Non High Density Lipoprotein Cholesterol, a Simple and Reliable Marker to Assess Cardiovascular Disease Risk in Hypothyroid Patients

Introduction: Thyroid hormones regulate growth, metabolism and cellular differentiation in our body. Thyroid disorders are among the commonly encountered endocrinopathies across the globe in the recent past. Hypothyroidism is prevalent to the extent of 9.45-11.73% among urban inland regions of I...

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Main Authors: N Chandrika, RN Devaki, S Reshma
Format: Article
Language:English
Published: JCDR Research and Publications Pvt. Ltd. 2021-10-01
Series:National Journal of Laboratory Medicine
Subjects:
Online Access:http://www.njlm.net/articles/PDF/2521/50181_CE[Ra1]_F(SHU)_PF1(AG_SHU)_PFA(KM)PB(AG_KM)_PN(KM).pdf
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author N Chandrika
RN Devaki
S Reshma
author_facet N Chandrika
RN Devaki
S Reshma
author_sort N Chandrika
collection DOAJ
description Introduction: Thyroid hormones regulate growth, metabolism and cellular differentiation in our body. Thyroid disorders are among the commonly encountered endocrinopathies across the globe in the recent past. Hypothyroidism is prevalent to the extent of 9.45-11.73% among urban inland regions of India as reported in a recent survey. Thyroid hormones influence lipid metabolism. The dyslipidemia in hypothyroidism presents as high serum Total Cholesterol (TC) levels, elevated Low Density Lipoprotein-Cholesterol (LDL-C) levels, hypertriglyceridemia and Increased Triglyceride (TGL)- Rich Lipoproteins or Remnant Lipoproteins (RLPs). Non High Density Lipoprotein-Cholesterol (Non-HDL-C) reflects the cholesterol content of these RLPs. The potential of Non-HDL-C seems to be underutilised in patients with hypothyroidism. Aim: To know the levels of Non-HDL-C in hypothyroid patients as compared to normal subjects and to assess its reliability to predict the future cardiovascular risk in hypothyroid patients. Materials and Methods: The study was a case-control study, that was conducted in District Hospital, Chamarajanagar, Karnataka, India, between December 2019 to September 2020, involving two groups. The first group were the cases, consisting of 50 hypothyroid patients between 18 and 55 years of age, 50 healthy age and sex matched controls were selected and inducted into this study. The ‘Case group was further divided into “Known cases” and ‘New cases’, based on the disease course. The ‘New cases’ are further classified into group of ‘Overt Hypothyroids’ and ‘Subclinical hypothyroids’. In all the subjects of present study, serum TC and serum HDLCholesterol (HDL-C) was estimated. The value of HDL-C was subtracted from TC level and Non-HDL-C level was calculated for all the study subjects. The values of the lipid fractions in both groups and in the subgroup were tabulated and compared using suitable statistical tool. Results: In the present study it was noted that Non-HDL-C was significantly high in hypothyroid patients when compared to healthy controls (p=0.02). Also, the newly diagnosed hypothyroid patients had significantly high Non-HDL-C levels than controls (p=0.01). The subgroup of ‘Known cases’ who were on Levothyroxine replacement did not show significantly elevated NonHDL-C levels. Overt Hypothyroid (OH) patients had higher values of Non-HDL-C than those with Subclinical Hypothyroidism (SCH). Conclusion: At each level of the present study, (controls vs cases, known vs new cases and OH vs SCH) non-HDL-C has emerged in an expected pattern, which is consistent with pathophysiology, course and severity of the disease. Therefore, present study suggest the feasibilty of non-HDL-C replacing the traditional lipid profile assays for assessment of dyslipidemia in hypothyroid patients.
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spelling doaj.art-90d1979cfadd47c09e75356199ca1dc92022-12-21T18:46:23ZengJCDR Research and Publications Pvt. Ltd.National Journal of Laboratory Medicine2277-85512455-68822021-10-01104050810.7860/NJLM/2021/50181:2521Non High Density Lipoprotein Cholesterol, a Simple and Reliable Marker to Assess Cardiovascular Disease Risk in Hypothyroid PatientsN Chandrika0RN Devaki1S Reshma2Associate Professor, Department of Biochemistry, Chamarajanagar Institute of Medical Sciences, Chamarajanagar, Karnataka, India.. Professor and Head, Department of Biochemistry, Chamarajanagar Institute of Medical Sciences, Chamarajanagar, Karnataka, India.Associate Professor, Department of Biochemistry, A.J. Institute of Medical Sciences and Research Centre, Mangalore, Karnataka, India.Introduction: Thyroid hormones regulate growth, metabolism and cellular differentiation in our body. Thyroid disorders are among the commonly encountered endocrinopathies across the globe in the recent past. Hypothyroidism is prevalent to the extent of 9.45-11.73% among urban inland regions of India as reported in a recent survey. Thyroid hormones influence lipid metabolism. The dyslipidemia in hypothyroidism presents as high serum Total Cholesterol (TC) levels, elevated Low Density Lipoprotein-Cholesterol (LDL-C) levels, hypertriglyceridemia and Increased Triglyceride (TGL)- Rich Lipoproteins or Remnant Lipoproteins (RLPs). Non High Density Lipoprotein-Cholesterol (Non-HDL-C) reflects the cholesterol content of these RLPs. The potential of Non-HDL-C seems to be underutilised in patients with hypothyroidism. Aim: To know the levels of Non-HDL-C in hypothyroid patients as compared to normal subjects and to assess its reliability to predict the future cardiovascular risk in hypothyroid patients. Materials and Methods: The study was a case-control study, that was conducted in District Hospital, Chamarajanagar, Karnataka, India, between December 2019 to September 2020, involving two groups. The first group were the cases, consisting of 50 hypothyroid patients between 18 and 55 years of age, 50 healthy age and sex matched controls were selected and inducted into this study. The ‘Case group was further divided into “Known cases” and ‘New cases’, based on the disease course. The ‘New cases’ are further classified into group of ‘Overt Hypothyroids’ and ‘Subclinical hypothyroids’. In all the subjects of present study, serum TC and serum HDLCholesterol (HDL-C) was estimated. The value of HDL-C was subtracted from TC level and Non-HDL-C level was calculated for all the study subjects. The values of the lipid fractions in both groups and in the subgroup were tabulated and compared using suitable statistical tool. Results: In the present study it was noted that Non-HDL-C was significantly high in hypothyroid patients when compared to healthy controls (p=0.02). Also, the newly diagnosed hypothyroid patients had significantly high Non-HDL-C levels than controls (p=0.01). The subgroup of ‘Known cases’ who were on Levothyroxine replacement did not show significantly elevated NonHDL-C levels. Overt Hypothyroid (OH) patients had higher values of Non-HDL-C than those with Subclinical Hypothyroidism (SCH). Conclusion: At each level of the present study, (controls vs cases, known vs new cases and OH vs SCH) non-HDL-C has emerged in an expected pattern, which is consistent with pathophysiology, course and severity of the disease. Therefore, present study suggest the feasibilty of non-HDL-C replacing the traditional lipid profile assays for assessment of dyslipidemia in hypothyroid patients.http://www.njlm.net/articles/PDF/2521/50181_CE[Ra1]_F(SHU)_PF1(AG_SHU)_PFA(KM)PB(AG_KM)_PN(KM).pdfatherosclerosisdyslipidemiaovert hypothyroidismsub clinical hypothyroidism
spellingShingle N Chandrika
RN Devaki
S Reshma
Non High Density Lipoprotein Cholesterol, a Simple and Reliable Marker to Assess Cardiovascular Disease Risk in Hypothyroid Patients
National Journal of Laboratory Medicine
atherosclerosis
dyslipidemia
overt hypothyroidism
sub clinical hypothyroidism
title Non High Density Lipoprotein Cholesterol, a Simple and Reliable Marker to Assess Cardiovascular Disease Risk in Hypothyroid Patients
title_full Non High Density Lipoprotein Cholesterol, a Simple and Reliable Marker to Assess Cardiovascular Disease Risk in Hypothyroid Patients
title_fullStr Non High Density Lipoprotein Cholesterol, a Simple and Reliable Marker to Assess Cardiovascular Disease Risk in Hypothyroid Patients
title_full_unstemmed Non High Density Lipoprotein Cholesterol, a Simple and Reliable Marker to Assess Cardiovascular Disease Risk in Hypothyroid Patients
title_short Non High Density Lipoprotein Cholesterol, a Simple and Reliable Marker to Assess Cardiovascular Disease Risk in Hypothyroid Patients
title_sort non high density lipoprotein cholesterol a simple and reliable marker to assess cardiovascular disease risk in hypothyroid patients
topic atherosclerosis
dyslipidemia
overt hypothyroidism
sub clinical hypothyroidism
url http://www.njlm.net/articles/PDF/2521/50181_CE[Ra1]_F(SHU)_PF1(AG_SHU)_PFA(KM)PB(AG_KM)_PN(KM).pdf
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AT rndevaki nonhighdensitylipoproteincholesterolasimpleandreliablemarkertoassesscardiovasculardiseaseriskinhypothyroidpatients
AT sreshma nonhighdensitylipoproteincholesterolasimpleandreliablemarkertoassesscardiovasculardiseaseriskinhypothyroidpatients