J Clin Diagn Res. 2016 Jun;10(6):BC04-8. doi: 10.7860/JCDR/2016/19775.8067. Epub 2016 Jun 01.
A Study of the Extended Lipid Profile including Oxidized LDL, Small Dense LDL, Lipoprotein (a) and Apolipoproteins in the Assessment of Cardiovascular Risk in Hypothyroid Patients.
Journal of clinical and diagnostic research : JCDR
Sanjiv Kumar Bansal, Rakhee Yadav
Affiliations
Affiliations
- Associate Professor, Department of Biochemistry, SGT Medical College, Hospital and Research Institute , Budhera, Gurgaon, Haryana, India .
- Assistant Professor, Department of Biochemistry, SGT Medical College, Hospital and Research Institute , Budhera, Gurgaon, Haryana, India .
PMID: 27504276
PMCID: PMC4963636 DOI: 10.7860/JCDR/2016/19775.8067
Abstract
INTRODUCTION: Hypothyroidism is one of the most common metabolic disorders associated with dyslipidemia which poses a higher risk of Coronary Artery Disease (CAD) in such patients. Biochemical markers which can pick up the risk promptly are becoming imperative now-a-days and thus the assessment beyond the conventional lipid profile is the need of the hour.
AIMS: To assess the association of non-conventional lipid parameters like small dense Low Density Lipoprotein (sd LDL), oxidized Low Density Lipoprotein (ox LDL), Apolipoprotein A (Apo A1), Apolipoprotein B (Apo B) and Lipoprotein (a) {Lp(a)} in hypothyroid patients and compare their values with the conventional lipid parameters such as Total Cholesterol (TC), Triglyceride (TG), Low-Density Lipoprotein Cholesterol (LDL-C) and High-Density Lipoprotein Cholesterol (HDL-C).
MATERIALS AND METHODS: One hundred and thirty clinically proven patients of hypothyroidism aged 20-60 years and equal number of age and gender matched healthy individuals were included in this case control study. Serum sd LDL, ox LDL, Apo A1, Apo B, Lp (a), lipid profile, Thyroid Stimulating Hormone (TSH), Free Triiodothyronine (FT3) and Free Tetraiodothyronine (FT4) levels were measured in both the groups. The data was recorded and analysed on SPSS system. The results of cases and controls were compared by student t-test and one-way ANOVA. All the parameters were correlated with TSH by Pearson's correlation.
RESULTS: We found significantly high levels of sd LDL, ox LDL, Apo B, Lp (a), TC, TG, LDL-C in cases as compared to the controls. Ox LDL has shown maximum correlation with serum TSH (p<0.0001, r=0.801) followed by sd LDL (p<0.0001, r=0.792), Apo B (p<0.001, r=0.783) and LDL-C (p<0.001, r=0.741). Moreover, ox LDL and sd LDL were found to be increased in normolipidemic hypothyroid patients thereby giving a strong supportive evidence that estimation of these parameters can become fundamental in prompt identification of the high risk patients of CAD in hypothyroid population.
CONCLUSION: Non-conventional lipid parameters appear to be better markers for the assessment of cardiovascular risk in hypothyroidism and might help in the designing of the effective treatment protocols and areas of intervention by the clinicians as well as researchers.
Keywords: Apolipoprotein A; Apolipoprotein B; Coronary artery disease; Hypothyroidism; oxidized; small dense Low Density Lipoprotein
References
- Clin Endocrinol (Oxf). 2009 Jul;71(1):130-6 - PubMed
- Biochim Biophys Acta. 2007 Sep;1771(9):1216-25 - PubMed
- Mayo Clin Proc. 2013 Nov;88(11):1294-311 - PubMed
- Am J Med Sci. 2011 Aug;342(2):135-42 - PubMed
- Indian J Biochem Biophys. 2012 Apr;49(2):77-85 - PubMed
- Biochemistry. 2004 Feb 17;43(6):1626-32 - PubMed
- Crit Care. 2008;12(1):R1 - PubMed
- Cell. 2006 Jan 13;124(1):35-46 - PubMed
- J Am Coll Cardiol. 2008 Apr 15;51(15):1512-24 - PubMed
- Curr Opin Lipidol. 2006 Apr;17 (2):122-7 - PubMed
- Proc Soc Exp Biol Med. 2000 May;224(1):8-19 - PubMed
- Endocrinol Metab Clin North Am. 2007 Sep;36(3):595-615, v - PubMed
- J Clin Endocrinol Metab. 2008 Mar;93(3):888-94 - PubMed
- J Biol Chem. 2006 Jan 6;281(1):295-302 - PubMed
- Am Heart J. 2009 Jan;157(1):111-117.e2 - PubMed
- Diabetol Metab Syndr. 2010 Aug 18;2:55 - PubMed
- Crit Rev Clin Lab Sci. 2003 Feb;40(1):1-42 - PubMed
- Arch Intern Med. 2000 Jun 12;160(11):1573-5 - PubMed
- J Clin Endocrinol Metab. 2003 Jun;88(6):2438-44 - PubMed
- Eur Heart J. 2010 Dec;31(23):2844-53 - PubMed
- Gastroenterology. 2008 Apr;134(4):1127-36 - PubMed
- Lancet. 2003 Mar 1;361(9359):777-80 - PubMed
- Arterioscler Thromb Vasc Biol. 2005 Dec;25(12 ):2445-7 - PubMed
- Eur J Endocrinol. 2007 Feb;156(2):181-6 - PubMed
- Lancet. 2008 Jul 19;372(9634):224-33 - PubMed
- Arterioscler Thromb Vasc Biol. 2004 Oct;24(10):1750-4 - PubMed
- Atherosclerosis. 1998 Jun;138(2):289-99 - PubMed
- Thyroid. 2002 Apr;12(4):287-93 - PubMed
- J Biol Chem. 2003 Sep 5;278(36):34114-8 - PubMed
- Open Cardiovasc Med J. 2011;5:76-84 - PubMed
- Hormones (Athens). 2002 Oct-Dec;1(4):218-23 - PubMed
- Atherosclerosis. 2009 Mar;203(1):269-76 - PubMed
- Thyroid. 2011 Jan;21(1):5-11 - PubMed
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