Effect of Sub Clinical Hypothyroidism on C-reactive Protein and Ischemia Modified Albumin

Thyroid disorders are associated with imbalance in redox status throughout the body along with a pro-inflammatory state. Aim of our present study was to evaluate any potential role of ischemia modified albumin (IMA) in both sub clinical and established hypothyroidism and to explore its potential relationship with the hsCRP. Serum TSH, fT4, IMA and hsCRP were measured in 30 cases and 40 age and sex matched controls by ELISA and standard photometric techniques. IMA value was compared between the sub clinical and clinical hypothyroid patients. Strength of association between the IMA and hsCRP was assessed also to analyze the prevalence of pro-inflammatory condition in hypothyroid patients. Serum values (mean ± SD) of hsCRP (07.49 ± 2.73), TSH (22.18 ± 12.9) and IMA (128.31 ± 16.96) were significantly higher in the case group. Bivariate correlation study indicated that TSH and fT4 showed direct and inverse relationship respectively with the hsCRP and IMA. IMA itself exhibited direct correlation with the pro-inflammatory marker hsCRP showing a positive correlation with IMA. Results of the general linear model analysis showed that only TSH had a significant positive predictive value on IMA while fT4 itself as a continuous covariate, or in the fraction of its normal or subnormal range, did not show any significant predictive value on IMA values. We suggest in conclusion that a pro-inflammatory status and derangement of the redox balance towards an overall ischemic state start at an early stage of sub clinical hypothyroidism. Early detection of these parameters may help in provision of necessary preventive measures against complications of hypothyroidism.