Abstract

Background and objective: The burden of thyroid diseases in the general population and patients with Metabolic Syndrome (Mets) is enormous. Therefore, the present study was an effort to investigate the association between Subclinical Hypothyroidism (SCH) and components of Mets in a selected group of patients with Mets in Saudi Arabia.

Design: We analyzed retrospectively 798 participants with Mets between the age 20 to 89 years. All patients were from the population of the Primary health center at King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia. Patients with Serum Thyroid Stimulating Hormone (TSH) level >4.2MIU/L and normal free Thyroxine (FT4) level were taken as SCH. Metabolic risk factors were defined using the 2006 IDF criteria.

Result: 798 patients with Mets were included. Patients with SCH were non-significantly older than without SCH, 55.0±12.6 vs. 53.3±12.4, p=0.07. There were 242 (30.3%) cases with SCH where female was found in 180 cases (74.4%) and male was 62 cases (25.6%), p=0.009. Patients in the age group of ≥60 years had non-significantly higher prevalence of SCH (36.8%) compared to < 40 years (12%), 40-49 years (20.2%) and 50-59 years (31%), p=0.2. Cases with HbA1c>5.6 or T2DM, HTN, TG (≥1.7mmol/l) and low HDL-C were significantly more prevalent in patients with than without SCH (87.4 vs. 80.5%, p=0.03), (56.6 vs. 47.8%, p=0.03), (52.7 vs. 34.0%, p< 0.0001) and (58.7 vs. 49.7%, p=0.03) respectively. SCH with HbA1c>5.6 or T2DM, HTN and low HDL-C were increased significantly with advanced ages and non-significantly increased with advanced ages in patients with SCH and TG (≥1.7mmol/l). Regression analysis of odd ratio of risk factors for patients with SCH and Mets showed that gender, BMI≥30kg/m2, HTN, TG (≥1.7 mmol/l) and low HDL-C were associated with higher likely hood of SCH.

Conclusion: Our study suggests that SCH might be a risk factor for Mets and its components. Further investigations are needed to evaluate the mechanism of this correlation.

Keywords: Subclinical hypothyroidism; Components of metabolic syndrome