Kota Sunil Kumar, Meher Lalit Kumar, Krishna Svs, Modi Kd
Department of Endocrinology, Medwin hospital, Hyderabad, India.
Indian J Endocrinol Metab. 2012 Dec;16(Suppl 2):S332-3. doi: 10.4103/2230-8210.104079.
Metabolic syndrome (MetS) and hypothyroidism are well established forerunners of atherogenic cardiovascular disease. Considerable overlap occurs in the pathogenic mechanisms of atherosclerotic cardiovascular disease by metabolic syndrome and hypothyroidism. Insulin resistance has been studied as the basic pathogenic mechanism in metabolic syndrome.[1] This cross sectional study intended to assess thyroid function in patients with metabolic syndrome and to investigate the association between hypothyroidism and metabolic syndrome.
One hundred patients with metabolic syndrome who fulfilled the National Cholesterol Education Program- Adult Treatment Panel (NCEP-ATP) III criteria [ 3 out of 5 criteria positive namely blood pressure ≥ 130/85 mm hg or on antihypertensive medications, fasting plasma glucose > 100 mg/dl or on anti-diabetic medications, fasting triglycerides > 150 mg/dl, high density lipoprotein cholesterol (HDL-C) < 40 mg/dl in males and < 50 mg/dl in females, waist circumference > 102 cms in men and 88 cms in women] were included in the study group.[2] Fifty patients who had no features of metabolic syndrome (0 out of 5 criteria for metabolic syndrome) were included in the control group. Patients with liver disorders, renal disorders, congestive cardiac failure, pregnant women, patients on oral contraceptive pills, statins and other medications that alter thyroid functions and lipid levels and those who are under treatment for any thyroid related disorder were excluded from the study. Acutely ill patients were excluded taking into account sick euthyroid syndrome. Patients were subjected to anthropometry, evaluation of vital parameters, lipid and thyroid profile along with other routine laboratory parameters. Students t-test, Chi square test and linear regression, multiple logistic regression models were used for statistical analysis. P value < 0.05 was considered significant.
Of the 100 patients in study group, 55 were females (55%) and 45 were males (45%). Of the 50 persons in control group, 26 (52%) were females and 24 (48%) were males. The baseline characteristics of two groups are depicted in. The two groups were similar with respect to age and sex distribution. However, body mass index, waist circumference, mean systolic pressure, diastolic pressure, fasting blood sugar, total cholesterol, LDL-C, triglycerides and TSH were significantly higher in study group compared to control group. HDL-C was significantly lower in study group.
代谢综合征（MetS）和甲状腺功能减退是动脉粥样硬化性心血管疾病公认的先兆。代谢综合征和甲状腺功能减退在动脉粥样硬化性心血管疾病的致病机制中存在相当大的重叠。胰岛素抵抗已被作为代谢综合征的基本致病机制进行研究。[1] 本横断面研究旨在评估代谢综合征患者的甲状腺功能，并调查甲状腺功能减退与代谢综合征之间的关联。
100例符合美国国家胆固醇教育计划成人治疗小组（NCEP-ATP）III标准[5项标准中3项阳性，即血压≥130/85 mmHg或正在服用抗高血压药物、空腹血糖>100 mg/dl或正在服用抗糖尿病药物、空腹甘油三酯>150 mg/dl、男性高密度脂蛋白胆固醇（HDL-C）<40 mg/dl且女性<50 mg/dl、男性腰围>102 cm且女性>88 cm]的代谢综合征患者纳入研究组。[2] 50例无代谢综合征特征（代谢综合征5项标准均为阴性）的患者纳入对照组。排除患有肝脏疾病、肾脏疾病、充血性心力衰竭的患者、孕妇、正在服用口服避孕药、他汀类药物及其他会改变甲状腺功能和血脂水平的药物的患者，以及正在接受任何甲状腺相关疾病治疗的患者。考虑到病态甲状腺综合征，排除急性病患者。对患者进行人体测量、生命体征参数评估、血脂和甲状腺功能检查以及其他常规实验室检查。采用学生t检验、卡方检验、线性回归和多元逻辑回归模型进行统计分析。P值<0.05被认为具有统计学意义。
研究组的100例患者中，女性55例（55%）；男性45例（45%）。对照组的50例患者中，女性26例（52%），男性24例（48%）。两组的基线特征见表。两组在年龄和性别分布方面相似。然而，研究组的体重指数、腰围、平均收缩压、舒张压、空腹血糖、总胆固醇、低密度脂蛋白胆固醇、甘油三酯和促甲状腺激素（TSH）均显著高于对照组。研究组的高密度脂蛋白胆固醇显著低于对照组。
