Pattern of Thyroid Functional Derangements in Patients with Metabolic Syndrome
A. Ali
Department of Internal Medicine, Faculty of Medicine, Suez Canal University, Egypt
A. El Deeb
Department of Internal Medicine, Faculty of Medicine, Suez Canal University, Egypt
A. Orabi
Department of Internal Medicine, Faculty of Medicine, Zagazig University, Egypt
M. Abdu
Department of Internal Medicine, Faculty of Medicine, Suez Canal University, Egypt
A. Gad *
Department of Internal Medicine, Faculty of Medicine, Suez Canal University, Egypt
*Author to whom correspondence should be addressed.
Abstract
Aim: To study the pattern of thyroid functional derangements in patients with metabolic syndrome.
Methods: The current study was designed as a cross sectional descriptive study of 130 patients with metabolic syndrome.
Results: The mean age was 57.5, with 88 [67.69%] females. According to HOMA-IR estimation; 129 (99.2%) of the studied patients were found to have insulin resistance. Subclinical hypothyroidism was diagnosed in 34 (26.15%). There was no age or sex difference between patients with and without subclinical hypothyroidism however a significant higher prevalence of dyslipidemia (high triglyceride, 25[73.53%] vs. 33[34.38%,], p=0.001) and (low HDL-C, 34[100%] VS. 81[84.38%], P=0.01) in patients with compared to without subclinical hypothyroidism respectively. Also, the mean ± SD waist circumference (138.6 cm ± 1.4 vs 118.9 ± 9.9, p=0.001) and waist/hip ratio (1.24 ± 0.08 vs. 1.098 ± 0.09, p= 0.001) were significantly higher in patients with compared to without subclinical hypothyroidism respectively.
There was no statistically significant difference between the two groups regarding HOMA-IR. In addition, there was no significant correlation between HOMA-IR and either free thyroxine (FT4) or thyroid stimulating hormone (TSH). However, TSH was significantly positively correlated with triglycerides; R= 0.2, P=0.02 and negatively correlated with HDL-C; R=-.02, P=0.01. There was significant strong positive correlation between TSH and obesity parameters (waist circumference; R=0.6, P=0.001 and waist/hip ratio; R=0.5, P=0.001), while a significant negative correlation was found between FT4 and fasting insulin; R= -0.2, 0.04, waist circumference; R= -0.2, P=0.01 and waist hip ratio; R= -0.3, P=0.002. The area under the ROC (95% CI) was 0.93 (0.88-0.97), P=0.001 for the waist circumference as a predictor of subclinical hypothyroidism with a sensitivity of 97% and specificity of 81%, while that of waist / hip ratio was 0.86 (0.79-0.91), p=0.001, with a sensitivity of 91% and specificity of 77%.
Conclusion: Subclinical hypothyroidism is prevalent among patients with metabolic syndrome. TSH is significantly associated with metabolic syndrome parameters particularly dyslipidemia and obesity indicators.
Keywords: Hypothyroidism, thyroid stimulating hormone, obesity, diabetes mellitus.