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Relationship between total homocysteine, total cholesterol and creatinine levels in overt hypothyroid patients
Saleh A Bamashmoos1, Mohammed Ak Al-Nuzaily, Ali M Al-Meeri
1Haematology Department, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen.
Insights
Hypothyroidism elevates serum total homocysteine (tHcy), a cardiovascular risk factor. This study found higher tHcy, TSH, cholesterol, and creatinine, with lower fT4 and fT3 in hypothyroid patients.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Clinical Chemistry
Background:
- Hypothyroidism is linked to increased cardiovascular disease risk.
- Traditional risk factors like lipids do not fully explain this association.
- Plasma total homocysteine (tHcy) is an independent cardiovascular risk factor.
Purpose of the Study:
- To investigate serum total homocysteine (tHcy) levels in overt hypothyroidism.
- To examine the relationship between tHcy and thyroid hormones (fT3, fT4, TSH), total cholesterol, and creatinine.
- To compare these markers between hypothyroid patients and healthy controls.
Main Methods:
- Enzyme immunoassay (EIA) for serum tHcy.
- Elecsys cobas e 601 analyzer for fT3, fT4, and TSH.
- Enzymatic and kinetic methods for total cholesterol and creatinine, respectively.
- Statistical analysis using SPSS-10.
Main Results:
- Hypothyroid patients showed significantly elevated tHcy (113%), TSH (12-fold), total cholesterol (58%), and creatinine (54%).
- Free thyroxine (fT4) and free triiodothyronine (fT3) levels were significantly decreased (49.6% and 56.4%, respectively).
- tHcy positively correlated with TSH, creatinine, and age, and negatively with fT4.
Conclusions:
- Elevated serum tHcy, total cholesterol, and creatinine are confirmed in overt hypothyroidism.
- An inverse relationship exists between tHcy and fT4.
- A positive relationship is observed between tHcy and TSH in hypothyroid patients.
Abstract:
Hypothyroidism is associated with an increased risk for cardiovascular disease, which can not be fully explained by the atherogenic lipid profile, particularly total cholesterol and LDL-C, and other pathogenic factors may be involved. Plasma total homocysteine (tHcy) is an independent risk factor for cardiovascular disease and accelerated atherosclerosis. The aim of this study was to investigate the serum total homocysteine (tHcy) levels and its relation to total cholesterol, creatinine and thyroid hormones fT3, fT4 and TSH levels in overt hypothyroid patients compared to control subjects. In this study thirty recently diagnosed, non-treated overt hypothyroid patients (f=27, m=3) and twenty normal volunteers control (f=18, m=2) were included and subjected to determination of serum tHcy by enzyme immunoassay (EIA) technique, fT3, fT4 and TSH by Elecsys cobas e 601 analyzer, total cholesterol by enzymatic method and creatinine by kinetic method. The data was statistically analysed by SPSS-10 and p values less than 0.05 were considered significant.Our results showed that there were a significant increase of tHcy, TSH, T.cholesterol and creatinine levels by 113%, 12-folds, 58% and 54%, respectively, and a significant decrease of fT4 and fT3 levels by 49.6% and 56.4% , respectively, in hypothyroid patients than in control group. For tHcy (Mean±SD, 24.45±5.50 μmol/l vs 11.48±3.03 μmol/l, respectively; P < 0.001). tHcy was significantly positively correlated with TSH, creatinine and age and negatively correlated with free thyroxine (fT4) and no significant correlations with fT3 and T.cholesterol. In conclusion, our study confirmed the observation of elevated serum tHcy, T.cholesterol and creatinine in overt hypothyroidism and the presence of an inverse relation between tHcy with fT4 and a positive relation with TSH.
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