| Peer-Reviewed

Patterns of Thyroid Function in Metabolic Syndrome Patients and Its Relationship with Components of Metabolic Syndrome

Received: 10 May 2021    Accepted: 4 June 2021    Published: 16 June 2021
Views:       Downloads:
Abstract

Background: Metabolic syndrome (MetS) is a cluster of metabolic abnormalities characterized by central obesity, hyperglycemia plus insulin resistance, hypertriglyceridaemia plus low high density lipoprotein (HDL) cholesterol and hypertension. This cluster of metabolic syndrome is associated with some of the endocrine disorders prominently thyroid dysfunction. Thyroid dysfunction and metabolic syndrome are both associated with cardiovascular disease risk conversely increasing both morbidity and mortality. Objectives: This study was carried out to evaluate thyroid function in patients with metabolic syndrome and to assess its relationship with the components of metabolic syndrome in a tertiary care hospital. Methods: A cross sectional study was carried out among metabolic syndrome patients attending Hormone and Diabetes clinic in a tertiary care hospital, Dhaka, Bangladesh during June 2019 to March 2020. We included 346 patients who fulfilled National Cholesterol Education Program-Adult Treatment Panel (NCEP ATP) III criteria. Anthropometric parameters include; height, weight and waist circumference were measured and blood pressure were taken in standard conditions. Fasting blood samples were analyzed to measure glucose, triglyceride (TG), high density lipoprotein (HDL) cholesterol and thyroid hormones [Thyroid stimulating hormone (TSH) and Free Thyroxine (FT4)]. Patients categorized as euthyroid if all thyroid hormone levels fell within normal reference range [TSH: 0.47-5.0mIU/L; FT4: 0.71-1.85 ng/dL]. Subclinical hypothyroidism (SCH) was considered if TSH >5.0mIU/L and free T4 is within normal reference value (0.71-1.85 ng/dL). Conversely, overt hypothyroidism was diagnosed if TSH >5.0 mIU/L and freeT4<0.71 ng/dL. Results: Among study population 22.8% were males and 77.2% were females, with mean age of 42.61±9.13 years. Average body mass index (BMI) of the study subjects was 26.37±3.78 kg/m2. Thyroid dysfunction was seen in 47.1% of metabolic syndrome patients. The prime thyroid dysfunction was subclinical hypothyroidism (34.4%) followed by overt hypothyroidism (12.7%). Thyroid dysfunction was much common in females (37.3%) than males (9.9%) but was not statistically significant; [p=0.19]. Triglyceride showed significant positive correlation with TSH level (r=0.168, p<0.05) but negative correlation with free T4 (r=-0.200, p=<0.001). However, HDL cholesterol showed significant negative correlation with TSH level (r=-0.150, p<0.05). Conclusions: Our study recognizes thyroid dysfunction in metabolic syndrome patients; subclinical hypothyroidism was the commonest followed by overt hypothyroidism. The current study also correlates thyroid function with some components of metabolic syndrome (high density lipoprotein cholesterol and triglycerides).

Published in International Journal of Diabetes and Endocrinology (Volume 6, Issue 2)
DOI 10.11648/j.ijde.20210602.15
Page(s) 80-87
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Metabolic Syndrome, Thyroid Dysfunction, Subclinical Hypothyroidism, Hypothyroidism

References
[1] Gyawali P, Takanche JS, Shrestha RK, Bhattarai P, Khanal K, Risal P, et al. Pattern of thyroid dysfunction in patients with metabolic syndrome and its relationship with components of metabolic syndrome. Diabetes Metab J. 2015; 39 (1): 66–73.
[2] Grundy SM. Obesity, metabolic syndrome, and cardiovascular disease. J Clin Endocrinol Metab. 2004; 89 (6): 2595-600.
[3] Michalaki MA, Vagenakis AG, Londu AS, Marianna NA, Ioannis GH, Makri MG, et al. Thyroid function in humans with morbid obesity. Thyroid. 2006; 16 (1): 73-78.
[4] Roos A, Bakker SJL, Links TP, Gans ROB, Wolffenbutte lBHR. Thyroid Function Is Associated with Components of the Metabolic Syndrome in Euthyroid Subjects. J Clin Endocrinol Metab. 2007; 92 (2): 491-6.
[5] Ghanshyam P, Subash S, Anita A, Kumar V. Association between primary hypothyroidism and metabolic syndrome and the role of C reactive protein: a cross–sectional study from South India. Thyroid Research. 2009; 2 (2): 1-7.
[6] Waring AC, Rodondi N, Harrison S, Kanaya AM, Simonsick EM, Miljkovic I, et al. Thyroid Function and Prevalent and Incident Metabolic Syndrome in Older Adults: The Health, Aging, and Body Composition Study. Clin Endocrinol (Oxf). 2012; 76 (6): 911–8.
[7] Khatiwada1 S, Sah SK, Rajendra KC, Baral N, Lamsal M. Thyroid dysfunction in metabolic syndrome patients and its relationship with components of metabolic syndrome. Clinical Diabetes and Endocrinology. 2016; 2: 3. DOI: 10.1186/s40842-016-0021-0.
[8] Chowdhury MZI, Anik AM, Farhana Z, Bristi PD, Mamun BMA, Uddin MJ, et al. Prevalence of metabolic syndrome in Bangladesh: a systematic review and meta-analysis of the studies. BMC Public Health. 2018; 18: 308. https://doi.org /10. 1186/s12889-018-5209-z.
[9] International diabetes federation, the IDF consensus worldwide definition of the metabolic syndrome. https:// www. idf.org/e-library/consensus-statements/60-idfconsensus- worldwide–definition-of-the-metabolic-syndrome. Accessed 10 Aug 2017.
[10] Karar ZA, Alam N, Streatfield PK. Epidemiological transition in rural Bangladesh, 1986–2006. Glob Health Action. 2009; 2: 1904.
[11] Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001; 285: 2486.
[12] Smith Liz. New AHA recommendations for blood pressure measurement: American Heart Association Practice Guidelines. Am Fam Physician. 2005; 72 (7): 1391–98.
[13] Chugh K, Goyal S, Shankar V, Chugh SN. Thyroid function tests in metabolic syndrome. Indian J Endocrinol Metab. 2012; 16 (6): 958–61.
[14] Meher LK, Raveendranathan SK, Kota SK, Sarangi J, Jali SN. Prevalence of hypothyroidism in patients of metabolic syndrome. Thyroid Res Pract. 2013; 10: 60-4.
[15] Shantha GP, Kumar A A, Jeyachandran V, Rajamanickam D, Rajkumar K, Salim S, et al. Association between primary hypothyroidism and metabolic syndrome and the role of C reactive protein: a cross-sectional study from South India. Thyroid Res. 2009; 2: 2.
[16] Wang JY, Wang CY, Pei D, Lai CC, Chen YL, Wu CZ, et al. Association between thyroid function and metabolic syndrome in elderly subjects. J Am Geriatr Soc. 2010; 58: 1613-4.
[17] Park HT, Cho GJ, Ahn KH, Shin JH, Hong SC, Kim T, et al. Thyroid stimulating hormone is associated with metabolic syndrome in euthyroid postmenopausal women. Maturitas. 2009; 62 (3): 301-5.
[18] Park SB, Choi HC, Joo NS. The Relation of Thyroid Function to Components of the Metabolic Syndrome in Korean Men and Women. J Korean Med Sci. 2011; 26 (4): 540–5.
[19] Kc R, Khatiwada S, Deo Mehta K, Pandey P, Lamsa lM, Majhi S. Cardiovascular Risk Factors in Subclinical Hypothyroidism: A Case Control Study in Nepalese Population. J Thyroid Res. 2015; 2015: 305241. doi: 10.1155/2015/305241.
[20] Gluvic Z, Sudar E, Tica J, Jovanovic A, Zafirovic S, Tomasevic R, et al. Effects of levothyroxine replacement therapy on parameters of metabolic syndrome and atherosclerosis in hypothyroid patients: a prospective pilot study. Int J Endocrinol. 2015; 2015: 147070.
[21] Udenze I, Nnaji I, Oshodi T. Thyroid function in adult Nigerians with metabolic syndrome. Pan Afr Med J. 2014; 18: 352. doi: 10.11604/pamj.2014.18.352.4551.
[22] Tarcin O, Abanonu GB, Yazici D, Tarcin O. Association of metabolic syndrome parameters with TT3 and FT3/FT4 ratio in obese Turkish population. Metab Syndr Relat Disord. 2012; 10 (2): 137–42.
Cite This Article
  • APA Style

    Nazma Akter, Zafar Ahmed Latif. (2021). Patterns of Thyroid Function in Metabolic Syndrome Patients and Its Relationship with Components of Metabolic Syndrome. International Journal of Diabetes and Endocrinology, 6(2), 80-87. https://doi.org/10.11648/j.ijde.20210602.15

    Copy | Download

    ACS Style

    Nazma Akter; Zafar Ahmed Latif. Patterns of Thyroid Function in Metabolic Syndrome Patients and Its Relationship with Components of Metabolic Syndrome. Int. J. Diabetes Endocrinol. 2021, 6(2), 80-87. doi: 10.11648/j.ijde.20210602.15

    Copy | Download

    AMA Style

    Nazma Akter, Zafar Ahmed Latif. Patterns of Thyroid Function in Metabolic Syndrome Patients and Its Relationship with Components of Metabolic Syndrome. Int J Diabetes Endocrinol. 2021;6(2):80-87. doi: 10.11648/j.ijde.20210602.15

    Copy | Download

  • @article{10.11648/j.ijde.20210602.15,
      author = {Nazma Akter and Zafar Ahmed Latif},
      title = {Patterns of Thyroid Function in Metabolic Syndrome Patients and Its Relationship with Components of Metabolic Syndrome},
      journal = {International Journal of Diabetes and Endocrinology},
      volume = {6},
      number = {2},
      pages = {80-87},
      doi = {10.11648/j.ijde.20210602.15},
      url = {https://doi.org/10.11648/j.ijde.20210602.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijde.20210602.15},
      abstract = {Background: Metabolic syndrome (MetS) is a cluster of metabolic abnormalities characterized by central obesity, hyperglycemia plus insulin resistance, hypertriglyceridaemia plus low high density lipoprotein (HDL) cholesterol and hypertension. This cluster of metabolic syndrome is associated with some of the endocrine disorders prominently thyroid dysfunction. Thyroid dysfunction and metabolic syndrome are both associated with cardiovascular disease risk conversely increasing both morbidity and mortality. Objectives: This study was carried out to evaluate thyroid function in patients with metabolic syndrome and to assess its relationship with the components of metabolic syndrome in a tertiary care hospital. Methods: A cross sectional study was carried out among metabolic syndrome patients attending Hormone and Diabetes clinic in a tertiary care hospital, Dhaka, Bangladesh during June 2019 to March 2020. We included 346 patients who fulfilled National Cholesterol Education Program-Adult Treatment Panel (NCEP ATP) III criteria. Anthropometric parameters include; height, weight and waist circumference were measured and blood pressure were taken in standard conditions. Fasting blood samples were analyzed to measure glucose, triglyceride (TG), high density lipoprotein (HDL) cholesterol and thyroid hormones [Thyroid stimulating hormone (TSH) and Free Thyroxine (FT4)]. Patients categorized as euthyroid if all thyroid hormone levels fell within normal reference range [TSH: 0.47-5.0mIU/L; FT4: 0.71-1.85 ng/dL]. Subclinical hypothyroidism (SCH) was considered if TSH >5.0mIU/L and free T4 is within normal reference value (0.71-1.85 ng/dL). Conversely, overt hypothyroidism was diagnosed if TSH >5.0 mIU/L and freeT42. Thyroid dysfunction was seen in 47.1% of metabolic syndrome patients. The prime thyroid dysfunction was subclinical hypothyroidism (34.4%) followed by overt hypothyroidism (12.7%). Thyroid dysfunction was much common in females (37.3%) than males (9.9%) but was not statistically significant; [p=0.19]. Triglyceride showed significant positive correlation with TSH level (r=0.168, p<0.05) but negative correlation with free T4 (r=-0.200, p=<0.001). However, HDL cholesterol showed significant negative correlation with TSH level (r=-0.150, p<0.05). Conclusions: Our study recognizes thyroid dysfunction in metabolic syndrome patients; subclinical hypothyroidism was the commonest followed by overt hypothyroidism. The current study also correlates thyroid function with some components of metabolic syndrome (high density lipoprotein cholesterol and triglycerides).},
     year = {2021}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Patterns of Thyroid Function in Metabolic Syndrome Patients and Its Relationship with Components of Metabolic Syndrome
    AU  - Nazma Akter
    AU  - Zafar Ahmed Latif
    Y1  - 2021/06/16
    PY  - 2021
    N1  - https://doi.org/10.11648/j.ijde.20210602.15
    DO  - 10.11648/j.ijde.20210602.15
    T2  - International Journal of Diabetes and Endocrinology
    JF  - International Journal of Diabetes and Endocrinology
    JO  - International Journal of Diabetes and Endocrinology
    SP  - 80
    EP  - 87
    PB  - Science Publishing Group
    SN  - 2640-1371
    UR  - https://doi.org/10.11648/j.ijde.20210602.15
    AB  - Background: Metabolic syndrome (MetS) is a cluster of metabolic abnormalities characterized by central obesity, hyperglycemia plus insulin resistance, hypertriglyceridaemia plus low high density lipoprotein (HDL) cholesterol and hypertension. This cluster of metabolic syndrome is associated with some of the endocrine disorders prominently thyroid dysfunction. Thyroid dysfunction and metabolic syndrome are both associated with cardiovascular disease risk conversely increasing both morbidity and mortality. Objectives: This study was carried out to evaluate thyroid function in patients with metabolic syndrome and to assess its relationship with the components of metabolic syndrome in a tertiary care hospital. Methods: A cross sectional study was carried out among metabolic syndrome patients attending Hormone and Diabetes clinic in a tertiary care hospital, Dhaka, Bangladesh during June 2019 to March 2020. We included 346 patients who fulfilled National Cholesterol Education Program-Adult Treatment Panel (NCEP ATP) III criteria. Anthropometric parameters include; height, weight and waist circumference were measured and blood pressure were taken in standard conditions. Fasting blood samples were analyzed to measure glucose, triglyceride (TG), high density lipoprotein (HDL) cholesterol and thyroid hormones [Thyroid stimulating hormone (TSH) and Free Thyroxine (FT4)]. Patients categorized as euthyroid if all thyroid hormone levels fell within normal reference range [TSH: 0.47-5.0mIU/L; FT4: 0.71-1.85 ng/dL]. Subclinical hypothyroidism (SCH) was considered if TSH >5.0mIU/L and free T4 is within normal reference value (0.71-1.85 ng/dL). Conversely, overt hypothyroidism was diagnosed if TSH >5.0 mIU/L and freeT42. Thyroid dysfunction was seen in 47.1% of metabolic syndrome patients. The prime thyroid dysfunction was subclinical hypothyroidism (34.4%) followed by overt hypothyroidism (12.7%). Thyroid dysfunction was much common in females (37.3%) than males (9.9%) but was not statistically significant; [p=0.19]. Triglyceride showed significant positive correlation with TSH level (r=0.168, p<0.05) but negative correlation with free T4 (r=-0.200, p=<0.001). However, HDL cholesterol showed significant negative correlation with TSH level (r=-0.150, p<0.05). Conclusions: Our study recognizes thyroid dysfunction in metabolic syndrome patients; subclinical hypothyroidism was the commonest followed by overt hypothyroidism. The current study also correlates thyroid function with some components of metabolic syndrome (high density lipoprotein cholesterol and triglycerides).
    VL  - 6
    IS  - 2
    ER  - 

    Copy | Download

Author Information
  • Department of Medicine, MARKS Medical College & Hospital, Dhaka, Bangladesh

  • BIRDEM General Hospital, Dhaka, Bangladesh

  • Sections