Subclinical hypothyroidism – A state of hypercoagualability and impending risk of atherosclerosis

Authors : S Birundha, A Balasubramanian, N Sivaranjani, K Rajalakshmi, M C Archana

DOI : 10.18231/j.ijcbr.2019.098

Volume : 6

Issue : 4

Year : 2019

Page No : 470-473

Introduction: Subclinical Hypothyroidism (SH) represents a condition of mild to moderate thyroid failure
characterized by normal levels of serum thyroid hormones with mildly elevated serum TSH concentrations.
The possibility of an increased prevalence of non-traditional risk factors (endothelial dysfunction, low grade
inflammation, and alterations in coagulation parameters) in SH remains to be clarified.
The present study was undertaken t o evaluate if hypercoagulabililty exists in subclinical hypothyroid
Materials and Methods: The study was conducted for a period of three months in Government Omandurar
Medical College antenatal and Medicine OPDs. The subjects diagnosed as subclinical hypothyroid based
on TSH levels were recruited into the study group based on the inclusion and exclusion criteria. The total
number of subjects is 60 subjects and were divided into group A(30 subjects with SH - cases) and B (30
subjects euthyroid - controls). 5 ml fasting blood samples were collected.
Free T3, free T4, TSH, fibrinogen, Homocysteine and Hs-CRP were estimated. All statistical analyses
were carried out for two tailed significance and p value 0.05 was considered as statistically significant
using SPSS v16.0.
Results: FT3, FT4 values were normal in both cases and controls, whilst TSH values differed significantly
(with a mean of 2.59 mIU /L in controls and 7.76 mIU/L in cases) Fibrinogen (282.37 81.91 in controls
vs 321.95 85.44 mg/dl in cases).
HsCRP levels (1013.5 in controls vs 3367.87 ng/ml in cases) were significantly higher in the Subclinical
Hypothyroid subjects when compared to healthy controls. However the levels of Homocysteine were not
significantly different in Subclinical Hypothyroid patients when compared to the control group.
Conclusion: This study found out that the risk factors for hypercoagulable state like fibrinogen and
inflammatory state like hsCRP were significantly elevated in subclinical hypothyroids (TSH elevated
with normal FT3, FT4) when compared to controls indicating a disturbance in coagulation, inflammation
processes escalating the risk for atherosclerosis.

Keywords: Subclinical Hypothyroidism, TSH, Hypercoagulabililty, Fibrinogen, Homocysteine, hsCRP, Cardiovascular risk, Hemostasis.

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