ASSOCIATION BETWEEN SUBCLINICAL HYPOTHYROIDISM AND METABOLIC SYNDROME

Background: sub-clinical Hypothyroidism and metabolic syndrome are recognized risk factors for atherosclerotic cardiovascular disease. Aim: This study aimed to investigate associations between subclinical thyroid disease, insulin resistance, and metabolic syndrome. Methods: A cross-sectional study from a tertiary care Kasr Al Ainy teaching hospital in Cairo, Egypt. 30 patients with subclinical hypothyroidism and 30 healthy age matched euthyroid control subjects were included in the study. TSH, FT4 were measured for both the groups using electrochemiluminescence immuno assay. The metabolic syndrome criteria according to the National Cholesterol Education Program/ATP III were sought for in both groups. Fasting plasma Insulin levels were measured and the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) was calculated. The baseline characteristics between the groups were compared with Student’s\' test. Chi-square test was used to analyze the association between metabolic syndrome and sub-clinical hypothyroidism. Logistic regression analysis was applied to identify the association between sub-clinical hypothyroidism and the patient characteristics in the study group. Results: Of the 30 patients in the study group, 20 were females (66.7%), 10 were males (33.3%) with mean age 44.8 ± 11.0 years. Of the 30 subjects in the control group, 10 were females (33.3%), 20 males (66.7%) with mean age 47 ± 11.6 years. In the study group, 26 had metabolic syndrome (86.7%), 4 had no metabolic syndrome (13.3%). In the control group 9 subjects had metabolic syndrome (30%), 21 subjects had no metabolic syndrome (70%) (P<0.001).Data showed that insulin resistance is significantly higher in the subclinical hypothyroid patient group than in the control group (P = 0.05), so there is positive correlation between TSH and insulin resistance (HOMA-IR) but not with the insulin level (P = 0.124). Logistic regression analysis recognized the association between female gender (P = 0.021) and metabolic syndrome Conclusion: Subclinical hypothyroidism was associated with metabolic syndrome and females were more at risk. Metabolic syndrome patients with insulin resistance (HOMA- IR) are at significant risk of having sub-clinical hypothyroidism.