Sand-wich double antibody ELISA method respectively using commercially supplied reagents (Human, Germany). The criteria for dyslipidemia was obtained by National Cholesterol Education Expert Panel/ Adult Treatment Protocol III (NCEP/ATPIII). RESULTS:Out of 276 cases the dyslipidemia was observed in 183 cases (66.30%).The dyslipidemia was mostly associated with primary hypothyroidism (55.07%) followed by Subclinical Hypothyroidism (38.04%) than Euthyroid (5.79 %) and Primary Hyperthyroidism (3.62 %) respectively. Out of all cases, the spectrum of dyslipidemia was mostly observed for decreased HDL (18.5 %) followed by increased TG (10.1 %). Moreover, it is significantly differ in relation in HDL (p=0.009), TG/HDL (p=0.02) and Non-HDL/HDL (p=0.033) where as non significant as compared to other lipid profile in different groups. CONCLUSION:Our study revealed the close association of thyroidal illness with dyslipidemia with increased TG, low HDL, increased TG/HDL and Non-HDL/HDL. The increased TG/HDL and/or Non-HDL/HDL could be better indicator than single lipid abnormality which needs to be ascertained prospectively in large population.