Main Article Content
Abstract
Background: Relationship between thyroid hormones and lipid profiles in patients with struma is a common condition found in IDD endemic areas.
Objective: This study observes relationships between thyroid functions and lipid profiles in woman patients of childbearing age with struma.
Methods: This paper is a cross-sectional study of 83 subjects/patients who met inclusion and exclusion criteria in this study. Total cholesterol, LDL, HDL, TSH, and free T4 concentration were measured in all the patients. Lipid concentrations in patients with thyroid dysfunction and patients with euthyroid were compared by using a linear regression model.
Results: Total cholesterol, LDL, and HDL was significantly lower in patients with primary hyperthyroidism (N=19) than in patients with euthyroid (N=48) (mean±SD 122.8±20.09 mg/dl vs 187.3±33.66 mg/dl, p=0.000 unadjusted, p= 0.000 adjusted for age and BMI); (63.5±16.33 mg/dl vs 121.7±29.71 mg/dl, p=0.000 unadjusted, p= 0.000 adjusted for age and BMI); (48.8±9.66 mg/dl vs 53.6±8.49 mg/dl, P=0.049 unadjusted, p=0.026 adjusted for age and BMI. Serum total cholesterol and LDL was lower in patients with subclinical hyperthyroidism (N= 14) than in patients with euthyroid (N=48), but it was not statistically significant (181.6±32.07 mg/dl vs 187.3±33.66 mg/dl, p=0.577 unadjusted, P=0.719 adjusted for age and BMI); (110.5±14.83 mg/dl vs 121.7±29.71 mg/dl, p=0.181 unadjusted, p=0.250 adjusted for age and BMI). Serum HDL was similarly elevated in patiemts with subclinical hypothyroidism (N=14) than in patients with euthyroid (N=48), but it was not statistically significant (57.4±11.04 mg/dl vs 53.6±8.49 mg/dl, p=0.185 unadjusted, p=0.229 adjusted for age and BMI).
Conclusion: Serum total cholesterol, LDL and HDL was significantly lower in patients with primary hyperthyroidism, but it was not significant for subclinical hyperthyroidism.
Keywords
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References
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- Vanderpump MPJ. Epidemiology of thyroid disorders. In: Luster M, Duntas LH, Wartofsky L, editors. The thyroid and its diseases a comprehensive guide for the clinician. Switzerland: Springer; 2019. p. 75–86.
- WHO. Assessment of the iodine deficiency disorders and monitoring their elimination. WHO, Geneva. 2007;1–107.
- Zimmermann MB, Boelaert K. Iodine deficiency and thyroid disorders. Lancet Diabetes Endocrinol. 2015;3(4):286–95.
- Rizos C, Elisaf M, Liberopoulos E. Effects of thyroid dysfunction on lipid profile. The Open Cardiovascular Medicine Journal. 2011;5:76–84.
- Delitala AP, Fanciulli G, Maioli M, Delitala G. Subclinical hypothyroidism, lipid metabolism and cardiovascular disease. Eur J Intern Med. 2017;38:17–24.
- Peppa M, Betsi G, Dimitriadis G. Lipid Abnormalities and Cardiometabolic Risk in Patients with Overt and Subclinical Thyroid Disease. Journal of Lipids. 2011;2011(Vldl):1–9.
- Duntas LH, Brenta G. The Effect of Thyroid Disorders on Lipid Levels and Metabolism. Medical Clinics of North America. 2012;96(2):269–81.
- Liu J, Liu L, Jia Q, Zhang X, Jin X, Shen H. Effects of excessive iodine intake on blood glucose, blood pressure, and blood lipids in adults. Biological Trace Element Research. 2019;192(2):136–44.
- Gropper SS, Smith JL, Carr TP. Advanced nutrition and human metabolism. Seventh. Boston: Cengage Learning; 2018. 528–533 p.
- Djokomoeljanto R. Kelenjar Tiroid-Hipotiroid-Hipertiroid. In: Buku Ajar Ilmu Penyakit Dalam Jilid III. ke-5. Jakarta: Interna Publishing; 2009. p. 1993–2008.
- Zheng X, Long J, Ren W, Liu C, Wei Q, Luo R, et al. Exposure to the Chinese famine in early life and the thyroid function and nodules in Adulthood. Endocrine Practice. 2019;25(6):598–604.
- Park VY, Han K, Seong YK, Park MH, Kim EK, Moon HJ, et al. Diagnosis of thyroid nodules: Performance of a deep learning convolutional neural network model vs. radiologists. Scientific Reports. 2019;9(1):1–9.
- Zimmermann MB. The Thyroid and Its Diseases. Luster M, Duntas LH, Wartofsky L, editors. The Thyroid and Its Diseases. A Comprehensive Guide for the Clinician. Cham: Springer International Publishing; 2019. 101–108 p.
- LiVolsi VA, Baloch ZW. The pathology of hyperthyroidism. Front Endocrinol (Lausanne). 2018 Dec 3;9:1–8.
- Stockigt J. Clinical strategies in the testing of thyroid function. In: Endotext. MDText.com Inc; 2011. Available from: www.endotext.org
- Lu S, Guan Q, Liu Y, Wang H, Xu W, Li X, et al. Role of extrathyroidal TSHR expression in adipocyte differentiation and its association with obesity. Lipids Health Dis. 2012;11:1–12.
- Gagnon AM, Antunes TT, Ly T, Pongsuwan P, Gavin C, Lochnan HA, et al. Thyroid-stimulating hormone stimulates lipolysis in adipocytes in culture and raises serum free fatty acid levels in vivo. Metabolism. 2010;59(4):547–53.
- Tian L, Song Y, Xing M, Zhang W, Ning G, Li X, et al. A novel role for thyroid-stimulating hormone: Up-regulation of hepatic 3-hydroxy-3-methyl-glutaryl-coenzyme a reductase expression through the cyclic adenosine monophosphate/protein kinase A/cyclic adenosine monophosphate-responsive element binding protei. Hepatology. 2010;52(4):1401–9.
- Waterhouse DF, McLaughlin AM, Walsh CD, Sheehan F, O’Shea D. An examination of the relationship between normal range thyrotropin and cardiovascular risk parameters: A study in healthy women. Thyroid. 2007;17(3):243–8.
- Xu C, Yang X, Liu W, Yuan H, Yu C, Gao L, et al. Thyroid stimulating hormone, independent of thyroid hormone, can elevate the serum total cholesterol level in patients with coronary heart disease: A cross-sectional design. Nutrition & Metabolism. 2012;9:1–8.
- Jung KY, Ahn HY, Han SK, Park YJ, Cho BY, Moon MK. Association between thyroid function and lipid profiles, apolipoproteins, and high-density lipoprotein function. Journal of Clinical Lipidology. 2017;11(6):1347–53.
- Wang F, Tan Y, Wang C, Zhang X, Zhao Y, Song X, et al. Thyroid-stimulating hormone levels within the reference range are associated with serum lipid profiles independent of thyroid hormones. The Journal of Clinical Endocrinology and Metabolism. 2012;97(8):2724–31.
- Zhenjiang H. The correlation of blood lipid profile and its ratio, cystatin C and homocysteine of thyroid dysfunction. American Journal of Clinical and Experimental Medicine. 2017;5(4):108.
- Chen Y, Wu X, Wu R, Sun X, Yang B, Wang Y, et al. Changes in profile of lipids and adipokines in patients with newly diagnosed hypothyroidism and hyperthyroidism. Scientific Reports. 2016;6:1–7.
- Selim FO, Ahmed AM. The Association between serum paraoxonase-1 activity, thyroid hormones and lipid profile in patients with primary hyperthyroidism. International Journal of Advanced Research. 2014;2(11):172–81.
- Sinha RA, Singh BK, Yen PM. Thyroid hormone regulation of hepatic lipid and carbohydrate metabolism. Trends in Endocrinology & Metabolism. 2014;25(10):538–45.
- Costantini F, Pierdomenico SD, De Cesare D, De Remigis P, Bucciarelli T, Bittolo-Bon G, et al. Effect of thyroid function on LDL oxidation. Arteriosclerosis, Thrombosis, and Vascular Biology. 1998;18(5):732–7.
- Giugliano RP, Wiviott SD, Blazing MA, De Ferrari GM, Park JG, Murphy SA, et al. Long-term safety and efficacy of achieving very low levels of low-density lipoprotein cholesterol: A prespecified analysis of the IMPROVE-IT trial. JAMA Cardiology 2017;2(5):547–55.
References
Aburto NJ, Abudou M, Candeias V, Tiaxiang Wu P. Effect and safety of salt iodization to prevent iodine deficiency disorders: A systematic review with meta-analyses WHO Library Cataloguing-in-Publication Data. 2014;91–3.
Vanderpump MPJ. Epidemiology of thyroid disorders. In: Luster M, Duntas LH, Wartofsky L, editors. The thyroid and its diseases a comprehensive guide for the clinician. Switzerland: Springer; 2019. p. 75–86.
WHO. Assessment of the iodine deficiency disorders and monitoring their elimination. WHO, Geneva. 2007;1–107.
Zimmermann MB, Boelaert K. Iodine deficiency and thyroid disorders. Lancet Diabetes Endocrinol. 2015;3(4):286–95.
Rizos C, Elisaf M, Liberopoulos E. Effects of thyroid dysfunction on lipid profile. The Open Cardiovascular Medicine Journal. 2011;5:76–84.
Delitala AP, Fanciulli G, Maioli M, Delitala G. Subclinical hypothyroidism, lipid metabolism and cardiovascular disease. Eur J Intern Med. 2017;38:17–24.
Peppa M, Betsi G, Dimitriadis G. Lipid Abnormalities and Cardiometabolic Risk in Patients with Overt and Subclinical Thyroid Disease. Journal of Lipids. 2011;2011(Vldl):1–9.
Duntas LH, Brenta G. The Effect of Thyroid Disorders on Lipid Levels and Metabolism. Medical Clinics of North America. 2012;96(2):269–81.
Liu J, Liu L, Jia Q, Zhang X, Jin X, Shen H. Effects of excessive iodine intake on blood glucose, blood pressure, and blood lipids in adults. Biological Trace Element Research. 2019;192(2):136–44.
Gropper SS, Smith JL, Carr TP. Advanced nutrition and human metabolism. Seventh. Boston: Cengage Learning; 2018. 528–533 p.
Djokomoeljanto R. Kelenjar Tiroid-Hipotiroid-Hipertiroid. In: Buku Ajar Ilmu Penyakit Dalam Jilid III. ke-5. Jakarta: Interna Publishing; 2009. p. 1993–2008.
Zheng X, Long J, Ren W, Liu C, Wei Q, Luo R, et al. Exposure to the Chinese famine in early life and the thyroid function and nodules in Adulthood. Endocrine Practice. 2019;25(6):598–604.
Park VY, Han K, Seong YK, Park MH, Kim EK, Moon HJ, et al. Diagnosis of thyroid nodules: Performance of a deep learning convolutional neural network model vs. radiologists. Scientific Reports. 2019;9(1):1–9.
Zimmermann MB. The Thyroid and Its Diseases. Luster M, Duntas LH, Wartofsky L, editors. The Thyroid and Its Diseases. A Comprehensive Guide for the Clinician. Cham: Springer International Publishing; 2019. 101–108 p.
LiVolsi VA, Baloch ZW. The pathology of hyperthyroidism. Front Endocrinol (Lausanne). 2018 Dec 3;9:1–8.
Stockigt J. Clinical strategies in the testing of thyroid function. In: Endotext. MDText.com Inc; 2011. Available from: www.endotext.org
Lu S, Guan Q, Liu Y, Wang H, Xu W, Li X, et al. Role of extrathyroidal TSHR expression in adipocyte differentiation and its association with obesity. Lipids Health Dis. 2012;11:1–12.
Gagnon AM, Antunes TT, Ly T, Pongsuwan P, Gavin C, Lochnan HA, et al. Thyroid-stimulating hormone stimulates lipolysis in adipocytes in culture and raises serum free fatty acid levels in vivo. Metabolism. 2010;59(4):547–53.
Tian L, Song Y, Xing M, Zhang W, Ning G, Li X, et al. A novel role for thyroid-stimulating hormone: Up-regulation of hepatic 3-hydroxy-3-methyl-glutaryl-coenzyme a reductase expression through the cyclic adenosine monophosphate/protein kinase A/cyclic adenosine monophosphate-responsive element binding protei. Hepatology. 2010;52(4):1401–9.
Waterhouse DF, McLaughlin AM, Walsh CD, Sheehan F, O’Shea D. An examination of the relationship between normal range thyrotropin and cardiovascular risk parameters: A study in healthy women. Thyroid. 2007;17(3):243–8.
Xu C, Yang X, Liu W, Yuan H, Yu C, Gao L, et al. Thyroid stimulating hormone, independent of thyroid hormone, can elevate the serum total cholesterol level in patients with coronary heart disease: A cross-sectional design. Nutrition & Metabolism. 2012;9:1–8.
Jung KY, Ahn HY, Han SK, Park YJ, Cho BY, Moon MK. Association between thyroid function and lipid profiles, apolipoproteins, and high-density lipoprotein function. Journal of Clinical Lipidology. 2017;11(6):1347–53.
Wang F, Tan Y, Wang C, Zhang X, Zhao Y, Song X, et al. Thyroid-stimulating hormone levels within the reference range are associated with serum lipid profiles independent of thyroid hormones. The Journal of Clinical Endocrinology and Metabolism. 2012;97(8):2724–31.
Zhenjiang H. The correlation of blood lipid profile and its ratio, cystatin C and homocysteine of thyroid dysfunction. American Journal of Clinical and Experimental Medicine. 2017;5(4):108.
Chen Y, Wu X, Wu R, Sun X, Yang B, Wang Y, et al. Changes in profile of lipids and adipokines in patients with newly diagnosed hypothyroidism and hyperthyroidism. Scientific Reports. 2016;6:1–7.
Selim FO, Ahmed AM. The Association between serum paraoxonase-1 activity, thyroid hormones and lipid profile in patients with primary hyperthyroidism. International Journal of Advanced Research. 2014;2(11):172–81.
Sinha RA, Singh BK, Yen PM. Thyroid hormone regulation of hepatic lipid and carbohydrate metabolism. Trends in Endocrinology & Metabolism. 2014;25(10):538–45.
Costantini F, Pierdomenico SD, De Cesare D, De Remigis P, Bucciarelli T, Bittolo-Bon G, et al. Effect of thyroid function on LDL oxidation. Arteriosclerosis, Thrombosis, and Vascular Biology. 1998;18(5):732–7.
Giugliano RP, Wiviott SD, Blazing MA, De Ferrari GM, Park JG, Murphy SA, et al. Long-term safety and efficacy of achieving very low levels of low-density lipoprotein cholesterol: A prespecified analysis of the IMPROVE-IT trial. JAMA Cardiology 2017;2(5):547–55.