Interrelationship of the Pro-Inflammatory Marker HSCRP With Dyslipidemic Changes: A Comparative Study Between Subclinical and Overt Hypothyroidism

Sustained hypercholesterolemia with low-grade inflammation makes hypothyroid patients more prone for cardiovascular disorders.Recently, these risks are also becoming evident in Subclinical Hypothyroidism (SH). AIMS, SETTINGS AND DESIGNWe made an effort to evaluate the interaction of hsCRP with dyslipidemic changes and their contributions as cardiovascular risk factors in both Subclinical (SH) and Overt Hypothyroidism (OH) patients in a hospital based, case control study consisting of 30 OH, 34 SH and 34 properly matched control subjects within a span of one year. METHODSChanges on serum hsCRP, TSH and fT4 levels were assessed by ELISA.Total serum Cholesterol (TC), LDL Cholesterol (LDLc), HDL Cholesterol (HDLc) and triglyceride (TG) were measured by standard pre-validated photometric tests as applicable. STATISTICAL ANALYSISData obtained were compared for difference between mean values by one way and post hoc ANOVA.Predictive values of individual lipid parameters on the rise of hsCRP were evaluated in both OH and SH groups by multivariate linear regression analysis.SPSS software, version 17 for Windows was used for all statistical analyses.For all analyses, P value was considered significant at a level of P <0.05 for 95% confidence interval. RESULTSPost hoc ANOVA showed that mean values of hsCRP, TG, TC and LDLc were increased most in the OH group followed by that in the SH with a significant difference between two groups (p <0.001).In contrast, fT4 and HDLc showed decreased levels in both SH and OH groups, also with a significant difference between themselves.Results of multiple linear regression analysis revealed that LDLc (β = 0.653, P <0.001 for SH and β = 0.326, P = 0.030 for OH) and fT4 (β = -0.241,P = 0.044 for SH and β = -0.444,P = 0.046 for OH) were most important positive and negative predictors respectively for changes in the hsCRP levels. CONCLUSIONSA low-grade inflammation starts in early stages of hypothyroidism, which is directly dependent on serum thyroxine and inversely dependent on LDLc.We conclude that there is a possible link between the development of low-grade inflammation and LDLc in the SH state that is more potentiated as the disease progresses to OH.