Variations of Adipokines and Insulin Resistance in Primary Hypothyroidism

Hypothyroidism is a common concern in endocrinology practice, which plays a significant role in metabolic and development processes. Obesity, hyperlipidaemia and hypertension may complicate hypothyroidism. Recent studies have shown that cytokines like leptin and adiponectin, secreted by adipose tissue and exert their endocrinal functions by modulating appetite, obesity and insulin sensitivity in conjunction with thyroid hormones. Interrelation between thyroid hormone, insulin resistance and adipokines are not yet clear.

To estimate serum leptin, adiponectin and insulin resistance in patients with hypothyroidism and to compare with control subjects and measure the relation between the mean value of one variable with others.

Forty primary hypothyroidism patients and forty age and sex matched controls were selected for the study with informed consent. Fasting serum Thyroid Stimulating Hormone (TSH), leptin, adiponectin, glucose and insulin were estimated. Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) was evaluated from fasting plasma glucose and serum insulin levels. Statistical analysis was carried out using SPSS version 17.0. Unpaired t-test and regression analysis were used to compare and determine the dependence, p<0.05 was considered significant.

Serum TSH, leptin, adiponectin HOMA-IR were significantly higher (p<0.05) in patients with hypothyroidism (10.37±4.10, 10.97±0.60, 31.09±4.07, 3.64±0.40) than controls (2.41±2.09, 10.37±0.12, 33.32±1.44, 2.36±0.35). Regression analysis showed that leptin was significantly (p=0.054) dependent on adiponectin but not on others.

Increased oxidative stress by hypothyroid mediated leptin secretion and increased insulin resistance can down-regulate the adiponectin secretion and future complications. Serum estimation and correction of imbalance of adipokines in hypothyroidism can prevent severe consequences.