Abstract
The effect of thyroid status on insulin sensitivity is of great interest but despite various studies there is conflicting data on this subject. The study group comprised of 25 female subjects each with subclinical hypothyroidism, overt hypothyroidism and euthyroid controls. Serum samples of all the patients were assayed for thyroid profile, Insulin and lipid profile. Homeostasis model of assessment (HOMA-IR) was employed to assess the level of insulin resistance. Patients with hypothyroidism demonstrated insulin resistance and dyslipidemia as observed by the higher HOMA-IR and cholesterol and triglyceride levels respectively as compared to the controls. A significantly positive correlation between TSH and HOMA-IR level was also observed in the hypothyroidism group. Thyroid dysfunction leads to alterations in glucose and lipid metabolism which is an important risk factor for cardiovascular diseases. The dyslipidemia and insulin resistance should be managed aggressively to reduce the impending risk.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Serter R, Demirbas B, Culha C, Cakal E. The effect of L-thyroxine replacement therapy on lipid based cardiovascular risk in sub clinical hypothyroidism. Invest J Endocrinol 2004;27:897–903.
American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism. Endocr Pract. 2002;8:457–469.
Fommei E, Iervasi G. The role of thyroid hormone in blood pressure homeostasis: evidence from short-term hypothyroidism in humans. J Clin Endocrinol Metab 2002;87:1996–2000.
Maratou E, Hadjidakis D, Kollias A, Tsegka K, Peppa M, Alevizaki M, et al. Studies of insulin resistance in patients with clinical and subclinical hypothyroidism. Eur J Endocrinol 2009 (In press)
Duntas LH. Thyroid disease and lipids. Thyroid 2002;12:287–293.
Biondi B, Klein I. Hypothyroidism as a risk factor for cardiovascular disease. Endocrine 2004;24:1–13.
Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado thyroid disease prevalence study. Arch Intern Med 2000;160:526–534.
Reaven GM. Banting lecture. Role of insulin resistance in human disease. Diabetes 1988;37:1595–1607.
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol In Adults. 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;285:2486–2497.
Alberti KG, Zimmet P, Shaw J. The metabolic syndrome-a new worldwide definition. Lancet 2005;366:1059–1062.
Bakker SJL, Ter Maaten JC, Popp-Snijders C, Slaets JPJ, Heine RJ, Gans ROB. The relationship between thyrotropin and low density lipoprotein cholesterol is modified by insulin sensitivity in healthy euthyroid subjects. J Clin Endocrinol Metab 2001;86:1206–1211.
Chubb SAP, Davis WA, Inman Z, Davis TME. Prevalence and progression of subclinical hypothyroidism in women with type 2 diabetes: the Fremantle Diabetes Study. Clin Endocrinol (Oxf) 2005;62:480–486.
Owecki M, El Ali Z, Nikisch E, Sowinski J. Serum insulin levels and the degree of thyroid dysfunction in hypothyroid women. Neuro Endocrinol Lett 2008;29(1):137–140.
Annemieke R, Stephan JL, Links Thera P, Gans Rijk OB, Wolffenbuttel Bruce HR. Thyroid Function is associated with components of the metabolic syndrome in euthyroid subjects. J Clin Endocrinol Metab 2007;92:491–496.
Tuzcu A, Bahceci M, Gokalp D, Tuzun Y, Gunes K. Subclinical hypothyroidism may be associated with elevated high-sensitive C — reactive protein (low grade inflammation) and fasting hyperinsulinemia. Endocr J 2005;52:89–94.
Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412–419.
Meier C, Staub JJ, Roth C-B, Guglielmetti M, Kunz M, Miserez AR, Drewe J, Huber P, Herzog R, Muller B. TSH-controlled L-thyroxine therapy reduces cholesterol levels and clinical symptoms in subclinical hypothyroidism: a double blind, placebo-controlled trial (Basel Thyroid Study). J Clin Endocrinol Metab 2001;86:4860–4866.
Perros P, McCrimmon R, Shaw G, Frier B. Frequency of thyroid dysfunction in diabetic patients: value of annual screening. Diabet Med 1995;7:622–627.
Tayal D, Goswami B, Gupta VK, Mallika V. Evaluation of lipid profile in hypothyroid patients. Our experience. Thyroid Res Pract 2008;5(2):43–47.
Shantha GPS, Kumar AA, 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.
Wallace TM, Levy JC, Matthews DR. Use and Abuse of HOMA Modeling. Diabetes Care 2004;27:1487–1495.
Turner RC, Holman RR, Matthews D, Hockaday TD, Peto J. Insulin deficiency and insulin resistance interaction in diabetes: estimation of their relative contribution by feedback analysis from basal plasma insulin and glucose concentrations. Metabolism. 1979;28:1086–1096.
Demidova T, Galieva OR. The role of thyroid hypofunction in development of metabolic syndrome. Ter Arkh 2009;81(4):69–73.
Khan SH, Khan FA, Ijaz A, Sattar A, Dilawar M, Hashim R. Spectrum of lipid and lipoprotein indices in human subjects with insulin resistance syndrome. J Ayub Med Coll Abbottabad 2008;20(3):17–22.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Singh, B.M., Goswami, B. & Mallika, V. Association between insulin resistance and hypothyroidism in females attending a tertiary care hospital. Indian J Clin Biochem 25, 141–145 (2010). https://doi.org/10.1007/s12291-010-0026-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12291-010-0026-x