Evaluation of insulin resistance and low grade inflammation in Egyptian women with subclinical hypothyroidism

ABSTRACT

Subclinical hypothyroidism [SCH] is a prevalent condition among adult population. SCH is characterized by slightly elevated serum TSH levels above the reference range and normal serum free T4 concentrations. The present study aimed to assess the association of hs-CRP [index of low grade inflammation] and insulin resistance index [HOMA-IR] in women with SCH. To achieve this goal a 26 women with SCH were enrolled in this work [age= 40.7 +/- 4.6 years] with TSH > 4.2 micro IU/ml and normal FT4, beside 20 woman. [age= 40.1 +/- 4.6SD years] as a control group. Participants with clinically apparent inflammatory thyroid diseases, any medications known to affect TSH, hs-CRP, lipid levels and insulin resistance, thyroid hormone medication up to 3 months before enrollment, pregnancy, and pituitary/hypothalamic disorders were excluded. BMI, waist circumference, FT3, FT4, hs-CRP, fasting insulin, glucose, total, HDL, LDL cholesterol, triglyceride, total cholesterol/HDL-c, LDL-c/ HDL-c ratios, HOMA-beta and HOMA-IR were determined in all participants. The mean serum levels of hs -CRP, TSH, fasting insulin, prolactin levels of subjects with SCH was higher than those of the control group [All p values = <0.05]. The SCH group had statistically non significant higher HOMA- IR values [2.1 +/- 0.4] than those of control subjects [1.9 +/- 0.3] [p=0.06]. However the mean values of serum fasting glucose, HOMA-J3, FT3, and FT4, were not differ in the 2 groups [all p values > 0.05]. There were positive correlation between insulin and hs-CRP [r=0.5, p=0.009], fasting insulin levels and TSH levels [r=043, p=0.03]. Female patients with SCH have higher serum hs-CRP level [low grade inflammation] which was associated with fasting hyperinsulinemia before obvious insulin resistance in patients with SCH. Therefore screening and early treatment for SCH may be an urge due to its adverse impacts on atherogenic indices