Subclinical hypothyroidism and cardiac risk: Lessons from a South Indian population study

Introduction: The benefits of treating subclinical hypothyroidism are currently under debate, prevention of adverse cardiac events purporting to be one of the main benefits. The effect of subclinical hypothyroidism on the cardiovascular health of the Indian sub-population is largely unknown. This st...

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Published in:	Indian journal of endocrinology and metabolism Vol. 22; no. 2; pp. 217 - 222
Main Authors:	Nair, Sashi, Kumar, Harish, Raveendran, Manoj, Menon, V
Format:	Journal Article
Language:	English
Published:	India Wolters Kluwer India Pvt. Ltd 01-03-2018 Medknow Publications and Media Pvt. Ltd Medknow Publications & Media Pvt. Ltd Medknow Publications & Media Pvt Ltd Wolters Kluwer Medknow Publications
Subjects:	Atherosclerosis Cardiovascular disease Cardiovascular diseases Cardiovascular system Care and treatment Cholesterol Complications and side effects Diabetes dyslipidemia Endocrinology Family medical history Health risk assessment Hypothyroidism India Lipids Lipoproteins Metabolism Minority & ethnic groups Morbidity Mortality Original Population Proteins Risk factors Studies Thyroid gland Womens health India thyroid gland cardiovascular diseases dyslipidemia hypothyroidism Atherosclerosis India
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Summary:	Introduction: The benefits of treating subclinical hypothyroidism are currently under debate, prevention of adverse cardiac events purporting to be one of the main benefits. The effect of subclinical hypothyroidism on the cardiovascular health of the Indian sub-population is largely unknown. This study was designed to examine these effects and to help guide treatment of this disorder. Methods: A cross-sectional adult population survey was carried out in urban coastal area of central Kerala. 986 volunteers underwent complete biochemical and physical examinations, 110 were found to have subclinical hypothyroidism (8.9%). The ten-year risk of an adverse cardiac event, was calculated using the Framingham score algorithm. Eligible subclinical hypothyroid subjects (N = 110) and a randomly selected, age and gender matched control group (N = 220) were compared. Results: This population was found to have high baseline levels of diabetes 19.5%, hypercholesterolemia 57.2% and systolic hypertension 24.6%. No association was found between subclinical hypothyroid status or rising TSH and Framingham 10-year risk. While no difference between groups was noted with respect to lipid profile, a rising TSH was found to be significantly correlated with mild worsening of the lipid profile. A significant positive correlation was found between skinfold thickness and TSH. Conclusions: Subclinical hypothyroidism is not a contributing factor to elevated Framingham risk in this population, and while a mild effect was observed on the lipid profile, its effect is unlikely to be clinically relevant. We hypothesize that in this population a genetic component may be responsible for the uniquely high rates of metabolic syndrome and other endocrine diseases.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2230-8210 2230-9500
DOI:	10.4103/ijem.IJEM_298_17