الجامعة:هيئة التعليم التقني
الكلية: كلية التقنيات الصحية والطبية
القسم: تقنيات التحليالت المرضية
الفرع: تقنيات التحليالت المرضية
: عنوان األطروحة
ASSOCIATION OF HYPOTHYROIDISM WITH INSULIN RESISTANCE AND
SOME INFLAMMATORY MARKERS
اسم الطالب: عدنان نافل مسلم العميري
المشرف: د.ساجدة عبد الحميد خليل
د.خالد إبراهيم اللهيبي
الدرجة العلمية: أستاذ
طبيب أستشاري
:االختصاص العام
:االختصاص الدقيق
2010 :السنة
Abstract
Hypothyroidism can be defined when thyroid gland , fails to
produce enough of a hormones called the thyroid hormones or when the
body fails to use thyroid hormones efficiently .These hormones are
necessary for energy production and body viability. The disease affects
both sexes and all ages. In many occasions this condition is
accompanied or followed by different metabolic disorders. Insulin
resistance occurs when tissues do not respond appropriately to normal
concentrations of circulating insulin. This is occurring because of
dysregulation of the intracellular molecular insulin signaling pathways.
When tissues do not respond properly to normal concentrations of
insulin, the pancreas compensates by secreting even more of the
hormone. Type 2 diabetes eventually occurs when this compensation is
not sufficient to regulate plasma glucose.
The current study is conducted in the '' Specialized Center for
Endocrinology and Diabetes '' and carried on 80 hypothyroidism
patients and 30 individuals with normal thyroid function. Both groups
were submitted to laboratory tests to evaluate thyroid function (FT3,
FT4, and TSH). The current study
involved evaluation of the '' association between hypothyroidism and
insulin resistance '' . Health problems related to many diseases became
commonly lately. Insulin resistance was diagnosed through two
important tests: HOMA-IR and C-peptide level.
HOMA-IR was calculated from fasting plasma glucose
and serum insulin levels. Patients are considered to have insulin
resistance, if they have abnormal HOMA-IR or high level of C-peptide .
The current study shown that both
conditions (hypothyroidism and insulin resistance) are associated and
common in women, old and abnormal weight individuals.
The results showed that most hypothyroid patients were at age
between (50–75) years, which constitute 57.5% and 42.5% at age (30-49)
years. Most of hypothyroid patients were women constituting 83.75%
compared with 16.25% for male. Most of hypothyroid patients were
obese (BMI≥30Kg/m2) constituting 72.5% compared with 21.25%
overweight and 6.25% were normal weight.
Insulin resistance incidence is increased in hypothyroid patients,
the results showed that 60% of hypothyroid patients have high HOMA-IR
level , the mean of HOMA-IR in hypothyroid patients were 4.35 , and in
healthy subjects were 2.46 ; while 42.5% of hypothyroid patient had C-
peptide level more than normal ; also hypothyroid patients who had
fasting blood glucose level more than normal constituting 33.75%.
This study is also considered some biochemical
and immunological parameters which include: Fasting blood glucose
,(FBG) and fasting insulin level ( to calculate of HOMA-IR) , C-peptide ,
lipid profile , FT3 , FT4 , TSH , IL-6 , and hsCRP .
The study confirmed the presence of higher levels of
inflammatory markers in hypothyroid patients as compared with normal
subjects. IL-6 and hsCRP, were significantly higher (Pvalue=0.000) among
the hypothyroid patients. Also these inflammatory markers(IL-6 and
hsCRP)were positively associated with HOMA-IR level (Pvalue =0.000),
and increased in insulin resistance patients. There is a highly positive
significance correlation between multiple parameters among
hypothyroid patients; which include BMI & HOMA-IR level (r=0.568, Pvalue
=0.000), hsCRP level & HOMA-IR level(r=0.429,Pvalue=0.000), hsCRP level
& BMI (r=0.473, Pvalue =0.000), HOMA-IR & C-peptide level ( r=0.317 , Pvalue
=0.004) , IL-6 level & BMI (r = 0.455, Pvalue = 0.003), IL-6 level & hsCRP
level( r =0.459 ,Pvalue = 0.000). Also a positive significance correlation
between TSH level & BMI(r=0.261,Pvalue=0.02), IL-6 level&HOMA-
IR(r=0.280, Pvalu =0.012).