ASSESSMENT OF THE THYROID PROFILE, HS-CRP AND LIPID PROFILE IN NEWLY DETECTED HYPOTHYROID ADULTS: CASE-CONTROL STUDY
Aim: to analyse the thyroid profile, hs-CRP and lipid profile in newly detected hypothyroid adults in comparison to controls and also to compare the above parameters in subclinical and clinical hypothyroid cases.
Material and methods: The study was a cross sectional study which was carried in Nalanda Medical College and Hospital, Patna, Bihar, India from October 2019 to march 2020. Total 240 patients were divided into 2 groups. Group-1 for newly detected hypothyroid adults and Group 2 as Controls. Blood samples were collected with full aseptic precautions after obtaining informed consent. Clot activator that contains vacuum evacuated tubes for analysis of serum TSH, FT3, FT4, TC, HDL-c, LDL-c, TG, hs-CRP. Then after collection, serum samples were stored at -200 until analyzed. Anthropometric measurements for BMI, height (cm) and body weight (kg) were measured.
Results: The mean age of cases and controls in our study was found to be 36.12±12.21years and 35.87±11.06years respectively (p = 0.81). BMI values in the study were higher in cases (27.24 ± 4.65kg/m2) compared to controls (25.17 ± 4.37kg/m2) and was statistically significant (P = 0.03). In the study, the mean TSH levels (15.27 ± 9.2µIU/ml) of cases were high compared to controls (3.1 ± 0.88µIU/ml) and were statistically significant (p<0.001). The mean serum hs-CRP levels in both the study groups was within the reference range, but it was high and statistically significant in cases than in control (p = 0.004). The total cholesterol level in cases (182.29 ± 39.75mg/dl) and control (184.27±28.37mg/dl) were within the reference range and there was no statistical significance (p = 0.82). Further it was found that HDL-c in cases (45.89±9.47mg/dl) and control (52.87±6.7mg/dl) were found to be lower in cases compared to controls and the difference was statistically significant (p < 0.001). The mean LDLc value in cases (145.14±34.12mg/dl) and control (132.05±32.14mg/dl) was high in cases and the difference was statistically significant (p= 0.01). The triglyceride levels of cases (159.26±49.87mg/dl) were significantly higher than that of control (146.23±29.27mg/dl) and was statistically significant (p=0.03). hs -CRP levels were in within reference range for 92 (76.67%) of cases and 109(90.83%)controls whereas above the normal range was seen in 28 (23.33%) cases and only 11(9.17%) controls. Out of 120, 64.17% (n=77) were subclinical hypothyroid (SCH) and 35.83% (n=43) were clinical hypothyroid (CH) cases. There was a significant increase in serum TSH in CH (24.11 ± 9.1µIU/ml) as compared to SCH (10.2 ± 2.2 µIU/ml). The difference was statistically significant (p<0.001).
Conclusion: we concluded that the hypertriglyceridemia and at risk hs-CRP levels though seen in hypothyroid cases were more prominent in CH cases than SCH. Dyslipidemia and inflammatory markers were found to be increased in the cases that helped in prediction and evaluation of patients at risk of cardiovascular disease.
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