Hypothyroidism in Metabolic Syndrome

Abstract

Metabolic syndrome (Syndrome X/Insulin resistance syndrome) consistsof central obesity, hypertriglyceridemia, low high-density lipoprotein (HDL) cholesterol,hyperglycemia and hypertension as its major features. All of them can be influenced by thefunctioning of a 20 g endocrine organ, the thyroid gland. Aims and objectives: To studythe proposed association between metabolic syndrome and thyroid dysfunction. Materialand methods: Hundred subjects aged more than 18 years, willing to participate in the studyand fulfilling criteria of the National Cholesterol Education Program-Adult Treatment PanelIII (NCEP-ATP III) for diagnosis of metabolic syndrome were included. Detailed clinicalexamination and laboratory investigations of all subjects were done. Risk factors wereidentified and analyzed by comparing the subjects with and without thyroid dysfunction.Results: Eighty-one out of 100 subjects with metabolic syndrome belonged to the age groupbetween 41 and 70 years. Females comprised 60% of the total patient population with sedentarylifestyle as the major risk factor, whereas males comprising rest of the 40% had addictivebehaviors as major risk factors. Observation of individual parameters under NCEP-ATP IIIshowed that 57 patients fulfilled all 5 criteria, 34 patients fulfilled 4 and 9 patients fulfilled3 criteria. Obesity and dyslipidemia were common among female subjects, whereas impairedglucose tolerance and hypertension were common among males. Thyroid dysfunction inthe form of hypothyroidism was present in 30 subjects with females (23 patients) being thestatistically significant population (p < 0.0001). Hypothyroidism was of subclinical type in21 of these 30 subjects. None had hyperthyroidism. Left ventricular ejection fraction (mean± SD) was lowered to 42.67 ± 6.53 from 49.07 ± 7.48 in presence of thyroid dysfunction inthese subjects with metabolic syndrome (p < 0.0001). Conclusion: Metabolic syndrome andhypothyroidism (even subclinical) are both individual as well as combined risk factors fordevelopment of atherogenic dyslipidemia, diabetes mellitus and cardiovascular disease withelderly females comprising the high risk group.