Horm Metab Res 2014; 46(13): 980-984
DOI: 10.1055/s-0034-1389997
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Prevalence of Hypothyroidism in Patients with Dyslipidemia: Tehran Thyroid Study (TTS)

M. Khazan
1   Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
,
A. Amouzegar
1   Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
,
S. Gharibzadeh
1   Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2   Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
,
L. Mehran
1   Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
,
M. Tohidi
3   Prevention of Metabolic disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
,
F. Azizi
1   Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
› Author Affiliations
Further Information

Publication History

received 17 March 2014

accepted after second revision 28 August 2014

Publication Date:
04 November 2014 (online)

Abstract

Hypothyroidism is a relatively common endocrine disorder usually accompanied with changes in serum lipid profiles. The purpose of this study was to assess the association between dyslipidemia and hypothyroidism in a population-based study. In this cross-sectional study, 2 315 dyslipidemic patients, aged 20–90 years (mean age: 38.1±13.2 years), were selected from among 5 760 participants of Tehran Thyroid Study and divided into 3 groups, the subclinical hypothyroid, overt hypothyroid, and euthyroid subjects, based on national reference ranges. Serum lipid profiles, free thyroxine (FT4), thyroid stimulating hormone (TSH), and thyroid peroxidase antibody (TPOAb) were measured in all subjects. In subjects with dyslipidemia and nondyslipidemia, the prevalence of subclinical was 7% and 4.1%, respectively, and for clinical hypothyroidism 3% and 1.2%, respectively. In dyslipidemic subjects, the mean low density lipoprotein-cholesterol (LDL-C) levels differed significantly (p=0.03) among the overt hypothyroid (144.3±36.1), subclinical hypothyroid (129.3±39.2), and euthyroid (132.7±39.0) groups. In the overt hypothyroid group, mean total cholesterol level was higher than in the normal group, but not significant. There were no differences in median triglycerides (TG) and mean high density lipoprotein-cholesterol (HDL-C) levels among the 3 groups mentioned. After adjusting for age and sex, hypothyroidism was not related to elevated serum lipid profiles in patient with dyslipidemia. In conclusion, there is significant difference in the prevalence of subclinical and clinical hypothyroidism between nondyslipidemic and dyslipidemic subjects; after adjustment for age and sex the presence of dyslipidemia did not predict the presence of hypothyroidism.

Supporting Information

 
  • References

  • 1 Pearce EN. Hypothyroidism and dyslipidemia: modern concepts and approaches. Curr Cardiol Rep 2004; 6: 451-456
  • 2 Rizos CV, Elisaf MS, Liberopoulos EN. Effects of thyroid dysfunction on lipid profile. Open Cardiovasc Med J 2011; 5: 76-84
  • 3 Bell RJ, Rivera-Woll L, Davison SL, Topliss DJ, Donath S, Davis SR. Well-being, health-related quality of life and cardiovascular disease risk profile in women with subclinical thyroid disease – a community-based study. Clin Endocrinol (Oxf) 2007; 66: 548-556
  • 4 Efstathiadou Z, Bitsis S, Milionis HJ, Kukuvitis A, Bairaktari ET, Elisaf MS, Tsatsoulis A. Lipid profile in subclinical hypothyroidism: is L-thyroxine substitution beneficial?. Eur J Endocrinol 2001; 145: 705-710
  • 5 Hueston WJ, Pearson WS. Subclinical hypothyroidism and the risk of hypercholesterolemia. Ann Fam Med 2004; 2: 351-355
  • 6 Walsh JP, Bremner AP, Bulsara MK, O’Leary P, Leedman PJ, Feddema P, Michelangeli V. Thyroid dysfunction and serum lipids: a community-based study. Clin Endocrinol (Oxf) 2005; 63: 670-675
  • 7 Velkoska Nakova V, Krstevska B, Bosevski M, Dimitrovski C, Serafimoski V. Dyslipidaemia and hypertension in patients with subclinical hypothyroidism. Prilozi 2009; 30: 93-102
  • 8 Liberopoulos EN, Elisaf MS. Dyslipidemia in patients with thyroid disorders. Hormones (Athens) 2002; 1: 218-223
  • 9 Diekman T, Lansberg PJ, Kastelein JJ, Wiersinga WM. Prevalence and correction of hypothyroidism in a large cohort of patients referred for dyslipidemia. Arch Intern Med 1995; 155: 1490-1495
  • 10 Tagami T, Kimura H, Ohtani S, Tanaka T, Tanaka T, Hata S, Saito M, Miyazaki Y, Araki R, Tanaka M, Yonezawa K, Sawamura M, Ise T, Ogo A, Shimbo T, Shimatsu A, Naruse M. Multi-center study on the prevalence of hypothyroidism in patients with hypercholesterolemia. Endocr J 2011; 58: 449-457
  • 11 Tsimihodimos V, Bairaktari E, Tzallas C, Miltiadus G, Liberopoulos E, Elisaf M. The incidence of thyroid function abnormalities in patients attending an outpatient lipid clinic. Thyroid 1999; 9: 365-368
  • 12 Glueck CJ, Lang J, Tracy T, Speirs J. The common finding of covert hypothyroidism at initial clinical evaluation for hyperlipoproteinemia. Clin Chim Acta 1991; 201: 113-122
  • 13 de Castro AV, Bononi AP, Aragon F, Padovani CR, Nogueira CR, Mazeto GM Pimenta Clinical and laboratory evaluation of hyperlipemic and hypothyroid patients. Arq Bras Cardiol 2001; 76: 119-126
  • 14 Shekhar R, Chowdary N, Das M, Vidya D, Prabodh S. Prevalence of subclinical hypothyroidism in coastal Andhra Pradesh. Biomed Res 2011; 22: 471-474
  • 15 Azizi F, Amouzegar A, Delshad H, Tohidi M, Mehran L, Mehrabi Y. Natural course of thyroid disease profile in a population in nutrition transition: tehran thyroid study. Arch Iran Med 2013; 16: 418-423
  • 16 Kriska AM, Knowler WC, LaPorte RE, Drash AL, Wing RR, Blair SN, Bennett PH, Kuller LH. Development of questionnaire to examine relationship of physical activity and diabetes in Pima Indians. Diabetes Care 1990; 13: 401-411
  • 17 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
  • 18 Fereidoun A, Ladan M, Atieh A, Hossein D, Maryam T, Sahar A, Hedayati M. Establishment of the trimester-specific reference range for free thyroxine index. Thyroid 2013; 23: 354-359
  • 19 Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado thyroid disease prevalence study. Arch Intern Med 2000; 160: 526-534
  • 20 Kuusi T, Taskinen MR, Nikkila EA. Lipoproteins, lipolytic enzymes, and hormonal status in hypothyroid women at different levels of substitution. J Clin Endocrinol Metab 1988; 66: 51-56
  • 21 Martinez-Triguero ML, Hernandez-Mijares A, Nguyen TT, Munoz ML, Pena H, Morillas C, Lorente D, Lluch I, Molina E. Effect of thyroid hormone replacement on lipoprotein(a), lipids, and apolipoproteins in subjects with hypothyroidism. Mayo Clin Proc 1998; 73: 837-841
  • 22 Tulloch BR. Lipid changes in thyroid disease: the effect of thyroxine and analogues. Proc R Soc Med 1974; 67: 670-671
  • 23 Vierhapper H, Nardi A, Grosser P, Raber W, Gessl A. Low-density lipoprotein cholesterol in subclinical hypothyroidism. Thyroid 2000; 10: 981-984
  • 24 Aviram M, Luboshitzky R, Brook JG. Lipid and lipoprotein pattern in thyroid dysfunction and the effect of therapy. Clin Biochem 1982; 15: 62-66
  • 25 Bindels AJ, Westendorp RG, Frolich M, Seidell JC, Blokstra A, Smelt AH. The prevalence of subclinical hypothyroidism at different total plasma cholesterol levels in middle aged men and women: a need for case-finding?. Clin Endocrinol (Oxf) 1999; 50: 217-220
  • 26 Christ-Crain M, Meier C, Guglielmetti M, Huber PR, Riesen W, Staub JJ, Muller B. Elevated C-reactive protein and homocysteine values: cardiovascular risk factors in hypothyroidism? A cross-sectional and a double-blind, placebo-controlled trial. Atherosclerosis 2003; 166: 379-386
  • 27 Garber JR, Cobin RH, Gharib H, Hennessey JV, Klein I, Mechanick JI, Pessah-Pollack R, Singer PA, Woeber KA. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocr Pract 2012; 18: 988-1028
  • 28 Jellinger PS, Smith DA, Mehta AE, Ganda O, Handelsman Y, Rodbard HW, Shepherd MD, Seibel JA. American Association of Clinical Endocrinologists’ Guidelines for Management of Dyslipidemia and Prevention of Atherosclerosis. Endocr Ppract 2012; 18 (Suppl. 01) 1-78
  • 29 Reiner Z, Catapano AL, De Backer G, Graham I, Taskinen MR, Wiklund O, Agewall S, Alegria E, Chapman MJ, Durrington P, Erdine S, Halcox J, Hobbs R, Kjekshus J, Filardi PP, Riccardi G, Storey RF, Wood D. ESC/EAS Guidelines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Eur Heart J 2011; 32: 1769-1818
  • 30 Willard DL, Leung AM, Pearce EN. Thyroid function testing in patients with newly diagnosed hyperlipidemia. JAMA 2014; 174: 287-289