Relationship of High Sensitive C-Reactive Protein and Lipid Profile with Left Ventricular Diastolic Dysfunction in Patients with Subclinical Hypothyroidism

Introduction: Hypothyroidism changes lipid metabolism significantly. Hence dyslipidemia is a common finding in sub clinical hypothyroidism(SCH). On the other hand, dyslipidemia increases the cardiovascular(CV) event risk. Highsensitive C-reactive protein (hs-CRP), an inflammatory marker associated with endothelial dysfunction and atherosclerosis and predictor of CV events. As cardiovascular system is a target organ of thyroid disorders, we need to predict CV abnormalities at an early stage of hypothyroidism. Hence our study aimed to see the relationship of hs-CRP and lipid profile with left ventricular diastolic dysfunction in subclinical hypothyroidism. Methods: 80 patients coming to OPD and IPD of Assam medical college and hospital, meeting the inclusion and exclusion criteria were taken up for the study. A detailed history and clinical examination, and necessary investigations were recorded as per the Proforma. Results: The mean age of patients in our study group was 47.84 ± 8.46 years. There was female preponderance in our study with a male to female ratio of 1: 1.86.The commonest symptom at presentation was fatigue (n=38, 47.5%). 28.75% had constipation, 20% had weight gain, 18.75% had cold intolerance, 10 % had decreased appetite. 30.77% of female subjects had menstrual irregularities. 46% of cases were asymptomatic. Majority of the subjects (70%) in the study group had hs-CRP levels more than 3mg/L. 25% of subjects had hs-CRP in the range of 1-3 mg/L. The mean value of hs-CRP was 4.89 ± 2.48 mg/L. Incidence of left ventricular diastolic dysfunction(LVDD) was significantly high, about 65% of subclinical hypothyroidism subjects had LVDD. There is Significant relationship was seen between hs-CRP and LVDD (p=0.002 and p=0.007). Association of lipid parameters and LVDD were seen, but did not reach statistical significance (p >0.05 for all parameters). Conclusion: High incidence of LVDD in SCH patients and significant association of hs-CRP with LVDD suggest all SCH patients should be screened for hs-CRP and lipid profile and echocardiography to predict and detect early CV involvement and prevent CV events.