Differences and associations of metabolic and vitamin D status among patients with and without sub-clinical hypothyroid dysfunction

BMC Endocrine Disorders

Shaun Sabico²  Badurudeen Mahmood Buhary³  Mussa Almalki³  Ahmed S Al-Ghamdi³  Abdulaziz F Alkabba³  Sobhy Yakout²  Abdulaziz Al-Othman⁵  Khalid M Alkhrafy¹  Majed S Alokail²  Omar S Al-Attas⁴  Nasser M Al-Daghri²  Naji J Aljohani² 

[1] Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia;Prince Mutaib Chair for Biomarkers of Osteoporosis, King Saud University, Riyadh, Saudi Arabia;Faculty of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Fahad Medical City, Riyadh, Saudi Arabia;Center of Excellence in Biotechnology Research Center, King Saud University, Riyadh, Saudi Arabia;College of Applied Medical Sciences, King Saud University, Riyadh, KSA, Saudi Arabia

关键词: Saudi;    Dyslipidemia;    Obesity;    Thyroid dysfunction;   

Others  :  1085742
DOI  :  10.1186/1472-6823-13-31

 received in 2013-06-18, accepted in 2013-08-20,  发布年份 2013

【 摘 要 】

Background

Sub-clinical hypothyroid dysfunction, a relatively understudied disorder in the Kingdom of Saudi Arabia (KSA), has significant clinical implications if not properly monitored. Also from KSA, more than 50% of the population suffer from hypovitaminosis D (<50 nmol/l). In this cross-sectional case-control study, we described the differences and associations in the metabolic patterns of adult Saudis with and without hypothyroid dysfunction in relation to their vitamin D status, PTH, calcium and lipid profile.

Methods

A total of 94 consenting adult Saudis [52 controls (without subclinical hypothyroidism), 42 cases (previously diagnosed subjects)] were included in this cross-sectional study. Anthropometrics were obtained and fasting blood samples were taken for ascertaining lipid and thyroid profile, as well as measuring PTH, 25(OH) vitamin D and calcium.

Results

Cases had a significantly higher body mass index than the controls (p < 0.001). Circulating triglycerides was also significantly higher in cases than the controls (p = 0.001). A significant positive association between HDL-cholesterol and PTH (R = 0.56; p = 0.001), as well as a negative and modestly significant negative association between LDL-cholesterol and PTH (R = - 20.0; p = 0.04) were observed. FT3 was inversely associated with circulating 25 (OH) vitamin D (R = -0.25; p = 0.01).

Conclusions

Patients with hypothyroid dysfunction possess several cardiometabolic risk factors that include obesity and dyslipidemia. The association between PTH and cholesterol levels as well as the inverse association between vitamin D status and FT3 needs to be reassessed prospectively on a larger scale to confirm these findings.

【 授权许可】

   
2013 Aljohani et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Akbar DH, Ahmed MM, Al-Mughales J: Thyroid dysfunction and thyroid autoimmunity in Saudi type 2 diabetics. Acta Diabetol 2006, 43:14-18.
• [2]Abdullah MA, Salman H, Al-Habib S, Ghareeb A, Abanamy A: Antithyroid antibodies and thyroid dysfunction in Saudi children with Down syndrome. Ann Saudi Med 1994, 14:283-285.
• [3]Bahammam SA, Sharif MM, Jammah AA, Bahammam AS: Prevalence of thyroid disease in patients with obstructive sleep apnea. Respir Med 2011, 105:1755-1760.
• [4]Yasuda T, Okamoto Y, Hamada N, Miyashita K, Takahara M, Sakamoto F, Miyatsuka T, Kitamura T, Katakami N, Kawamori D, Otuski M, Matsuoka TA, Kaneto H, Shinomura I: Serum vitamin D levels are decreased and associated with thyroid volume in female patients with newly onset Grave’s disease. Endocrine 2012, 42:739-741.
• [5]Yasuda T, Okamoto Y, Hamada N, Miyashita K, Takahara M, Sakamoto F, Miyatsuka T, Kitamura T, Katakami N, Kawamori D, Otsuki M, Matsuoka TA, Kaneto TH, Shimomura I: Serum vitamin D levels are decreased in patients without remission of Grave’s disease. Endocrine 2013, 43:230-232.
• [6]Rotondi M, Chiovato L: Vitamin D deficiency in patients with Grave’s disease: probably something more than a casual association. Endocrine 2013, 43:3-5.
• [7]Rizzoli R, Boonen S, Brandi ML, Bruyere O, Cooper C, Kanis JA, Kaufman JM, Ringe JD, Weryha G, Reginster JY: Vitamin D supplementation in elderly or postmenopausal women: a 2013 update of the 2008 recommendations from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Curr Med Res Opin 2013, 29:305-313.
• [8]Amin A, Dhillo WS, Murphy KG: The central effects of thyroid hormones on appetite. J Thyroid Res 2011, 2011:306510.
• [9]Al-Adsani H, Hoffer LJ, Silva JE: Resting energy expenditure is sensitive to small dose changes in patients on chronic thyroid hormone replacement. J Clin Endocrinol Metab 1997, 82:1118-1125.
• [10]Muscogiuri G, Sorice GP, Mezza T: High normal TSH values in obesity: is it insulin resistance or adipose tissue’s guilt? Obesity (Silver Spring) 2013, 21:101-106.
• [11]Wanjia X, Chenggang W, Aihong W, Xiaomei Y, Jiajun Z, Chunxiao Y, Jin X, Yinglong H, Ling G: A high normal TSH levels is associated with an atherogenic lipid profile in euthyroid non-smokers with newly diagnosed asymptomatic coronary heart disease. Lipids Health Dis 2012, 11:44. BioMed Central Full Text
• [12]Williams GR: Extrathyroidal expression of TSH receptor. Ann Endocrinol (Paris) 2011, 72:68-73.
• [13]Wang F, Tan Y, Wang C, Zhang X, Zhao Y, Song X, Zhang B, Guan Q, Xu J, Zhang J, Zhang D, Lin H, Yu C, Zhao J: Thyroid-stimulating hormone levels within the reference range are associated with serum lipid profiles independent of thyroid hormones. J Clin Endocrinol Metab 2012, 97:2724-2731.
• [14]Palmieri EA, Fazio S, Lombardi G, Biondi B: Subclinical hypothyroidism and cardiovascular risk: a reason to treat? Treat Endocrinol 2004, 3:233-244.
• [15]Al-Daghri NM, Al-Attas OS, Al-Okail MS, Alkharfy KM, Al-Yousef MA, Nadhrah HM, Sabico SB, Chrousos GP: Severe hypovitaminosis D is widespread in Saudi adults and is more common in non-diabetics than diabetics. Saudi Med J 2010, 31:775-780.
• [16]Al-Daghri NM, Al-Attas OS, Alokail MS, Alkharfy KMK, Yousef M, Nadhrah HM, Al-Othman A, Al-Saleh Y, Sabico S, Chrousos GP: Hypovitaminosis D and cardiometabolic risk factors among non-obese youth. Cent Eur J Med 2010, 5:752-757.
• [17]Tamer G, Mesci B, Tamer I, Kilic D, Arik S: Is vitamin D deficiency an independent risk factor for obesity and abdominal obesity in women? Endokrynol Pol 2012, 63:196-201.
• [18]Al-Saleh Y, Al-Daghri NM, Alkharfy KM, Al-Attas OS, Alokail MS, Al-Othman A, Sabico S, Chrousos GP: Normal circulating PTH in Saudi healthy individuals with hypovitaminosis D. Horm Metab Res 2013, 45:43-46.
• [19]Williams DM, Fraser A, Lawlor DA: Association of vitamin D, parathyroid hormone and calcium with cardiovascular risk factors in US adolescents. Heart 2011, 97:315-320.
• [20]Kayaniyil S, Vieth R, Harris SB, Retnakaran R, Knight JA, Gerstein HC, Perkins BA, Zinman B, Hanley AJ: Association of 25(OH)D and PTH with metabolic syndrome and its traditional and nontraditional components. J Clin Endocrinol Metab 2011, 96:168-175.
• [21]Chailurkit LO, Aekplakorn W, Ongphiphadhanakul B: High vitamin D status in younger individuals is associated with low circulating thyrotropin. Thyroid 2013, 23:25-30.
• [22]Effraimidis G, Badenhoop K, Tijssen JG, Wiersinga WM: Vitamin D deficiency is not associated with early stages of thyroid autoimmunity. Eur J Endocrinol 2012, 167:43-48.
• [23]Kozai M, Yamamoto H, Ishiguro M, Harada N, Masuda M, Kagawa T, Takei Y, Otani A, Nakahashi O, Ikeda S, Taketani Y, Takeyama K, Kato S, Takeda E: Thyroid hormones decrease plasma 1α,25-dihydroxyvitamin D levels through transcriptional repression of the renal 25-hydroxyvitamin D3 1α-hydroxylase gene (CYP27B1). Endocrinology 2013, 154:609-622.
• [24]Pani MA, Regulla K, Segni M, Krause M, Hofmann S, Hufner M, Herwig J, Pasquino AM, Usadel KH, Badenhoop K: Vitamin D1alpha-hydroxylase (CYP1alpha) polymorphism in Grave’s disease, Hashimoto’s thyroidits and type 1 diabetes mellitus. Eur J Endocrinol 2002, 146:777-781.
• [25]Mazziotti G, Porcelli T, Patelli I, Vescovi PP, Giustina A: Serum TSH values and risk of vertebral fractures in euthyroid post-menopausal women with low bone mineral density. Bone 2010, 46:747-751.
• [26]Maziotti G, Sorvillo F, Piscopo M, Cioffi M, Pilla P, Biondi B, Iorio S, Giustina A, Amato G, Carella C: Recombinant human TSH modulates in vivo C-telopeptides of type-1 collagen and bone alakaline phosphatase, but not osteoprotegerin production in postmenopausal women monitored for differentiated thyroid carcinoma. J Bone Miner Res 2005, 20:480-486.
• [27]Al-Daghri NM, Al-Attas OS, Alokail MS, Alkharfy KM, El-Kholie E, Yousef M, Al-Othman A, Al-Saleh Y, Sabico S, Kumar S, Chrousos GP: Increased vitamin D supplementation recommended during summer season in the gulf region: a counterintuitive seasonal effect in vitamin D levels in adult, overweight and obese Middle Eastern residents. Clin Endcrinol (Oxf) 2012, 76:346-350.