Kaliaperumal Ramachandran, William Ebenezer, Selvam Thangapaneer, Krishnan Shyam M
Tutor, Department of Biochemistry, SRM Medical College Hospital and Research Centre , Kattankulathur, Kanchipuram, Tamilnadu-603203, India .
Professor and Head, Department of Biochemistry, SRM Medical College Hospital and Research Centre , Kattankulathur, Kanchipuram, Tamilnadu-603203, India .
J Clin Diagn Res. 2014 Feb;8(2):37-9. doi: 10.7860/JCDR/2014/7817.4001. Epub 2014 Feb 3.
Changes in plasma lipid concentrations are well known metabolic consequences of thyroid dysfunction. The alterations are most prominent in hypothyroidism which is typically associated with pronounced hypercholesterolaemia and frequently with moderate hypertriglyceridaemia. In cases of hypothyroidism, how the serum Lp(a) levels are influenced by thyroid hormone remains unknown and contradictory results on the effect of thyroid hormone on serum Lp(a) levels have been reported. There is substantial evidence to suggest that elevated serum Lp(a) levels contribute significantly to the development of CHD. The present study was designed to determine the lipoprotein(a) [Lp(a)], lipid profile and thyroid hormone levels in newly diagnosed hypothyroid patients and to find any correlation that existed between Lp(a) and other parameters.
Untreated hypothyroid (n=50) patients were included in the study. We also included 40 normal healthy subjects as controls. Lipid profile, Lp(a) and thyroid profile were estimated by using autoanalyzers.
The results of this study showed that levels of HDL-cholesterol were significantly decreased (p<0.001), whereas those of other lipid parameters and Lp(a) levels were found to be significantly increased (p<0.001) in hypothyroid patients as compared to those in controls. Correlation study revealed a significant positive correlation between Lp(a) and TSH levels in hypothyroid patients.
Our present findings indicated that hypothyroidism could be strongly associated with lipid abnormalities that enhanced the development of cardiovascular diseases. Also, Lp(a) and non-HDL-C should be estimated with other lipid parameters as a useful index for measuring the cardiac risk in hypothyroid patients. A recommended screening should be advised for any patient with thyroid dysfunction, especially hypothyroidism, to assess lipid abnormalities by using Lp(a) and non- HDL-C and he/she should treated at the earliest.
血浆脂质浓度的变化是甲状腺功能障碍众所周知的代谢后果。这些改变在甲状腺功能减退症中最为显著,甲状腺功能减退症通常与明显的高胆固醇血症相关,且常伴有中度高甘油三酯血症。在甲状腺功能减退症病例中,甲状腺激素如何影响血清Lp(a)水平尚不清楚,并且关于甲状腺激素对血清Lp(a)水平影响的结果相互矛盾。有大量证据表明,血清Lp(a)水平升高对冠心病的发展有显著贡献。本研究旨在测定新诊断的甲状腺功能减退患者的脂蛋白(a)[Lp(a)]、血脂谱和甲状腺激素水平,并找出Lp(a)与其他参数之间存在的任何相关性。
未治疗的甲状腺功能减退患者(n = 50)纳入本研究。我们还纳入了40名正常健康受试者作为对照。使用自动分析仪测定血脂谱、Lp(a)和甲状腺谱。
本研究结果显示,与对照组相比,甲状腺功能减退患者的高密度脂蛋白胆固醇水平显著降低(p < 0.001),而其他脂质参数和Lp(a)水平显著升高(p < 0.001)。相关性研究显示,甲状腺功能减退患者的Lp(a)与促甲状腺激素水平之间存在显著正相关。
我们目前的研究结果表明,甲状腺功能减退可能与脂质异常密切相关,脂质异常会促进心血管疾病的发展。此外,Lp(a)和非高密度脂蛋白胆固醇应与其他脂质参数一起测定,作为评估甲状腺功能减退患者心脏风险的有用指标。建议对任何甲状腺功能障碍患者,尤其是甲状腺功能减退患者进行推荐筛查,并使用Lp(a)和非高密度脂蛋白胆固醇评估脂质异常,且应尽早治疗。