• GAURAV GUPTA Santosh University, Gaziabad, India


Subclinical hypothyroidism (SCH) and inflammatory diseases are now a day's one of the most popular topics of research. Previous studies have shown
that the patients with SCH have increased levels of triglycerides and signs of low-grade inflammation (raised C-reactive protein levels). Disorder
might be a risk factor for the development of cardiovascular and other inflammatory diseases. However, there is still some controversy concerning the
inflammatory impact of SCH. Treating patients with thyroid stimulating hormone values of <10 mIU/L is not compelling, except in pregnant women.
Fortifying the association between SCH and inflammation and a better understanding of research data may provide a more compelling argument for
future treatment.
Keywords: Thyroid stimulating hormone, C reactive protein, interleukin-6, inflammation

Author Biography

GAURAV GUPTA, Santosh University, Gaziabad, India

Asst.Professor, Department of Biochemistry.


1. Hennessey JV, Espaillat R. Subclinical hypothyroidism: A historical
view and shifting prevalence. Int J Clin Pract 2015;69(7):771-82.
2. Staub JJ, Noelpp B, Grani R, Gemsenjager E, Hauenstein M, Girard J.
The relationship of serum thyrotropin (TSH) to the thyroid hormones
after oral TSH-releasing hormone in patients with preclinical
hypothyroidism. J Clin Endocrinol Metab 1983;56:449-53.
3. Karmisholt J, Andersen S, Laurberg P. Variation in thyroid function
tests in patients with stable untreated subclinical hypothyroidism.
Thyroid 2008;18(3):303-8.
4. Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado
thyroid disease prevalence study. Arch Intern Med 2000;160(4):526-34.
5. Deshmukh V, Behl A, Iyer V, Joshi H, Dholye JP, Varthakavi PK.
Prevalence, clinical and biochemical profile of subclinical
hypothyroidism in normal population in Mumbai. Indian J Endocrinol
Metab 2013;17(3):454-9.
6. Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW,
Spencer CA. Serum TSH, T4, and thyroid antibodies in the United States
population (1988 to 1994): National health and nutrition examination
survey (NHANES III). J Clin Endocrinol Metab 2002;87(2):489-99.
7. Papi G, Uberti ED, Betterle C, Carani C, Pearce EN, Braverman LE,
et al. Subclinical hypothyroidism. Curr Opin Endocrinol Diabetes Obes
8. Dhanwal DK, Prasad S, Agarwal AK, Dixit V, Banerjee AK. High
prevalence of subclinical hypothyroidism during first trimester of
pregnancy in North India. Indian J Endocrinol Metab 2013;17(2):281-4.
9. Khandelwal D, Tandon N. Overt and subclinical hypothyroidism: Who
to treat and how. Drugs 2012;72(1):17-33.
10. Surks MI, Ortiz E, Daniels GH, Sawin CT, Col NF, Cobin RH, et al.
Subclinical thyroid disease: Scientific review and guidelines for
diagnosis and management. JAMA 2004;291(2):228-38.
11. Rugge B, Balshem H, Sehgal R, Relevo R, Gorman P, Helfand M.
Screening and Treatment of Subclinical Hypothyroidism or
Hyperthyroidism. Rockville, MD: Agency for Healthcare Research
and Quality (US); 2011. (Comparative Effectiveness Reviews, No. 24.)
Introduction. Available from:
12. Hulbert AJ. Thyroid hormones and their effects: A new perspective.
Biol Rev Camb Philos Soc 2000;75(4):519-631.
13. Satar S, Seydaoglu G, Avci A, Sebe A, Karcioglu O, Topal M. Prognostic
value of thyroid hormone levels in acute myocardial infarction: Just an
epiphenomenon? Am Heart Hosp J 2005;3(4):227-33.
14. Staykova ND. Rheumatoid arthritis and thyroid abnormalities. Folia
Med (Plovdiv) 2007;49(3-4):5-12.
15. Ichiki T. Thyroid hormone and atherosclerosis. Vascul Pharmacol
16. Doherty DE, Downey GP, Worthen GS, Haslett C, Henson PM.
Monocyte retention and migration in pulmonary inflammation.
Requirement for neutrophils. Lab Invest 1988;59(2):200-13.
17. Boots CE, Jungheim ES. Inflammation and human ovarian follicular
dynamics. Semin Reprod Med 2015;33(4):270-5.
18. Zulewski H, Müller B, Exer P, Miserez AR, Staub JJ. Estimation of
tissue hypothyroidism by a new clinical score: Evaluation of patients
with various grades of hypothyroidism and controls. J Clin Endocrinol
Metab 1997;82(3):771-6.
Asian J Pharm Clin Res, Vol 8, Issue 6, 2015, 24-27
Gupta et al.
19. Kershaw EE, Flier JS. Adipose tissue as an endocrine organ. J Clin
Endocrinol Metab 2004;89(6):2548-56.
20. Longo DL, Fauci AS, Kasper DL, Hausar SL, Jameson JL, Lozcalzo J.
Disorders of thyroid gland. In: Harrison’s Principles of Internal
Medicine. 18
ed., Vol. 1. New York: McGraw Hill Publication; 2012.
p. 2919.
21. Berk M, Williams LJ, Jacka FN, O’Neil A, Pasco JA, Moylan S,
et al. So depression is an inflammatory disease, but where does the
inflammation come from? BMC Med 2013;11:200.
22. Gao CX, Yang B, Guo Q, Wei LH, Tian LM. High thyroid-stimulating
hormone level is associated with the risk of developing atherosclerosis
in subclinical hypothyroidism. Horm Metab Res 2015;47(3):220-4.
23. Hak AE, Pols HA, Visser TJ, Drexhage HA, Hofman A, Witteman JC.
Subclinical hypothyroidism is an independent risk factor for
atherosclerosis and myocardial infarction in elderly women: The
Rotterdam study. Ann Intern Med 2000;132(4):270-8.
24. Valentina VN, Marijan B, Chedo D, Branka K. Subclinical
hypothyroidism and risk to carotid atherosclerosis. Arq Bras Endocrinol
Metabol 2011;55(7):475-80.
25. Hamdy N, Adly N, Bakr Y, Salem A, Aty SA. Association between
subclinical hypothyroidism and metabolic syndrome. Int J Adv Res
26. Taddei S, Salvetti A. Endothelial dysfunction in essential hypertension:
Clinical implications. J Hypertens 2002;20(9):1671-4.
27. Heitzer T, Schlinzig T, Krohn K, Meinertz T, Münzel T. Endothelial
dysfunction, oxidative stress, and risk of cardiovascular events in
patients with coronary artery disease. Circulation 2001;104(22):2673-8.
28. Guzel S, Seven A, Guzel EC, Buyuk B, Celebi A, Aydemir B. Visfatin,
leptin, and TNF- α: Interrelated adipokines in insulin-resistant clinical
and subclinical hypothyroidism. Endocr Res 2013.
29. Wang HC, Dragoo J, Zhou Q, Klein JR. An intrinsic thyrotropinmediated

30. Hase H, Ando T, Eldeiry L, Brebene A, Peng Y, Liu L, et al. TNFalpha
mediates the skeletal effects of thyroid-stimulating hormone. Proc Natl
Acad Sci U S A 2006;103(34):12849-54.
31. Yang SS, Tang L, Li RG, Ge GH, Qu XK, Ma JW, et al. The effects of
subclinical hypothyroidism on serum lipid level and TLR4 expression
of monocyte in peripheral blood of rats. Neuro Endocrinol Lett
32. Xiang G, Yue L, Zhang J, Xiang L, Dong J. The relationship between
circulating TRAIL and endothelial dysfunction in subclinical
hypothyroidism. Endocrine 2015;49(1):184-90.
33. Taddei S, Caraccio N, Virdis A, Dardano A, Versari D, Ghiadoni L,
et al. Low-grade systemic inflammation causes endothelial dysfunction
in patients with Hashimoto’s thyroiditis. J Clin Endocrinol Metab
34. Türemen EE, Çetinarslan B, Sahin T, Cantürk Z, Tarkun I.
Endothelial dysfunction and low grade chronic inflammation in
subclinical hypothyroidism due to autoimmune thyroiditis. Endocr J
35. Sieminska L, Wojciechowska C, Kos-Kudla B, Marek B, Kajdaniuk D,
Nowak M, et al. Serum concentrations of leptin, adiponectin, and
interleukin-6 in postmenopausal women with Hashimoto’s thyroiditis.
Endokrynol Pol 2010;61(1):112-6.
36. Nielsen CH, Brix TH, Leslie RG, Hegedüs L. A role for autoantibodies
in enhancement of pro-inflammatory cytokine responses to a selfantigen,
thyroid peroxidase. Clin Immunol 2009;133(2):218-27.
37. Elshenawy SZ, Hemi MH, Attia H. Serum levels of pro-inflammatory
cytokines (interleukin 6 and interleukin 15) and adiponectin in
hashimoto’s thyroiditis with different thyroid function States. J Am Sci
38. Olszanecka-Glinianowicz M, Zahorska-Markiewicz B, Janowska J.
Increased concentration of interleukin-6 (IL-6) is related to obesity but
not to insulin resistance. Pol J Endocrinol 2004;4:437-41.
39. Ridker PM, Rifai N, Stampfer MJ, Hennekens CH. Plasma concentration
of interleukin-6 and the risk of future myocardial infarction among
apparently healthy men. Circulation 2000;101(15):1767-72.
40. Antunes TT, Gagnon A, Bell A, Sorisky A. Thyroid-stimulating
hormone stimulates interleukin-6 release from 3T3-L1 adipocytes
through a cAMP-protein kinase A pathway. Obes Res 2005;13:2066-71.
41. La Vignera S, Condorelli R, Vicari E, Calogero AE. Endothelial
dysfunction and subclinical hypothyroidism: A brief review.
J Endocrinol Invest 2012;35(1):96-103.
42. Roy S, Banerjee U, Dasgupta A. Effect of sub clinical hypothyroidism
on C-reactive protein and ischemia modified albumin. Mymensingh
Med J 2015;24(2):379-84.
43. Libby P. Inflammation in atherosclerosis. Nature 2002;420(6917):
44. Karoli R, Fatima J, Shukla V, Chandra A, Khanduri S, Rawat A.
Hospital based study of carotid intima media thickness and high
sensitivity C-reactive protein in young hypothyroid patients. J Indian
Acad Clin Med 2014;15(2):116-9.
45. Mahto M, Chakraborthy B, Gowda SH, Kaur H, Vishnoi G, Lali P. Are
hsCRP levels and LDL/HDL ratio better and early markers to unmask
onset of dyslipidemia and inflammation in asymptomatic subclinical
hypothyroidism? Indian J Clin Biochem 2012;27(3):284-9.
46. Tian L, Gao C, Liu J, Zhang X. Increased carotid arterial stiffness in
subclinical hypothyroidism. Eur J Intern Med 2010;21(6):560-3.
47. Tuzcu A, Bahceci M, Gokalp D, Tuzun Y, Gunes K. Subclinical
hypothyroidism may be associated with elevated high-sensitive
C-reactive protein (low grade inflammation) and fasting
hyperinsulinemia. Endocr J 2005;52(1):89-94.
48. Sharma R, Sharma TK, Kaushik GG, Sharma S, Vardey SK, Sinha M.
Subclinical hypothyroidism and its association with cardiovascular risk
factors. Clin Lab 2011;57(9-10):719-24.
49. Yu YT, Ho CT, Hsu HS, Li CI, Davidson LE, Liu CS, et al. Subclinical
hypothyroidism is associated with elevated high-sensitive C-reactive
protein among adult Taiwanese. Endocrine 2013;44(3):716-22.
50. Verma S, Li SH, Badiwala MV, Weisel RD, Fedak PW, Li RK,
et al. Endothelin antagonism and interleukin-6 inhibition attenuate
the proatherogenic effects of C-reactive protein. Circulation
51. Hennige AM, Staiger H, Wicke C, Machicao F, Fritsche A, Häring HU,
et al. Fetuin-A induces cytokine expression and suppresses adiponectin
production. PLoS One 2008;3(3):e1765.
52. Ix JH, Shlipak MG, Brandenburg VM, Ali S, Ketteler M, Whooley MA.
Association between human fetuin-A and the metabolic syndrome:
Data from the Heart and Soul Study. Circulation 2006;113(14):1760-7.
53. Muratli S, Uzunlulu M, Gonenli G, Oguz A, Isbilen B. Fetuin A as a new
marker of inflammation in Hashimoto thyroiditis. Minerva Endocrinol
54. Bakiner O, Bozkirli E, Ertugrul D, Sezgin N, Ertorer E. Plasma fetuin-A
levels are reduced in patients with hypothyroidism. Eur J Endocrinol
55. Wu JT. Circulating homocysteine is an inflammatory marker and a
risk factor of life threatening inflammatory diseases. J Biomed Lab Sci
56. Andrees M, Boran G, Clarke G, Connor GO. Homocysteine in
subclinical hypothyroidism, a risk factor for atherosclerosis? Endocr
Abstr 2003;5:280.
57. Mariotto S, Suzuki Y, Persichini T, Colasanti M, Suzuki H, Cantoni O.
Cross-talk between NO and arachidonic acid in inflammation. Curr
Med Chem 2007;14(18):1940-4.
58. 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-hydroxy3-methyl-glutaryl-coenzyme

kinase A/cyclic

protein pathway.

59. Lu M, Yang CB, Gao L, Zhao JJ. Mechanism of subclinical
hypothyroidism accelerating endothelial dysfunction (Review). Exp
Ther Med 2015;9(1):3-10.
60. Dardano A, Monzani F. Recombinant human TSH acutely
impairs endothelium-dependent vasodilation. Eur J Endocrinol
61. Haynes R. Thyroid and antithyroid drugs. In: Gilman AG,
Rall TW, Nies AS, Taylor P, editors. Goodman and Gilman’s the
Pharmacological Basis of Therapeutics. New York: McGraw Hill,
Inc.; 1993. p. 1361-83.
62. Colucci P, Yue CS, Ducharme M, Benvenga S. A review of the
pharmacokinetics of levothyroxine for the treatment of hypothyroidism.
Eur Endocrinol 2013;9(1):40-7.
63. Bilgir O, Bilgir F, Calan M, Calan OG, Yuksel A. Comparison of
pre- and post-levothyroxine high-sensitivity c-reactive protein and
fetuin-a levels in subclinical hypothyroidism. Clinics (Sao Paulo)
64. Sengül E, Cetinarslan B, Tarkun I, Cantürk Z, Türemen E.
Homocysteine concentrations in subclinical hypothyroidism. Endocr
Res 2004;30(3):351-9.
65. 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.
Asian J Pharm Clin Res, Vol 8, Issue 6, 2015, 24-27
Gupta et al.
66. Monzani F, Dardano A, Caraccio N. Does treating subclinical
hypothyroidism improve markers of cardiovascular risk? Treat
Endocrinol 2006;5(2):65-81.
67. Cabral MD, Teixeira P, Soares D, Leite S, Salles E, Waisman M.
Effects of thyroxine replacement on endothelial function and carotid
artery intima-media thickness in female patients with mild subclinical
hypothyroidism. Clinics (Sao Paulo) 2011;66:1321-8.
68. 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
69. 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.
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How to Cite
GUPTA, G., P. SHARMA, P. KUMAR, and R. SHARMA. “SCOPE OF INFLAMMATORY MARKERS IN SUBCLINICAL HYPOTHYROIDISM”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 8, no. 6, Nov. 2015, pp. 24-27,
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