title: Effect of insulin resistance in assessing the clinical outcome of clinical and subclinical hypothyroid patients.
abstract: BACKGROUND
  The effect of thyroid status on insulin sensitivity is of great interest but despite various studies there is conflicting data on this subject. Hypothyroidism has been associated with disorders of glucose and insulin metabolism involving defective insulin secretion in response to glucose, hyperinsulinemia, altered peripheral glucose disposal and insulin resistance. 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.
  
  
  OBJECTIVE
  The prime objectives of the study were as follows: 1. To compare and correlate insulin resistance levels with T3, T4, and TSH in hypothyroidism patients. 2. To compare and correlate lipid profile with T3, T4, and TSH in hypothyroidism patients with healthy controls.
  
  
  METHODS
  Forty hypothyroidism patients and Forty healthy age and sex matched controls in the age group of 18 to 45 years were taken for the study. The venous blood samples collected were used for estimation of thyroid hormones, insulin, glucose and lipid profile.
  
  
  CONCLUSIONS
  There is significant increase in insulin, Homa-IR and glucose levels in hypothyroidism cases when compared to controls. Cholesterol, LDL, VLDL and triglycerides were significantly increased, whereas HDL was significantly decreased in hypothyroidism cases when compared with controls. Insulin was moderately correlated with cholesterol but there was no correlation with other lipid profile parameters in hypothyroidism patients. Homa-IR was significantly correlated with TSH in hypothyroidism cases when compared with controls. TSH was significantly correlated with cholesterol and LDL in hypothyroidism cases (both clinical and subclinical) when compared with controls. The present study helps to evaluate changes in insulin resistance and lipid risk factors. These factors should be managed aggressively to reduce the impending risk of cardiovascular diseases.
authors: Assistant Professor, Department of Biochemistry, The Oxford Medical College Hospital and Research Centre , Bangalore, India .
authors: Ujwal Upadya
authors: UU
authors: B
authors: Professor & Head, Department of Biochemistry, JSS Medical College, JSS University , Mysore, India .
authors: Suma
authors: S
authors: Mn
authors: Associate Professor, Department of Medicine, JSS Medical College, JSS University , Mysore, India .
authors: Srinath
authors: S
authors: Km
authors: Associate Professor, Department of Biochemistry, JSS Medical College, JSS University , Mysore, India .
authors: Akila
authors: A
authors: Prashant
authors: Lecturer, Department of Biochemistry, JSS Medical College, JSS University , Mysore, India .
authors: Parveen
authors: P
authors: Doddamani
authors: Registrar, Department of Biochemistry, HCG Hospitals, Near Subbaiah Circle , Bangalore, India .
authors: Shilpa
authors: S
authors: Sv
keywords: Dyslipidemia; HOMA-IR; Hypothyroidism; Insulin; TSH