Elevated serum homocysteine as a potential marker for cardiovascular changes in overt hypothyroidism

Abstract

ABSTRACT: Overt hypothyroidism(HO) defined as high Thyroid Stimulating Hormone (TSH) lev¬els with low levels of free thyroxine (FT4) and / or free triiodothyronine (FT3). Hypothyroidism is associated with an increased risk for atherosclerotic cardiovascular disease and cardiovascular morbidity, in particularly with Total cholesterol. However, there are other pathogenic factors which may also be involved. Serum Homocysteine (Hcy) is a independent risk factor for atherosclerosis and cardiovascular diseases. Elevated plasma homocysteine levels have been reported in overt hypothyroidism. Aim: To study the levels of Hcy in relation to TSH, FT4 and FT3 levels in overt hypothyroid patients compared to control groups and correlation between Hcy and thyroid hormones. Materials and Methods: This study included 50 female overt hypothyroid cases with the age group between 18-50 years and 50 healthy females controls with the same age group. Serum homocysteine was estimated by Homocysteine Enzyme Assay in Cobas Integra 400 plus. TSH, FT4 & FT3 estimated by Chemiluminescence immunoassay method using Beckman coulter Access 2. The parameters of cases and controls are compared using unpaired ‘t’ test and the association between parameters is assessed by using Pearson’s correlation, p value < 0.05 is statistically significant. Results: There is a significant increase in Serum Hcy levels 19.24 ± 7.15 μmol/L and TSH levels 30.91 ± 10.21 µIU/ml respectively (p value <0.0001) and significant decrease in FT4 and FT3 levels (p <0.0001). Hcy was positively correlated with TSH and negatively correlated with FT4 and FT3. Conclusion: Thus, from our study we can conclude that serum Hcy levels can be used as a marker, which points towards the possible risk factor for atherosclerosis and cardiovascular diseases in Overt hypothyroid patients.