Pattern of Lipid and Lipoproteins among Thyroid Dysfunction Patients Referred To Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia
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Date
2012-06
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Addis Abeba University
Abstract
Introduction: The relationship between thyroid hormones and lipids has long been studied, having beenfirst described more than 70 years ago. Since then, much new information has been discovered, whichjustifies a reevaluation of the relationship between thyroid pathology, dyslipidemia and furthercardiovascular disease rick. Relations between thyroid function and lipid status remain incompletelyunderstood in Ethiopia. Besides the emerging concern of stroke and hypertension, goiter is one of thehighly endemic and prevalent noninfectious diseases in the country. Moreover, the country healthpolicy and strategy mainly focus on prevention of communicable diseases and physicians may fail tomanage lipid and lipoprotein abnormalities, and cardiovascular risks while treating their patients forthyroid dysfunctions.
Objective: To determine the relationship between thyroid dysfunction versus serum lipid profile and riskof cardiovascular disease among patients referred to the Ethiopian Health and Nutrition ResearchInstitute.
Methods: Correctional with Control study was conducted from September, 2011 to May 2012. A total of212 participants, 106 of them referred for thyroid function laboratory investigation or on follow-up andthe rest 106 sex and age matched apparently healthy control group were consented, considered for exitinterview and physical examination about their antropometrical, medication, nutritional status, and forsine and symptom of thyroid disfunction with trained nurses. The laboratory investigation includes lipidand lipoprotein panels, and thyroid functional test using COBAS Integra-400, and COBAS e-411analyzers. Data entry was done using Microsoft Excel 2007. Data analysis wsbe performed using Chi-square,Student-t-test and odds ratio, using SPSS version 19 and STATA version 8 were used to assessassociation between variables. p value <0.05 was considered as statistically significant.
Result: Of 212 study participants, 89.6% were females, mean age, mean age was 39.2 years; mean BMIwas 23.4±4.9 among cases and 22.1±2.6 among control subjects. BP was statistically significantly higheramong control than cases p<0.0001. Majority of the subjects were euthyroid (54.7%), followed byhyperthyroidism (23%) in which 9.4%, 6.1%, and 7.6% account for overt hyperthyroid, sub-clinicalhyperthyroid, and T3 toxicosis, respectively. The rest 22.2% were hypothyroid in which 2.8%, 19.3%,account for overt hypothyroid and sub-clinical hypothyroid, respectively and 37% of the subjects haveelevated thyrogloblin. However, sub-clinical hypothyroids 12.7%. Lipids and lipoproteins (TC, TRI, LDL,Apo-A, and Lp-A) were significantly elevated in hypothyroid condition than control subjects whereasHDL decreased significantly. And the reverse condition happens in hyperthyroid subjects. 47.3% of thecase where taking medication for their thyroid dysfunction. Of this 21.1 % of them became euethyroidsubjects after medication with L-thyroxin. And there lipid and lipoprotein profiles seem normal.
Conclusion: Thyroid dysfunction is associated with higher BP, higher BMI, and lipid and lipoproteinprofile. Apparently healthy subjects may became sub-clinical hypothyroid and had higher thyrogloblins;this indicate below optimum iodine supplement. L-hhyroxine may help in the optimization of lipid andlipoproteins.
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Keywords
Thyroid Dysfunction,Lipid , Lipoproteins,Patients