Skip to main content
NCBI home page
Indian Journal of Clinical Biochemistry logoLink to Indian Journal of Clinical Biochemistry
. 2010 May 27;25(2):141–145. doi: 10.1007/s12291-010-0026-x

Association between insulin resistance and hypothyroidism in females attending a tertiary care hospital

Bhawna M Singh 1,2,✉, B Goswami 1, V Mallika 1
PMCID: PMC3453097  PMID: 23105900

Abstract

The effect of thyroid status on insulin sensitivity is of great interest but despite various studies there is conflicting data on this subject. The study group comprised of 25 female subjects each with subclinical hypothyroidism, overt hypothyroidism and euthyroid controls. Serum samples of all the patients were assayed for thyroid profile, Insulin and lipid profile. Homeostasis model of assessment (HOMA-IR) was employed to assess the level of insulin resistance. Patients with hypothyroidism demonstrated insulin resistance and dyslipidemia as observed by the higher HOMA-IR and cholesterol and triglyceride levels respectively as compared to the controls. A significantly positive correlation between TSH and HOMA-IR level was also observed in the hypothyroidism group. Thyroid dysfunction leads to alterations in glucose and lipid metabolism which is an important risk factor for cardiovascular diseases. The dyslipidemia and insulin resistance should be managed aggressively to reduce the impending risk.

Key Words: Insulin, Hypothyroidism, HOMA-IR, TSH, Dyslipidemia

Full Text

The Full Text of this article is available as a PDF (82.6 KB).

References

  • 1.Serter R., Demirbas B., Culha C., Cakal E. The effect of L-thyroxine replacement therapy on lipid based cardiovascular risk in sub clinical hypothyroidism. Invest J Endocrinol. 2004;27:897–903. doi: 10.1007/BF03347530. [DOI] [PubMed] [Google Scholar]
  • 2.American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluationtreatment of hyperthyroidismhypothyroidism. Endocr Pract. 2002;8:457–469. [PubMed] [Google Scholar]
  • 3.Fommei E., Iervasi G. The role of thyroid hormone in blood pressure homeostasis: evidence from short-term hypothyroidism in humans. J Clin Endocrinol Metab. 2002;87:1996–2000. doi: 10.1210/jc.87.5.1996. [DOI] [PubMed] [Google Scholar]
  • 4.Maratou E, Hadjidakis D, Kollias A, Tsegka K, Peppa M, Alevizaki M, et al. Studies of insulin resistance in patients with clinical and subclinical hypothyroidism. Eur J Endocrinol 2009 (In press) [DOI] [PubMed]
  • 5.Duntas L.H. Thyroid disease and lipids. Thyroid. 2002;12:287–293. doi: 10.1089/10507250252949405. [DOI] [PubMed] [Google Scholar]
  • 6.Biondi B., Klein I. Hypothyroidism as a risk factor for cardiovascular disease. Endocrine. 2004;24:1–13. doi: 10.1385/ENDO:24:1:001. [DOI] [PubMed] [Google Scholar]
  • 7.Canaris G.J., Manowitz N.R., Mayor G., Ridgway E.C. The Colorado thyroid disease prevalence study. Arch Intern Med. 2000;160:526–534. doi: 10.1001/archinte.160.4.526. [DOI] [PubMed] [Google Scholar]
  • 8.Reaven G.M. Banting lecture. Role of insulin resistance in human disease. Diabetes. 1988;37:1595–1607. doi: 10.2337/diabetes.37.12.1595. [DOI] [PubMed] [Google Scholar]
  • 9.Expert Panel on Detection, Evaluation,Treatment of High Blood Cholesterol In Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III) JAMA. 2001;285:2486–2497. doi: 10.1001/jama.285.19.2486. [DOI] [PubMed] [Google Scholar]
  • 10.Alberti K.G., Zimmet P., Shaw J. The metabolic syndrome-a new worldwide definition. Lancet. 2005;366:1059–1062. doi: 10.1016/S0140-6736(05)67402-8. [DOI] [PubMed] [Google Scholar]
  • 11.Bakker S.J.L., Maaten J.C., Popp-Snijders C., Slaets J.P.J., Heine R.J., Gans R.O.B. The relationship between thyrotropin and low density lipoprotein cholesterol is modified by insulin sensitivity in healthy euthyroid subjects. J Clin Endocrinol Metab. 2001;86:1206–1211. doi: 10.1210/jc.86.3.1206. [DOI] [PubMed] [Google Scholar]
  • 12.Chubb S.A.P., Davis W.A., Inman Z., Davis T.M.E. Prevalence and progression of subclinical hypothyroidism in women with type 2 diabetes: the Fremantle Diabetes Study. Clin Endocrinol (Oxf) 2005;62:480–486. doi: 10.1111/j.1365-2265.2005.02246.x. [DOI] [PubMed] [Google Scholar]
  • 13.Owecki M., Ali Z., Nikisch E., Sowinski J. Serum insulin levels and the degree of thyroid dysfunction in hypothyroid women. Neuro Endocrinol Lett. 2008;29(1):137–140. [PubMed] [Google Scholar]
  • 14.Annemieke R., Stephan J.L., Links Thera P., Gans Rijk O.B., Wolffenbuttel Bruce H.R. Thyroid Function is associated with components of the metabolic syndrome in euthyroid subjects. J Clin Endocrinol Metab. 2007;92:491–496. doi: 10.1210/jc.2006-1718. [DOI] [PubMed] [Google Scholar]
  • 15.Tuzcu A., Bahceci M., Gokalp D., Tuzun Y., Gunes K. Subclinical hypothyroidism may be associated with elevated high-sensitive C — reactive protein (low grade inflammation) and fasting hyperinsulinemia. Endocr J. 2005;52:89–94. doi: 10.1507/endocrj.52.89. [DOI] [PubMed] [Google Scholar]
  • 16.Matthews D.R., Hosker J.P., Rudenski A.S., Naylor B.A., Treacher D.F., Turner R.C. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–419. doi: 10.1007/BF00280883. [DOI] [PubMed] [Google Scholar]
  • 17.Meier C., Staub J.J., Roth C.-B., Guglielmetti M., Kunz M., Miserez A.R., Drewe J., Huber P., Herzog R., Muller B. TSH-controlled L-thyroxine therapy reduces cholesterol levels and clinical symptoms in subclinical hypothyroidism: a double blind, placebo-controlled trial (Basel Thyroid Study) J Clin Endocrinol Metab. 2001;86:4860–4866. doi: 10.1210/jc.86.10.4860. [DOI] [PubMed] [Google Scholar]
  • 18.Perros P., McCrimmon R., Shaw G., Frier B. Frequency of thyroid dysfunction in diabetic patients: value of annual screening. Diabet Med. 1995;7:622–627. doi: 10.1111/j.1464-5491.1995.tb00553.x. [DOI] [PubMed] [Google Scholar]
  • 19.Tayal D., Goswami B., Gupta V.K., Mallika V. Evaluation of lipid profile in hypothyroid patients. Our experience. Thyroid Res Pract. 2008;5(2):43–47. [Google Scholar]
  • 20.Shantha G.P.S., Kumar A.A., Jeyachandran V., Rajamanickam D., Rajkumar K., Salim S., et al. Association between primary hypothyroidism and metabolic syndrome and the role of C reactive protein: a cross-sectional study from South India. Thyroid Res. 2009;2:2. doi: 10.1186/1756-6614-2-2. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 21.Wallace T.M., Levy J.C., Matthews D.R. Use and Abuse of HOMA Modeling. Diabetes Care. 2004;27:1487–1495. doi: 10.2337/diacare.27.6.1487. [DOI] [PubMed] [Google Scholar]
  • 22.Turner R.C., Holman R.R., Matthews D., Hockaday T.D., Peto J. Insulin deficiency and insulin resistance interaction in diabetes: estimation of their relative contribution by feedback analysis from basal plasma insulin and glucose concentrations. Metabolism. 1979;28:1086–1096. doi: 10.1016/0026-0495(79)90146-X. [DOI] [PubMed] [Google Scholar]
  • 23.Demidova T., Galieva O.R. The role of thyroid hypofunction in development of metabolic syndrome. Ter Arkh. 2009;81(4):69–73. [PubMed] [Google Scholar]
  • 24.Khan S.H., Khan F.A., Ijaz A., Sattar A., Dilawar M., Hashim R. Spectrum of lipid and lipoprotein indices in human subjects with insulin resistance syndrome. J Ayub Med Coll Abbottabad. 2008;20(3):17–22. [PubMed] [Google Scholar]

Articles from Indian Journal of Clinical Biochemistry are provided here courtesy of Springer

RESOURCES