DYSLIPIDEMIA AND ITS CORRELATION WITH HEPATIC ENZYMES IN HYPOTHYROID PATIENTS: A PUBLIC HEALTH PERSPECTIVE

Main Article Content

Amjad Ali Bhatti
Muhammad Siddique Rajput
Habibullah Shaikh
Mahak Memon
Gotam Kumar
Rukhsana Malik

Keywords

Hypothyroidism, Deranged liver enzymes, Deranged lipid enzymes

Abstract

Background: Underactive thyroid is an endocrine system disorder defined by inadequate thyroid hormone synthesis by the thyroid gland. Hypothyroidism affects lipid profiles is via thyroid hormone and thyroid hormone receptor, which is mostly expressed in the liver, may bind to thyroid hormone to control the expression of downstream target genes. The objectives of this study aimed to determine lipid parameters and liver function in hypothyroid patients and correlate dyslipidemia and deranged Liver functions with the thyroid profile.


Methodology: This Descriptive Cross-Sectional study was conducted in the Medical department at PMC Hospital and NORIN Hospital Nawabshah, SBA for the period of 06 months from July 2023 to Dec 2023. After taking approval from Ethical review committee of the Institute, 200 males and females diagnosed patients of hypothyroidism fulfilling the inclusion Criteria were selected. Non probability purposive sampling technique was used. A written consent was taken and required laboratory reports were collected for information. Demographic information, history of the patient and physical examination were collected using a structured questionnaire. To analyze the pattern of dyslipidemia, a lipid profile and routine tests were performed.


Results: Mean age of the participants was 38.46 ± 2.68 years and majority of the participants were belonging to lower and middle socioeconomic class. There was statistical significant association (p-value <0.05) between poor class and middle class. There was significant association between obesity and deranged liver function (p-value 0.037) and with deranged lipid parameters (p-value 0.010). Pearson correlation (2 tailed) test was applied to measure the correlation between deranged lipid profiles and deranged liver enzyme. There was positive correlation (0.169) between deranged lipids profile and deranged liver enzyme.


Conclusion: Results of this study reveal that hypothyroidism is directly linked with deranged liver enzymes and lipid parameters because in hypothyroidism there is low metabolism especially in liver. Dyslipidemia and abnormal liver enzymes make the condition worse and have an impact on the prognosis and course of the disease. To lessen the severity, it is advised that dyslipidemia should also be treated in these patients.

Abstract 54 | Pdf Downloads 5

References

1. Pagadala MR, Zein CO, Dasarathy S, Yerian LM, Lopez R, McCullough AJ, Prevalence of hypothyroidism in nonalcoholic fatty liver disease, Dig Dis Sci. 2012;57(2012):528-34.
2. Brandt F, Thvilum M, Almind D, Christensen K, Green A, Hegedüs L, et al. Morbidity before and after the Diagnosis of Hyperthyroidism: A Nationwide Register-Based Study. PLoS One, 2013;8(6):112-19.
3. Bieler BM, Gaughan J, Khan M, Rao G, Hunter K, Morgan fh. Lack of an association between bmi and tsh in treated hypothyroid patients and euthyroid controls, EndocrPract. 2016;22(5):555-60.
4. Abdel-Gayoum AA, Dyslipidemia and serum mineral profiles in patients with thyroid disorders. Saudi Medical Journal 2014;35(12);1469-76.
5. Alsamghan AS, Alsaleem SA, Alzahrani MAS, Patel A, Mallick AK, Sheweita SA, Effect of hypovitaminosis D on lipid profile in hypothyroid patients in Saudi Arabia. Oxidative Medicine and Cellular Longevity, 2020;20(2020):664671.
6. Gagnon A, Antunes TT, Ly T, Pongsuwan P, Gavin C, Lochnan HA,et al. Thyroid stimulating hormone stimulates lipolysis in adipocytes in culture and raises serum free fatty acid levels in vivo. Metabolism, 2010;59(4):547-53.
7. Goldberg IJ, Huang LS, Huggins LA, Yu S, Nagareddy PR, Scanlan TS, et al. Thyroid hormone reduces cholesterol via a non-LDL receptor-mediated pathway. Endocrinology, 2012; 153(11):5143-49.
8. Zhang X, Song Y, Feng M, Zhou X, Lu Y, Gao L, et al. Thyroid-stimulating hormone decreases HMG-CoA reductase phosphorylation via AMP-activated protein kinase in the liver. Journal of Lipid Research, 2015;56(5);963-71.
9. Hazlehurst JM, Tomlinson JW, Non-alcoholic fatty liver disease in common endocrine disorders. Eur. J. Endocrinology, 2013;169(2):27-37.
10. Gariani K, Jornayvaz FR, Pathophysiology of NASH in endocrine diseases. Endocr. Connect. 2021;10(2):52-65.
11. Pihlajamaki J, Boes T, Kim EY, Dearie F, Kim BW, Schroeder J, et al. Thyroid hormone-related regulation of gene expression in human fatty liver. J. Clin. Endocrinol. Metab. 2009;94(9):3521-29.
12. Duntas LH, Brenta G, A Renewed Focus on the Association Between Thyroid Hormones and Lipid Metabolism, Frontiers in Endocrinology, 2018;9{511):1-10
13. Parthasarathy G, Revelo, X, Malhi H, Pathogenesis of Nonalcoholic Steatohepatitis: An Overview. Hepatol. Commun. 2020;4(4):478-92.
14. D’Ambrosio R, Campi I, Maggioni M, Perbellini R, Giammona E, Stucchi R, et al. The relationship between liver histology and thyroid function tests in patients with non-alcoholic fatty liver disease (NAFLD), PLoS ONE 2021;16(4):e0249614.
15. Mavromati M, Jornayvaz FR, Hypothyroidism-Associated Dyslipidemia: Potential Molecular Mechanisms Leading to NAFLD, International Journal of Molecular Sciences, 2021;22(23):1-14.
16. Karthick K, Dillara K, Poornima KN, Subhasini AS, Dyslipidaemic Changes in Women with Subclinical Hypothyroidism, Journal of Clinical and Diagnostic Research. 2013;7(10):2122-25.
17. Shaikh S, Abro M, Qazi I, Yousfani A. Frequency of cirrhotic cardiomyopathy in patients with cirrhosis of liver: a tertiary care hospital experience, Pak J Medical Sciences, 2011;27(4):744-48.
18. Tauseef A, Zafar M, Rashid B, Thirumalareddy J, Chalfant V, Farooque U et al. Correlation of fasting lipid profile in patients with chronic liver disease: a descriptive cross-sectional study in tertiary care hospital, Cureus, 2020;12(10):e11019.
19. Farooque U, Lohano AK, Dahri Q, Arain N, Farukhuddin FNU, Khadke C, Prince F, et al, The Pattern of Dyslipidemia in Chronic Liver Disease Patients, Cureus. 2021; 13(2):e13259.
20. Kivimaki M, Batty GD, Pentti J, Shipley MJ, Sipila PN, Nyberg S, et al, Association between socioeconomic status and the development of mental and physical health conditions in adulthood: a multi-cohort study, The Lancet Public Health, 2020;5(3):140-49.
21. Giammarino AM, Qiu H, Bulsara K, Khan S, Jiang Y, Da BL, et al, Community Socioeconomic Deprivation Predicts Nonalcoholic Steatohepatitis, Hepatology Communications, 2022;6(3):550-60.
22. Schiavo L, Busetto L, Cesaretti M, Zelber-Sagi S, Deutsch L, Iannelli A, Nutritional issues in patients with obesity and cirrhosis, World J Gastroenterol 2018;24(30):3330-46.
23. Gopalakrishnan M, Ramidha VP, Vinitha V, Comparative study of lipid profile anomalies in thyroid dysfunction, National Journal of Physiology, Pharmacy and Pharmacology, 2022;12 (9):1366-70.
24. Badawi R, Abu Rahma MZ, Ramadan HK, Soliman S, Mohareb DA, Hawash N. Lipid Profiles as Markers for the Severity of Liver Diseases in Cirrhotic Patients, The Open Biomarkers Journal, 2021;11(2021):93-8.
25. Hou X, Guan Y, Tang Y, Song A, Zhao J, Ren L, et al, A correlation study of the relationships between nonalcoholic fatty liver disease and serum triglyceride concentration after an oral fat tolerance test, BMC Lipids in Health and Disease, 2021; 20(1):54.

Most read articles by the same author(s)