INTERACTIVE STUDIES ON HYPERTHYROIDISM, HYPOTHYROIDISM AND EUTHYROIDISM WITH SERUM LIPID PROFILE, CREATININE AND ALANINE AMINO TRANSFERASE

Abstract

Diseases of the thyroid are common, affecting some 5% of the population, predominantly females. The thyroid axis is involved in the regulation of cellular differentiation and metabolism in virtually all nucleated cells, so that disorders of thyroid function have diverse manifestation. The pathophysiology of many thyroid diseases relates to TSH, T3 and T4. The TSH level is the most sensitive index of thyroid function. Hyperthyroidism especially as Thyrotoxicosis is the hyper-metabolic condition connected by way of eminent levels of free thyroxine (fT4), free triiodothyronine (fT3), or both of them. Hypothyroidism is an ordinary endocrine disorder ensuing from shortage of thyroid hormone. It is frequently the key progression in which the thyroid glands fabricate inadequate quantity of thyroid hormone. As these disorders may severely affect the patients at almost all levels of physical, mental, metabolic and social conditioning that could be extendable to even death status. Not only this, but these diseases may become long lasting and can bring bad impact on socio-economic status of their concerned families as well. To elucidate some of these major relations, while keeping in view the various selected demographic details (age, gender and locality etc) of included patients, this study aims at understanding the relation between thyroid dysfunction and functioning of certain major organs of human body i.e kidney and liver. It also aims at studying the influence of thyroid mal function on lipid profile including total cholesterol, triacylglycerol, LDL-C, HDL-C, VLDL-C. To execute, the study was ethically permitted by the ethical committee of Post Graduate Medical Institute (PGMI) Hayatabad Medical Complex Peshawar, xiii and was conducted in the Institute of Radioactive Nuclear Medicine (IRNUM) Peshawar, Pakistan. Blood samples of all included patients were analysed in Pakistan Medical Research Centre (PMRC), Khyber Medical College Peshawar, Pakistan. A total of 600 cases were chosen of 214, 195 and 191 each Euthyroid, Hypothyroid and Hyperthyroid patients, respectively from the Institute of Radioactive Nuclear Medicine (IRNUM) Peshawar, Pakistan. A well designed proforma was used to record patients sample No, name, age, sex, address, clinical diagnosis etc: The blood samples of all included patients were collected, followed by their analysis for required parametric evaluation included with complete lipid profile, serum creatinine and alanine transaminase in comparison to T3, T4 and TSH of all respectively assessed patients. During this study, the results obtained regarding the demographical aspects of the patients revealed that female gender has categorically significantly high percentage of occurrence of thyroid abnormality as compared to male (75.8 % vs. 24.2 %). Similarly, it has been observed that in case of euthyroidism, hyperthyroidism and hypothyroidism, the comparative number of cases of occurrence between female vs male gender were 162 vs. 52, 158 vs. 37 and 155 vs. 56, respectively. In consideration to the nature of abnormality of thyroid disorder, it has been observed that patients of euthyroidism i-e., 214 were more than 191 and 195 for hypothyroidism and hyperthyroidism, respectively. Results regarding locality distribution of the patients depicted that majority of those belongs to the local population of Peshawar and Charsadda region. Importantly, the data showed that significant percentage of patients was from Afghanistan. xiv Furthermore, results regarding age distribution of the included subjects showed that these thyroid disorders mostly exist among age group of 31-40 years, which may be the most effective age limit for productivity and where the above mentioned hormonal changes and associated activity become at peak. Results regarding locality distribution of the patients depicted that majority of those belongs to local population of Peshawar and Charsadda region. In consideration to the impact of type of thyroid disorder on the level of respective parameter of lipid profile, the results revealed that there was reduction of blood cholesterol level and HDL in patients suffering from hyperthyroidism as compared to euthyroidism. The Aims and objectives of the study were to evaluate the prevalence of thyroid dysfunction in male and female subjects of different age groups and to establish the relation between locality of the considered patients and thyroid disorder. The specific objective is to study the association between sub clinical hypothyroidism and hyper cholesterolaemia, and to determine the link of different degrees of thyroid dysfsunction with kidney and liver function. The data were finally imported in SPSS version 20.0 for analysis. The student’s “t” test is being used to find out the significance between two values, in various diseased groups. Frequencies, p-value, and other descriptive analysis were computed to calculate the mean and standard deviation of different parameters. Coefficient of correlation (r) was also calculated using SPSS version 16.00 as a soft ware statistical package. The correlation value (r-value) was calculated between two parameters i-e EU, hyper, and hypo with serum Lipid profile, CTN and serum ALT respectively.