Study of the association between thyroid dysfunction and serum lipid abnormalities

Al‑Odat,Ibrahim; Al‑Fawaeir,Saad; Al‑Mahmoud,Malik H.

doi:10.3892/br.2024.1826

Study of the association between thyroid dysfunction and serum lipid abnormalities

Authors:
- Ibrahim Al‑Odat
- Saad Al‑Fawaeir
- Malik H. Al‑Mahmoud
View Affiliations

Affiliations: Department of Medical Laboratory Science, Faculty of Allied Medical Sciences, Jadara University, Irbid 21110, Jordan, Department of Endocrinology, Saudi German Hospital Dubai, Dubai 391093, UAE
Published online on: July 31, 2024 https://doi.org/10.3892/br.2024.1826
Article Number: 138

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

The prevalence of thyroid dysfunction is increasing, often leading to unfavorable alterations in lipid profiles. Dyslipidemia is a risk factor for cardiovascular disease. The present study aimed to assess the prevalence of thyroid dysfunction and examine its effects on serum lipid profiles among Jordanians. A total of 228 subjects were recruited and divided into two groups: patients with thyroid dysfunction (n=178, mean age=52.6±9.8 years) and a control group (n=50, mean age=51.7±9.2 years). Serum thyroid‑stimulating hormone, free thyroxine 4, free triiodothyronine 3, total cholesterol (TC), low‑density lipoprotein (LDL), high‑density lipoprotein and triglycerides (TG) were measured. Results showed that thyroid dysfunction was diagnosed in 75% of participants, with an increased frequency among females. The prevalence of overt hypothyroidism was 17.4%, subclinical hypothyroidism was 43.8%, overt hyperthyroidism was 18.4% and subclinical hyperthyroidism was 20.4%. There was a significant association between hypothyroidism and elevated TC (>200 mg/dl), LDL (>130 mg/dl) and TG (>200 mg/dl; P<0.05). Among the hypothyroid patients, 48.4% had hypercholesterolemia and 32.3% had hypertriglyceridemia. In conclusion, public screening and education are necessary to combat thyroid dysfunction. There is a notable link between thyroid dysfunction and lipid abnormalities, necessitating regular monitoring for dyslipidemia and cardiovascular disease in affected patients.

View Figures

View References

1	Bayer MF: Effective laboratory evaluation of thyroid status. Med Clin North Am. 75:1–26. 1991.PubMed/NCBI View Article : Google Scholar
2	Regmi A, Shah B, Rai BR and Pandeya A: Serum lipid profile in patients with thyroid disorders in central Nepal. Nepal Med Coll J. 12:253–256. 2010.PubMed/NCBI
3	Heuck CC, Kallner A, Kanagasabapathy AS and Riesen W: Diagnosis and monitoring of diseases of the thyroid. World Health Organization, 2000.
4	Pucci E, Chiovato L and Pinchera A: Thyroid and lipid metabolism. Int J Obes Relat Metab Disord. 24 (Suppl 2):S109–S112. 2000.PubMed/NCBI View Article : Google Scholar
5	WHO: Assessment of iodine deficiency disorders and monitoring their elimination: A guide for programme managers. World Health Organization, 2001.
6	Bilek R, Dvořáková M, Grimmichova T and Jiskra J: Iodine, thyroglobulin and thyroid gland. Physiol Res. 69 (Suppl 2):S225–S236. 2020.PubMed/NCBI View Article : Google Scholar
7	Moini J, Pereira K and Samsam M: Epidemiology of thyroid disorders. Netherlands, Elsevier, 116-152, 2020.
8	Hatch-McChesney A and Lieberman HR: Iodine and iodine deficiency: A comprehensive review of a re-emerging issue. Nutrients. 14(3474)2022.PubMed/NCBI View Article : Google Scholar
9	Wiersinga WM, Poppe KG and Effraimidis G: Hyperthyroidism: Aetiology, pathogenesis, diagnosis, management, complications, and prognosis. Lancet Diabetes Endocrinol. 11:282–298. 2023.PubMed/NCBI View Article : Google Scholar
10	Duntas LH: Thyroid disease and lipids. Thyroid. 12:287–293. 2002.PubMed/NCBI View Article : Google Scholar
11	Shahid MA, Ashraf MA and Sharma S: Physiology, thyroid hormone. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2022.
12	Taylor PN, Albrecht D, Scholz A, Gutierrez-Buey G, Lazarus JH, Dayan CM and Okosieme OE: Global epidemiology of hyperthyroidism and hypothyroidism. Nat Rev Endocrinol. 14:301–316. 2018.PubMed/NCBI View Article : Google Scholar
13	Liu YY and Brent GA: Thyroid hormone crosstalk with nuclear receptor signaling in metabolic regulation. Trends Endocrinol Metab. 21:166–173. 2010.PubMed/NCBI View Article : Google Scholar
14	Mullur R, Liu YY and Brent GA: Thyroid hormone regulation of metabolism. Physiol Rev. 94:355–382. 2014.PubMed/NCBI View Article : Google Scholar
15	Ridgway EC: Modern concepts of primary thyroid gland failure. Clin Chem. 42:179–182. 1996.PubMed/NCBI
16	Abu-Helalah M, Alshraideh HA, Al-Sarayreh SA, Al Shawabkeh AHK, Nesheiwat A, Younes N and Al-Hader A: A cross-sectional study to assess the prevalence of adult thyroid dysfunction disorders in Jordan. Thyroid. 29:1052–1059. 2019.PubMed/NCBI View Article : Google Scholar
17	Asvold BO, Vatten LJ, Nilsen TIL and Bjøro T: The association between TSH within the reference range and serum lipid concentrations in a population-based study. The HUNT study. Eur J Endocrinol. 156:181–186. 2007.PubMed/NCBI View Article : Google Scholar
18	Neves C, Alves M, Medina JL and Delgado JL: Thyroid diseases, dyslipidemia and cardiovascular pathology. Rev Port Cardiol. 27:1211–1236. 2008.PubMed/NCBI(In English, Portuguese).
19	Pappan N and Rehman A: Dyslipidemia. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2022.
20	Krauss RM: Dietary and genetic probes of atherogenic dyslipidemia. Arterioscler Thromb Vasc Biol. 25:2265–2272. 2005.PubMed/NCBI View Article : Google Scholar
21	Ajlouni KM, Khawaja N, El-Khateeb M, Batieha A and Farahid O: The prevalence of thyroid dysfunction in Jordan: A national population-based survey. BMC Endocr Disord. 22(253)2022.PubMed/NCBI View Article : Google Scholar
22	Zhang X, Wang X, Hu H, Qu H, Xu Y and Li Q: Prevalence and trends of thyroid disease among adults, 1999-2018. Endocr Pract. 29:875–880. 2023.PubMed/NCBI View Article : Google Scholar
23	Garmendia Madariaga A, Santos Palacios S, Guillén-Grima F and Galofré JC: The incidence and prevalence of thyroid dysfunction in Europe: A meta-analysis. J Clin Endocrinol Metab. 99:923–931. 2014.PubMed/NCBI View Article : Google Scholar
24	Atrooz OM, Hiresh MN, Dlewan AR, Atrooz MO, Hiresh GN, Alasoufi AM and Atrooz IO: Prevalence of dyslipidemia and the association with levels of TSH and T4 hormones among patients in south region of Jordan. J Med Biochem. 42:706–713. 2023.PubMed/NCBI View Article : Google Scholar
25	Friedewald WT, Levy RI and Fredrickson DS: Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 18:499–502. 1972.PubMed/NCBI
26	Friis T and Pedersen LR: Serum lipids in hyper- and hypothyroidism before and after treatment. Clin Chim Acta. 162:155–163. 1987.PubMed/NCBI View Article : Google Scholar
27	Canaris GJ, Manowitz NR, Mayor G and Ridgway EC: The Colorado thyroid disease prevalence study. Arch Intern Med. 160:526–534. 2000.PubMed/NCBI View Article : Google Scholar
28	Cooper DS and Biondi B: Subclinical thyroid disease. Lancet. 379:1142–1154. 2012.PubMed/NCBI View Article : Google Scholar
29	Ross DS: Hypothyroidism during pregnancy: clinical manifestations, diagnosis, and treatment. UpToDate Waltham, MA (Accessed 8 Jun 2013), 2013.
30	Wang C and Crapo LM: The epidemiology of thyroid disease and implications for screening. Endocrinol Metab Clin North Am. 26:189–218. 1997.PubMed/NCBI View Article : Google Scholar
31	Mansfield BS, Bhana S and Raal FJ: Dyslipidemia in South African patients with hypothyroidism. J Clin Transl Endocrinol. 29(100302)2022.PubMed/NCBI View Article : Google Scholar
32	Hueston WJ and Pearson WS: Subclinical hypothyroidism and the risk of hypercholesterolemia. Ann Fam Med. 2:351–355. 2004.PubMed/NCBI View Article : Google Scholar
33	Jayasingh IA and Puthuran P: Subclinical hypothyroidism and the risk of hypercholesterolemia. J Family Med Prim Care. 5:809–816. 2016.PubMed/NCBI View Article : Google Scholar
34	Su X, Peng H, Chen X, Wu X and Wang B: Hyperlipidemia and hypothyroidism. Clin Chim Acta. 527:61–70. 2022.PubMed/NCBI View Article : Google Scholar
35	O'Brien T, Dinneen SF, O'Brien PC and Palumbo PJ: Hyperlipidemia in patients with primary and secondary hypothyroidism. Mayo Clin Proc. 68:860–866. 1993.PubMed/NCBI View Article : Google Scholar
36	Ahmed NU, Kabir MA, Razzak A and Akter S: Relation of hypothyroidism on BMI and dyslipidemia. Med Today. 31:93–97. 2019.
37	Walsh JP, Bremner AP, Bulsara MK, O'leary P, Leedman PJ, Feddema P and Michelangeli V: Thyroid dysfunction and serum lipids: A community-based study. Clin Endocrinol (Oxf). 63:670–675. 2005.PubMed/NCBI View Article : Google Scholar
38	Deschampheleire M, Luyckx FH and Scheen AJ: Thyroid disorders and dyslipidemias. Rev Med Liege. 54:746–750. 1999.PubMed/NCBI(In French).
39	Ineck BA and Ng TMH: Effects of subclinical hypothyroidism and its treatment on serum lipids. Ann Pharmacother. 37:725–730. 2003.PubMed/NCBI View Article : Google Scholar
40	Jawzal K, Hami M, Mohammed L and Ibrahiem A: The relationship between thyroid hormones and lipid profile in subclinical hypothyroidism female patients. Baghdad J Biochem Appl Biol Sci. 3:200–209. 2022.
41	Duntas LH and Brenta G: A renewed focus on the association between thyroid hormones and lipid metabolism. Front Endocrinol (Lausanne). 9(511)2018.PubMed/NCBI View Article : Google Scholar
42	Pearce EN: Update in lipid alterations in subclinical hypothyroidism. J Clin Endocrinol Metab. 97:326–333. 2012.PubMed/NCBI View Article : Google Scholar
43	Chen C, Xie Z, Shen Y and Xia SF: The roles of thyroid and thyroid hormone in pancreas: Physiology and pathology. Int J Endocrinol. 2018(2861034)2018.PubMed/NCBI View Article : Google Scholar
44	Lagrost L: Regulation of cholesteryl ester transfer protein (CETP) activity: Review of in vitro and in vivo studies. Biochim Biophys Acta. 1215:209–236. 1994.PubMed/NCBI View Article : Google Scholar
45	Faure P, Oziol L, Artur Y and Chomard P: Thyroid hormone (T3) and its acetic derivative (TA3) protect low-density lipoproteins from oxidation by different mechanisms. Biochimie. 86:411–418. 2004.PubMed/NCBI View Article : Google Scholar
46	Moon JH, Kim HJ, Kim HM, Choi SH, Lim S, Park YJ, Jang HC and Cha BS: Decreased expression of hepatic low-density lipoprotein receptor-related protein 1 in hypothyroidism: A novel mechanism of atherogenic dyslipidemia in hypothyroidism. Thyroid. 23:1057–1065. 2013.PubMed/NCBI View Article : Google Scholar
47	Su X, Chen X, Peng H, Song J, Wang B and Wu X: Novel insights into the pathological development of dyslipidemia in patients with hypothyroidism. Bosn J Basic Med Sci. 22:326–339. 2022.PubMed/NCBI View Article : Google Scholar
48	Kuusi T, Saarinen P and Nikkilä EA: Evidence for the role of hepatic endothelial lipase in the metabolism of plasma high density lipoprotein2 in man. Atherosclerosis. 36:589–593. 1980.PubMed/NCBI View Article : Google Scholar
49	Baral N, Lamsal M, Koner BC and Koirala S: Thyroid dysfunction in eastern Nepal. Southeast Asian J Trop Med Public Health. 33:638–641. 2002.PubMed/NCBI
50	Olmos RD, de Figueiredo RC, Aquino EM, Lotufo PA and Bensenor IM: Gender, race and socioeconomic influence on diagnosis and treatment of thyroid disorders in the Brazilian longitudinal study of adult health (ELSA-Brasil). Braz J Med Biol Res. 48:751–758. 2015.PubMed/NCBI View Article : Google Scholar
51	Santos Palacios S, Llavero Valero M, Brugos-Larumbe A, Díez JJ, Guillén-Grima F and Galofré JC: Prevalence of thyroid dysfunction in a Large Southern European Population. Analysis of modulatory factors. The APNA study. Clin Endocrinol (Oxf). 89:367–375. 2018.PubMed/NCBI View Article : Google Scholar
52	Redmond GP: Thyroid dysfunction and women's reproductive health. Thyroid. 14 (Suppl 1):S5–S15. 2004.PubMed/NCBI View Article : Google Scholar
53	Weetman AP: Immunity, thyroid function and pregnancy: Molecular mechanisms. Nat Rev Endocrinol. 6:311–318. 2010.PubMed/NCBI View Article : Google Scholar
54	Kokandi AA, Parkes AB, Premawardhana LDKE, John R and Lazarus JH: Association of postpartum thyroid dysfunction with antepartum hormonal and immunological changes. J Clin Endocrinol Metab. 88:1126–1132. 2003.PubMed/NCBI View Article : Google Scholar