OJEMD  Vol.3 No.2 , May 2013
A Comparative Study of Thyroid Hormone and Lipid Status of Patient with and without Diabetes in Adults
Abstract: Introduction: Lipid and thyroid function abnormalities are common in IDDM and NIDDM. Very few studies have addressed this issue in Bangladesh though Bangladeshi population is very much susceptible to patient with diabetes. Aims: To study on lipid profile and thyroid function in IDDM and NIDDM and the effect of glycemic control on it. Patients and Methods: This was a retrospective study carried out in the Dept. of Endocrinology, BIRDEM, Dhaka, Bangladesh during the period of January, 2012 to May, 2012. In this study, population consisted of 120 subjects (Age between 40 - 72 years; and Sex matched) divided into two groups: patient with diabetes 60 subjects (male-30, female-30) and patient without diabetes 60 subjects (male-30, female-30). Plasma glucose, HbA1c and serum lipids were measured by enzymatic method. Thyroid hormones were measured by a Chemiluminescent Micro particle Immunoassay (CMIA).Results: The statistical significance was evaluated by Student’s t-test, Correlation-Coefficient test. All Values are given as mean ± SD. The level of serum TSH in patient with diabetes (3.43 ± 2.71) was significantly (p < 0.05) increased compared to patient without diabetes subjects (1.98 ± 1.72). TSH levels were positively correlated with fasting plasma glucose (r = 0.240, p < 0.05), serum cholesterol (r = 0.290, p < 0.020) and triglyceride concentration (r = 0.246, p < 0.05). On the other hand, free T4 levels were inversely correlated with postprandial blood glucose (r =-0.256, p < 0.046). Conclusions: It may be concluded that the lipid and thyroid function abnormalities with others socio-demographic and biophysical risk factors were more common in patient with diabetes cases rather than patient without diabetes cases. Therefore, further prospective studies with larger number of patients are required to strengthen the observations of the present study.
Cite this paper: H. Saha, H. Khan, B. Sarkar, S. Khan, N. Sana, A. Sugawara and S. Choudhury, "A Comparative Study of Thyroid Hormone and Lipid Status of Patient with and without Diabetes in Adults," Open Journal of Endocrine and Metabolic Diseases, Vol. 3 No. 2, 2013, pp. 113-119. doi: 10.4236/ojemd.2013.32017.

[1]   C. V. Rizos, M. S. Elisaf and E. N. Liberopoulos, “Effects of Thyroid Dysfunction on Lipid Profile,” Open Cardiovascular Medicine Journal, Vol. 5, 2011, pp. 76-84. doi:10.2174/1874192401105010076

[2]   T. O’Brien, S. F. Dinneen, P. C. O’Brien and P. J. Palumbo, “Hyperlipidemia in Patients with Primary and Secondary Hypothyroidism,” Mayo Clinic Proceedings, Vol. 68, No. 9, 1993, pp. 860-866. doi:10.1016/S0025-6196(12)60694-6

[3]   J. P. Walsh, A. P. Bremner, M. K. Bulsara, P. O’Leary, P. J. Leedman, P. Feddema and V. Michelangeli, “Thyroid Dysfunction and Serum Lipids: A Community-Based Study,” Clinical Endocrinology, Vol. 63, No. 6, 2005, pp. 670-675. doi:10.1111/j.1365-2265.2005.02399.x

[4]   D. Pallas, D. A. Koutras, P. Adamopoulos, P. Marafelia, A. Souvatzoglou, G. Piperingos and S. D. Moulopoulos, “Increased Mean Serum Thyrotropin in Apparently Euthyroid Hypercholesterolemic Patients: Does It Mean Occult Hypothyroidism?” Journal of Endocrinological Investigation, Vol. 14, No. 9, 1991, pp. 743-746.

[5]   B. O. Asvold, L. J. Vatten, T. I. L. Nilsen and T. Bjoro, “The Association between TSH within the Reference Range and Serum Lipid Concentrations in a Population-Based Study. The HUNT Study,” European Journal of Endocrinology, Vol. 156, 2007, pp. 181-186. doi:10.1530/eje.1.02333

[6]   S. J. Bakker, J. C. ter Maaten, C. Popp-Snijders, J. P. Slaets, R. J. Heine and R. O. Gans, “The Relationship between Thyrotropin and Low Density Lipoprotein Cholesterol Is Modified by Insulin Sensitivity in Healthy Euthyroid Subjects,” Journal of Clinical Endocrinology & Metabolism, Vol. 86, No. 3, 2001, pp. 1206-1211. doi:10.1210/jc.86.3.1206

[7]   J.-M. Fernandez-Real, A. Lopez-Bermejo, A. Castro, R. Casamitjana and W. Ricart, “Thyroid Function Is Intrinsically Linked to Insulin Sensitivity and Endothelium-Dependent Vasodilation in Healthy Euthyroid Subjects,” Journal of Clinical Endocrinology & Metabolism, Vol. 91, No. 9, 2006, pp. 3337-3343. doi:10.1210/jc.2006-0841

[8]   S. Proces, E. Delgrange, T. V. Vander Borght, J. Jamart and J. E. Donckier, “Minor Alterations in Thyroid Function Tests Associated with Diabetes Mellitus and Obesity in Outpatients without Known Thyroid Illness,” Acta Clinica Belgica, Vol. 56, No. 2, 2001, pp. 86-90.

[9]   A. M. Michalek, M. C. Mahoney and D. Calebaugh, “Hypothyroidism and Diabetes Mellitus in an American-Indian Population,” Journal of Family Practice, Vol. 49, No. 7, 2000, pp. 638-640.

[10]   M. Nakazono, M. Kudo, T. Baba, H. Kikuchi and K. Takebe, “Thyroid Abnormalities in Diabetes Mellitus,” Tohoku Journal of Experimental Medicine, Vol. 141, 1983, pp. 275-281. doi:10.1620/tjem.141.Suppl_275

[11]   A. Khan, M. M. A. Khan and S. Akhter, “Thyroid Disorders, Etiology and Prevalence,” Journal of Medical Sciences, Vol. 2, No. 2, 2002, pp. 89-94. doi:10.3923/jms.2002.89.94

[12]   G. Saravanan and L. Pari, “Effect of an Herbal Drug, Cogent db on Plasma and Tissue Glycoproteins in Alloxan-Induced Diabetic Rats,” Research Journal of Medicinal Plant, Vol. 1, No. 3, 2007, pp. 83-91. doi:10.3923/rjmp.2007.83.91

[13]   A. Bobb, D. Gale, S. Manmohan, A. Mohammed, F. Seetahal, P. Small and K. Mungrue, “The Impact of the Chronic Disease Assistance Plan (CDAP) on the Control of Type 2 Diabetes in Trinidad,” Diabetes Research and Clinical Practice, Vol. 80, No. 3, 2008, pp. 360-364. doi:10.1016/j.diabres.2007.11.010

[14]   S. Wild, G. Roglic, A. Green, R. Sicree and H. King, “Global Prevalence of Diabetes: Estimates for the Year 2000 and Projections for 2030,” Diabetes Care, Vol. 27, No. 5, 2004, pp. 1047-1053. doi:10.2337/diacare.27.5.1047

[15]   P. Perros, R. McCrimmon, G. Shaw and B. Frier, “Frequency of Thyroid Dysfunction in Diabetic Patients: Value of Annual Screening,” Diabetic Medicine, Vol. 12, No. 7, 1995, pp. 622-627. doi:10.1111/j.1464-5491.1995.tb00553.x

[16]   N. Bagchi, T. R. Brown, B. Shilver, S. Lucus and R. E. Mack, “Decreased Thyroidal Response to Thyrotropin in Diabetes Mellitus,” Endocrinology, Vol. 109, No. 5, 1981, p. 1428. doi:10.1210/endo-109-5-1428

[17]   C. S. Pitman, J. B. Chamber Jr. and V. H. Read, “The Extra Thyroidal Conversion Rate of Thyroxine to T3 in Normal Man,” Journal of Clinical Investigation, Vol. 50, No. 6, 1971, pp. 1187-1196. doi:10.1172/JCI106596

[18]   J. Saunders, S. E. H. Hall and P. H. Sonksen, “Thyroid Hormone in Insulin Requiring Diabetics before and after Treatment,” Diabetologia, Vol. 15, No. 1, 1978, pp. 29-32. doi:10.1007/BF01219324

[19]   U. M. Kabadi, “Impaired Pituitary Thyrotropin Function in Uncontrolled Type II Diabetes Mellitus: Normalization on Recovery,” Journal of Clinical Endocrinology & Metabolism, Vol. 59, No. 3, 1984, p. 521. doi:10.1210/jcem-59-3-521

[20]   N. Bagchi, N. Palaniswami, H. Desai, J. Felicetta and T. R. Brown, “Decreased Thyroidal Response to Thyrotropin in Type II DIABETES Mellitus,” Metabolism, Vol. 37, No. 7, 1988, pp. 669-671. doi:10.1016/0026-0495(88)90088-1

[21]   J. N. Carter, C. J. Eastman, J. M. Corcoran and L. Lazarus, “Effect of Severe, Chronic Illness on Thyroid Function,” The Lancet, Vol. 1, 1976, p. 653.

[22]   J. H. Oppenheimer, R. Squet, M. I. Surks and H. Haner, “Binding of Thyroxine by Serum Proteins Evauated by Dialysis and Electrophoretic Techniques, Alteration in Nonthyroidal Illness,” Journal of Clinical Investigation, Vol. 42, No. 11, 1963, pp. 1769-1782. doi:10.1172/JCI104862

[23]   C. E. Reusch and K. Tomsa, “Serum Fructosamine Concentration in Cats with Overt Hyperthyroidism,” Journal of the American Veterinary Medical Association, Vol. 215, 1999, pp. 1297-1330.

[24]   F. Gloria-Botthini, E. Antonacci, N. Bottini, A. Ogana, P. Borgiani, G. De Santis and N. Lucarini, “Rh Blood Groups and Diabetic Disorders: Is There an Effect on Glycosylated Hemoglobin Level,” Human Biology, Vol. 72, 2000, pp. 287-294.

[25]   M. J. Sampson, D. A. Hughes, M. J. Carrier and I. R. Davies, “Status of HbA1c during Acute Hyperglycemia in Type 2 Diabetes,” Diabetes Care, Vol. 25, No. 3, 2002, pp. 537-541. doi:10.2337/diacare.25.3.537

[26]   L. H. Duntas, “Thyroid Disease and Lipids,” Thyroid, Vol. 12, No. 4, 2002, pp. 287-293. doi:10.1089/10507250252949405