Title: A Study of Thyroid Dysfunction in Patients with Metabolic Syndrome
Authors: Dr E. Prabhu, Dr M.S. Senthil Kumar
DOI: https://dx.doi.org/10.18535/jmscr/v9i2.06
Abstract
Introduction: Metabolic syndrome (MetS) is a combination of risk factors such as hypertension, atherogenic dyslipidemia, hyperglycemia, truncal (central) obesity, and prothrombotic and proinflammatory conditions, which could increase the risk of cardiovascular illness, diabetes, and death. Metsare closely associated with thyroid dysfunction (TD) due to the impact of thyroid hormones on lipid metabolism, glucose, blood pressure, and cardiovascular dysfunction.
Aim of the Study: To study the prevalence and to find the types of thyroid dysfunction in Metabolic Syndrome and to find the association of Thyroid Dysfunction and Metabolic Syndrome.
Materials and Methods: A total of 60 Patients with metabolic syndrome fulfilling IDF criteria have selected the study. A detailed history of medication and anthropometric measurements were noted in a semi-structured proforma. Blood pressure was recorded in the right upper limb in a sitting posture. After eight hours of fasting, blood was drawn for fasting blood sugar, lipid profile, and thyroid assay in a single sitting.
Results: In this study, thyroid dysfunction prevalence is 18.33% among metabolic syndrome patients. Subclinical Hypothyroidism is 15% prevalent in metabolic syndrome patients and Overt Hypothyroidism is 3.3% prevalent. There is no incidence of either overt or subclinical Hyperthyroidism in our study population. The prevalence of thyroid dysfunction and hypothyroidism in metabolic syndrome patients is higher than the prevalence in the normal population, which is 5.9% for thyroid dysfunction and 4.6% for hypothyroidism (0.3% overt and 4.3% subclinical hypothyroidism). The incidence of metabolic syndrome is significantly higher in women (25.8) than in men (8%) with metabolic syndrome.
Conclusion: Thyroid dysfunction occurs in 18.33% of metabolic syndrome patients. The prevalence of Subclinical hypothyroidism (15.0%) and Overt Hypothyroidism (3.33%) in metabolic syndrome patients is higher than that of the general population. One-sixth of metabolic syndrome patients or every sixth metabolic syndrome had Subclinical Hypothyroidism. Prevalence of thyroid dysfunction is much more common in Females with thyroid dysfunction than males. Exclude the presence of Thyroid dysfunction while managing metabolic syndrome patients.
Keywords: Metabolic Syndrome, Body Mass Index, Free Thyroxine, Thyroid Stimulating Hormone.
References
- Alberti KG et al., Diagnosis, and definition - provisional report of WHO Diabet Med 1998; 15:539-553.
- Balkau B et al., European Group for Study of Insulin Resistance (EGIR). Diabet Med 1999; 16: 442-443.
- Boden G et al., Free fatty acids in obesity and type 2 diabetes – Insulin resistance. Eur J Clin Invest 2002; 32,14-23.
- Cappola AR et al., Hypothyroidism and atherosclerosis J Clin Endocrinol Metab 2003; 88:2438-2444.
- Chandra L et al., Association of metabolic syndrome and its components with thyroid dysfunction in females. Int J Diab Dev Ctries 2007; 27:124-26.
- Defranco RA et al., A multifaceted syndrome responsible for NIDDM, obesity, hypertension, dyslipidemia, and atherosclerotic cardiovascular disease. Diabetes Care 1991;14:173-94.
- Dillman WH et al., Mechanism of action of thyroid hormones. Med Clin North Am 1985;69:849
- Dundas LH., Thyroid disease, and lipids. Thyroid 2002;12:287-293.
- Ford ES et al., The prevalence of metabolic syndrome among US adults. JAMA 2002; 287: 356-59.
- Grundy SM, Obesity, metabolic syndrome, and cardiovascular disease. J Clin Endocrinol Metab 2004;89:2595-2600.
- Hak AE et al., Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction; The Rotterdam study. Ann Intern Med 2000; 132:270-278.
- Isomaa B et al., Cardiovascular morbidity, and mortality associated with metabolic syndrome. Diabetes Care 2001; 24:683-89.
- Jean PD et al., RIO-Lipids study group. Effects of rimonabant on metabolic risk factors in overweight patients with dyslipidemia. N Eng J Med 2005; 353: 2121-34.
- Lakka HM et al., metabolic syndrome, and cardiovascular disease mortality. JAMA 2002; 228:2709-16.
- Mohan V et al., The prevalence of metabolic syndrome in a selected south Indian population. Indian J Med Res 2002; 115:118-27.