• BAYAR AHMED QASIM Lecturer, Department of Medicine, College of Medicine, University of Duhok, Kurdistan Region, Iraq.
  • AYAD AHMAD MOHAMMED Lecturer, Department of Surgery, College of Medicine, University of Duhok, Kurdistan Region, iraq.
  • MAZYAR JABBAR AHMED Physician, Kurdistan Board for Medical Specialities , Kurdistan Region, Iraq.
Keywords: Dyslipidemia;, Subclinical Hypothyroidism (SCH), Case Control Study.


Background: Subclinical hypothyroidism (SCH) is estimated to affect around 7.5-8.5% of females and 2.8-4.4% of males. One of the features of clinical hypothyroidism is dyslipidemia. There is a great debate about the presence of abnormal lipid profiles in patients with subclinical hypothyroidism (SCH) and weather it is clinically significant or not. Some evidences show reduction in the level of the serum lipid profile after replacement with thyroid hormones. The purpose of this study is to estimate the prevalence of dyslipidemia in patients with subclinical hypothyroidism in Duhok and Erbil cities, Iraq.

Patients and Methods: This is a case-control study that was done on 200 individuals. One hundred patients confirmed with subclinical hypothyroidism were compared with a group of 100 apparently healthy individuals. These two groups were matched for age and sex. The study done in 2 centres; Azadi Teaching Hospital in Duhok and Rizgari Teaching Hospital in Erbil, Kurdistan Region, Iraq from from 1st December 2017 to 1st December 2018.

Results: Dyslipidemia was commoner in patients with subclinical hypothyroidism compared to control group (p value 0.001) compared to the control group (p value 0.766). The total cholesterol and the triglyceride levels were steadily increased in relation to the level of the thyroid stimulating hormone (TSH).

Conclusions: Subclinical hypothyroidism (SCH) is regarded as an atherogenic condition because it increases the cholesterol and the triglyceride levels. Management of subclinical hypothyroidism with thyroid hormones may have a positive impact on the cardiovascular health. It is reasonable to measure the levels of the serum lipids and cardiovascular risk in these patients and to manage them when it is clinically applicable.


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1. Axelband F, Dias J, Ferrao F, Einicker‐Lamas M. Nongenomic signaling pathways triggered by thyroid hormones and their metabolite 3‐iodothyronamine on the cardiovascular system. Journal of cellular physiology. 2011;226(1):21-8.
2. Mariela JC, Yamila VC, Liliana BO, Maria SG. Hypothyroidism on Lipid Metabolism, Hypothyroidism - Influences and Treatments: Drahomira Springer; February 8th 2012.
3. Seely EW, Williams GH. The heart in endocrine disorders. Heart Disease (6th Edition) Philadelphia: WB Saunders. 2001;2166.
4. Jiskra J, Limanova Z, Antosova M. Thyroid diseases, dyslipidemia and cardiovascular risk. Vnitrni lekarstvi. 2007;53(4):382-5.
5. Surks MI, Ortiz E, Daniels GH, Sawin CT, Col NF, Cobin RH, et al. Subclinical thyroid disease: scientific review and guidelines for diagnosis and management. Jama. 2004;291(2):228-38.
6. Helfand M. Screening for subclinical thyroid dysfunction in nonpregnant adults: a summary of the evidence for the US Preventive Services Task Force. Ann Intern Med 2004;140(2):128-41.
7. Shah SN, Joshi SR. Think thyroid. J Assoc Physicians India. 2011;59:15-20.
8. Hu G, Sarti C, Jousilahti P, Peltonen M, Qiao Q, Antikainen R, et al. The impact of history of hypertension and type 2 diabetes at baseline on the incidence of stroke and stroke mortality. Stroke. 2005;36(12):2538-43.
9. Biondi B, Bartalena L, Cooper DS, Hegedüs L, Laurberg P, Kahaly GJ. The 2015 European Thyroid Association guidelines on diagnosis and treatment of endogenous subclinical hyperthyroidism. European thyroid journal. 2015;4(3):149-63.
10. Choi J, Choi H. The regulatory effects of thyroid hormone on the activity of 3-hydroxy-3-methylglutaryl coenzyme A reductase. Endocrine research. 2000;26(1):1-21.
11. Neves C, Alves M, Medina J, Delgado J. Thyroid diseases, dyslipidemia and cardiovascular pathology. Portuguese journal of cardiology: an official journal of the Portuguese Society of Cardiology. 2008;27(10):1211-36.
12. Dubey T, Upadhyay V, Deopujari K. Correlation of Subclinical Hypothyroidism with Dyslipidemia in Perimenopausal Women. IJCMR. July 2016 3(7):1928-31.
13. Tagami T, Tamanaha T, Shimazu S, Honda K, Nanba K, Nomura H, et al. Lipid profiles in the untreated patients with Hashimoto thyroiditis and the effects of thyroxine treatment on subclinical hypothyroidism with Hashimoto thyroiditis. Endocrine journal. 2010;57(3):253-8.
14. Farwell A. Sick euthyroid syndrome in the intensive care unit. irwin and rippe’s intensive Care Medicine, Philadelphia, PA: Lippincott Williams & Wilkins. 2003:1205-16.
15. Economidou F, Douka E, Tzanela M, Nanas S, Kotanidou A. Thyroid function during critical illness. Hormones. 2011;10(2):117-24.
16. Jellinger P, Smith D, Mehta A, Ganda O, Handelsman Y, Rodbard H, et al. American Association of Clinical Endocrinologists' guidelines for management of dyslipidemia and prevention of atherosclerosis. Endocrine practice. 2012;18(Supplement 1):1-78.
17. Meyerovitch J, Rotman-Pikielny P, Sherf M, Battat E, Levy Y, Surks MI. Serum thyrotropin measurements in the community: five-year follow-up in a large network of primary care physicians. Arch Intern Med. 2007;167(14):1533-8.
18. McQuade C, Skugor M, Brennan DM, Hoar B, Stevenson C, Hoogwerf BJ. Hypothyroidism and moderate subclinical hypothyroidism are associated with increased all-cause mortality independent of coronary heart disease risk factors: a PreCIS database study. Thyroid. 2011;21(8):837-43.
19. Razvi S, Weaver JU, Butler TJ, Pearce SH. Levothyroxine treatment of subclinical hypothyroidism, fatal and nonfatal cardiovascular events, and mortality. Arch Intern Med. 2012;172(10):811-7.
20. Tseng F-Y, Lin W-Y, Lin C-C, Lee L-T, Li T-C, Sung P-K, et al. Subclinical hypothyroidism is associated with increased risk for all-cause and cardiovascular mortality in adults. Journal of the American College of Cardiology. 2012;60(8):730-7.
21. Gencer B, Collet T-H, Virgini V, Auer R, Rodondi N. Subclinical thyroid dysfunction and cardiovascular outcomes among prospective cohort studies. Endocrine, Metabolic & Immune Disorders-Drug Targets (Formerly Current Drug Targets-Immune, Endocrine & Metabolic Disorders). 2013;13(1):4-12.
22. Imaizumi M, Akahoshi M, Ichimaru S, Nakashima E, Hida A, Soda M, et al. Risk for ischemic heart disease and all-cause mortality in subclinical hypothyroidism. The Journal of Clinical Endocrinology & Metabolism. 2004;89(7):3365-70.
23. Bandyopadhyay SK, Basu A, Pal SK, Roy P, Chakrabarti S, Pathak H, et al. A study on dyslipidaemia in subclinical hypothyroidism. Journal of the Indian Medical Association. 2006;104(11):622-4, 6.
24. Danese MD, Ladenson PW, Meinert CL, Powe NR. Effect of thyroxine therapy on serum lipoproteins in patients with mild thyroid failure: a quantitative review of the literature. The Journal of Clinical Endocrinology & Metabolism. 2000;85(9):2993-3001.
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