LIPIDS AND ISCHEMIA MODIFIED ALBUMIN IN MILD SUBCLINICAL HYPOTHYROIDISM: RESPONSE TO LEVOTHYROXINE REPLACEMENT

  • Jaseem T RESEARCH SCHOLAR KMC, MANGALURU
  • Anupama Hegde Associate Professor Department of Biochemistry KMC Mangalore, Manipal University
  • Chakrapani M ProfessorDepartment of Internal MedicineKMC Mangalore,Manipal University
  • SATHISH RAO Additional ProfessorDepartment of Internal MedicineKMC Mangalore, Manipal University
  • Poornima Manjrekar Professor and Head Department of Biochemistry KMC Mangalore,Manipal University
  • Rukmini MS Associate ProfessorDepartment of Biochemistry KMC Mangalore,Manipal University

Abstract

Objective: Subclinical hypothyroidism (SCH) with thyroid-stimulating hormone (TSH) less than 10 µIU/ml is a common finding discovered during
routine thyroid function testing. Thyroxine substitution and its benefits to alleviate dyslipidemia and oxidative stress (OXs) markers at this stage are
a matter of debate.

Methods: This study aimed to investigate the influence of thyroxine substitution on lipid profile and OXs markers in newly diagnosed SCH subjects.
The study included a total number of 50 newly diagnosed (20 treated and 30 untreated), SCH subjects aged 20-50 years with (TSH<10 µIU/ml), and
free thyroxine (FT4) levels in the normal range. Patients on medications that could cause thyroid hormone dysfunction, diabetes mellitus, and current
or pregnancy during the last 2 years were excluded from the study. Serum TSH, T3, T4, FT4, anti-thyroid peroxidase antibodies, total cholesterol (TC),
high-density lipoprotein cholesterol (HDL), triglycerides (TG), low-density lipoprotein cholesterol (LDL), and ischemia modified albumin (IMA) were
determined in all subjects at baseline and after 9 months.

Results: After thyroxine replacement, a significant decrease in TSH, LDL, IMA and an increase in FT4 were observed. The decrease in TC was not
statistically evident. There was no significant change in T3, T4, TG, HDL, after treatment. The untreated group showed an insignificant increase only
in TSH.

Conclusion: Thyroid substitution therapy has a favorable influence on lipid profile and OXs, where it particularly reduced LDL and IMA.

Keywords: Subclinical hypothyroidism, L-thyroxine, Lipids, Ischemia-modified albumin, Oxidative stress.

Author Biography

Jaseem T, RESEARCH SCHOLAR KMC, MANGALURU
 

References

1. Garber JR, Cobin RH, Gharib H, Hennessey JV, Klein I, Mechanick JI, et al. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Thyroid. 2012;22:1200–35.
2. Pearce SH, Brabant G, Duntas LH, Monzani F, Peeters RP, Razvi S, et al. 2013 ETA Guideline: Management of Subclinical Hypothyroidism. Eur Thyroid J. 2013;2:215-28.
3. Unnikrishnan AG, Menon UV. Thyroid disorders in India: An epidemiological perspective. Indian J Endocrinol Metab. 2011;15:578-81.
4. Rodondi N, Bauer DC. Subclinical Hypothyroidism and Cardiovascular Risk: How to End the Controversy. J Clin Endocrinol Metab. 2013;98:2267-9.
5. Cooper DS, Biondi B. Subclinical thyroid disease. Lancet. 2012;379:1142–54.
6. Bar-Or D, Lau E, Winkler JV. A novel assay for cobalt-albumin binding and its potential as a marker for myocardial ischemia-a preliminary report. J Emerg Med. 2000;19:311-5.
7. Millán J, Pintó X, Muñoz A, Zúñiga M, Rubiés-Prat J, Pallardo LF, et al. Lipoprotein ratios: Physiological significance and clinical usefulness in cardiovascular prevention. Vasc Health Risk Manag. 2009;5:757-65.
8. Anagnostis P, Efstathiadou ZA, Slavakis A, Selalmatzidou D, Poulasouchidou M, Katergari S, et al. The effect of L-thyroxine substitution on lipid profile, glucose homeostasis, inflammation and coagulation in patients with subclinical hypothyroidism. Int J Clin Pract. 2014;68:857-63.
9. Aksoy DY, Cinar N, Harmanci A, Karakaya J, Yildiz BO, Usman A, et al. Serum resistin and high sensitive CRP levels in patients with subclinical hypothyroidism before and after L-thyroxine therapy. Med Sci Monit. 2013;19:210-5.
10. Adrees M, Gibney J, El-Saeity N, Boran G. Effects of 18 months of L-T4 replacement in women with subclinical hypothyroidism. Clin Endocrinol. 2009;71:298-303.
11. Razvi S, Ingoe L, Keeka G, Oates C, McMillan C, Weaver JU. The beneficial effect of L-thyroxine on cardiovascular risk factors, endothelial function, and quality of life in subclinical hypothyroidism: randomized, crossover trial. J Clin Endocrinol Metab. 2007;92:1715–23.
12. Villar HC, Saconato H, Valente O, Atallah AN. Thyroid hormone replacement for subclinical hypothyroidism. Cochrane Database Syst Rev. 2007;(3):CD003419.
13. Mutlu S, Parlak A, Aydogan U, Aydogdu A, Soykut B, Akay C, et al. The effect of levothyroxine replacement therapy on lipid profile and oxidative stress parameters in patients with subclinical hypothyroid. Arch Pharm Res. 2013; doi:10.1007/s12272-013-0227-y
14. Asranna A, Taneja RS, Kulshreshta B. Dyslipidemia in subclinical hypothyroidism and the effect of thyroxine on lipid profile. Indian J Endocrinol Metab. 2012;16:347-9.
15. Karmisholt J, Andersen S, Laurberg P. Variation in thyroid function tests in patients with stable untreated subclinical hypothyroidism. Thyroid. 2008;18:303-8.
16. Gaze DC. Ischemia modified albumin: a novel biomarker for the detection of cardiac ischemia. Drug Metab Pharmacokinet. 2009;24:333-41.
17. Duarte MM, Rocha JB, Moresco RN, Duarte T, Da Cruz IB, Loro VL, Schetinger MR. Association between ischemia-modified albumin, lipids and inflammation biomarkers in patients with hypercholesterolemia. Clin Biochem. 2009;42:666-71.
18. Ma SG, Yang LX, Bai F, Xu W, Hong B. Ischemia-modified albumin in patients with hyperthyroidism and hypothyroidism. Eur J Intern Med. 2012;23:e136-40.
19. Reddy SV, Suchitra MM, Pradeep V, Alok S, Suresh V, Bitla AR, Srinivasa RaoPV. Ischemia-modified albumin levels in overt and subclinical hypothyroidism. J Endocrinol Invest. 2015 ;38:885-90.
20. Lakshminarayana, Suresh DR, Pratibha K. Significance of Ischemia Modified Albumin in Subclinical Hypothyroidism Patients - A Pilot Study. Indian Journal of Public Health Research & Development. 2014;5:99-102.
21. Oncel M, Kıyıcı A, Onen S. Evaluation of the Relationship Between Ischemia-Modified Albumin Levels and Thyroid Hormone Levels. J Clin Lab Anal. 2015;29:427-31.
22. Erem C, Suleyman AK, Civan N, Mentese A, Nuhoglu İ, Uzun A, Ersoz HO, Deger O.Ischemia-modified albümin and malondialdehyde levels in patients with overt and subclinical hyperthyroidism: effects of treatment on oxidative stress. Endocr J. 2015;62:493-501.

23. Rostami R, Aghasi MR, Mohammadi A, Nourooz-Zadeh J. Enhanced oxidative stress in Hashimoto's thyroiditis: inter-relationships to biomarkers of thyroid function. Clin Biochem. 2013 Mar;46:308-12.
24. Nanda N, Bobby Z, Hamide A. Oxidative stress in anti thyroperoxidase antibody positive hypothyroid patients. Asian J Biochem 2012;7:54‑8.

25. Mishra P, Samanta L. Oxidative stress and heart failure in altered thyroid States. ScientificWorldJournal. 2012;2012:741861.
26. Mancini A, Di Segni C, Raimondo S, Olivieri G, Silvestrini A, Meucci E, Currò D. Thyroid Hormones, Oxidative Stress, and Inflammation. Mediators Inflamm. 2016;2016:6757154.
27. Dardano A, Ghiadoni L, Plantinga Y, Caraccio N, Bemi A, Duranti E, et al. Recombinant human thyrotropin reduces endothelium‑dependent vasodilation in patients monitored for differentiated thyroid carcinoma. J Clin Endocrinol Metab 2006;91:4175‑8.

28. Nadol'nik LI. Stress and the thyroid gland. Biomed Khim. 2010;56:443-56.

29. Baser H, Can U, Baser S, Yerlikaya FH, Aslan U, Hidayetoglu BT. Assesment of oxidative status and its association with thyroid autoantibodies in patients with euthyroid autoimmune thyroiditis. Endocrine. 2015 Apr;48:916-23.
Statistics
264 Views | 360 Downloads
Citatons
How to Cite
T, J., A. Hegde, C. M, SATHISH RAO, P. Manjrekar, and Rukmini MS. “LIPIDS AND ISCHEMIA MODIFIED ALBUMIN IN MILD SUBCLINICAL HYPOTHYROIDISM: RESPONSE TO LEVOTHYROXINE REPLACEMENT”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 10, no. 5, May 2017, pp. 336-8, doi:10.22159/ajpcr.2017.v10i5.17373.
Section
Original Article(s)