title: Subclinical hypothyroidism may be associated with elevated high-sensitive c-reactive protein (low grade inflammation) and fasting hyperinsulinemia.
abstract: The association between coronary heart disease and subclinical hypothyroidism (SCH) is unclear. We aimed to determine hs-CRP concentrations in patients with SCH. Seventy-seven patients (age 34.6 +/- 13.7 yr) with SCH (TSH > 4.2 microIU/ml and serum free thyroxine level between 0.932-1.71 ng/dL), and 80 control subjects (age 33.9 +/- 13.3 yr) were studied. Thyroid hormones, C-reactive protein, insulin, glucose, total, HDL, LDL and VLDL-cholesterol levels and HOMA-IR index were also determined. TSH levels of SCH group were higher than control (7.4 +/- 2.9 and 1.55 +/- 0.78 microIU/ml, respectively, p = 0.0001). However, FT4 levels were lower than control subjects (1.18 +/- 0.22 ng/dL and 1.38 +/- 0.26, respectively, p = 0.001). Serum hs-CRP levels of subjects with SCH were higher than control subjects (4.2 +/- 0.8 mg/l and 1.05 +/- 0.3 mg/l respectively, p = 0.0001). Insulin levels of SCH group were higher than control (8.5 +/- 4.3 microU/ml and 7.1 +/- 3.1 microU/ml respectively, p<0.02) but, Homa-IR levels of the two groups were not different. Mean total and LDL-cholesterol levels of SCH group were higher than control (p = 0.01 and p<0.02). We also found a positive correlation between hs-CRP levels and insulin (r = 0.362, p = 0.002 in men, r = 0.358, p = 0.0001 in women), TSH (r = 0.611, p = 0.0001 in men, r = 0.411 p = 0.0001 in women), and prolactin (r = 0.340, p = 0.01 in men r = 0.553, p = 0.0001 in women).
  
  
  CONCLUSIONS
  Patients with SCH, irrespective of gender, have higher serum hs-CRP, insulin, total and LDL-cholesterol levels than healthy subjects. 2- High hs-CRP level, and thereby low grade inflammation may be associated with fasting hyperinsulinemia before insulin resistance becomes evident in patients with SCH.
authors.affiliation: Dicle University School of Medicine, Department of Endocrinology and Metabolism, Dicle University, Diyarbakir, Turkey.
authors.forename: Alpaslan
authors.initials: A
authors.lastname: Tuzcu
authors.forename: Mithat
authors.initials: M
authors.lastname: Bahceci
authors.forename: Deniz
authors.initials: D
authors.lastname: Gokalp
authors.forename: Yekta
authors.initials: Y
authors.lastname: Tuzun
authors.forename: Kemal
authors.initials: K
authors.lastname: Gunes
mesh_terms: D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism*; D016022:Case-Control Studies; D008078:Cholesterol, LDL / Q000097:blood; D005215:Fasting / Q000097:blood*; D005260:Female; D006801:Humans; D006946:Hyperinsulinism / Q000209:etiology*; D007037:Hypothyroidism / Q000097:blood / Q000150:complications* / Q000503:physiopathology*; D007249:Inflammation / Q000097:blood / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index
chemical_list: D008078:Cholesterol, LDL; D002097:C-Reactive Protein