Muhammad Siddique Ahmed Khan

Abstract

Objective: To study the relationship between thyroid stimulating hormone levels, 25 hydroxycholecalciferol (Vitamin D3) and Insulin resistance and secretion in subclinical hypothyroidism Materials and Methods: The study population was divided into two groups, Group I include 4 0 subjects diagnosed with subclinical hypothyroidism and Group II includes 40 ages matched healthy euthyroid control group. Serum Thyroid stimulation hormone, Vitamin D3 (25-Hydroxycholecalciferol) were analyzed by Electrochemiluminisence immune assay. Insulin resistance and insulin secretion were calculated from fasting glucose and fasting insulin by Homeostasis model assessment HOMA IR and HOMA B. Results: In subclinical hypothyroidism Serum Thyroid stimulation hormone levels and Insulin resistance were elevated(p Hydroxycholecalciferol) and insulin secretion(HOMA B) (p to euthyroids. Vitamin D3 (25-Hydroxycholecalciferol) is negatively correlated with TSH and Insulin resistance (P Conclusion: Subclinical hypothyroidism is associated with a decreased vitamin D and insulin secretion and increased insulin resistance. This prompts us to question whether prevalence of vitamin D deficiency in Subclinical hypothyroidism, predisposes to early development of diabetes especially where both diabetes and hypothyroidism are highly prevalent. Both Insulin resistance and Vitamin D3 deficiency in subclinical hypothyroidism together lead to early development of insulin resistance disorders, metabolic syndrome and cardiovascular diseases. Keywords: HOMA IR: Homeostatic Model, Assessment -Insulin Resistance, HOMA-B: Homeostatic Model, Assessment-Beta cell secretion, TSH: Thyroid Stimulating Hormone, Vitamin D 3 :25-Hydroxycholecalciferol ECLIA: Electro Chemiluminisence, Immuno assay.

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Abstract

Introduction: Insulin resistance and secretion are highly dependent on variable influencing factors, in the developmental process of Diabetes mellitus. Growing incidence of diabetes prompt us to study the various contributing factors in the development of Diabetes mellitus in healthy individuals. Objective: To study the relationship associated between anthropometric measurements, plasma lipids, glycemic indices, thyroid stimulating hormone with Insulin resistance and secretion in healthy individuals. Materials and Methods: A cross-sectional study was conducted in normal healthy individuals, from general population.(n=142).Body mass index, body fat, were measured, Glycemic indices, fasting glucose, post prondial glucose, Glycated hemoglobin, fasting insulin levels, Thyroid stimulating hormone, fasting lipid profile were analysed. Result: Insulin resistance (HOMA IR) is positively correlated with Glycemic indices (FBS, PPBG, HbA1C) P<0.05, Body mass index P<0.05, Body fat P<0.05, and Cholesterol/HDL ratio. Serum Thyroid Stimulating Hormone (TSH) P<0.05 is negatively associated with Insulin Secretion. Glycemic Indices, Triacylglycerol, cholesterol, LDL are negatively correlated with Insulin Secretion. Conclusions: Glycemic indices, body mass index, body fat and lipid profile are intrinsically related to Insulin resistance and Insulin secretion. Increased TSH is associated with decreased insulin secretion leading to increase blood glucose levels, which indicates that thyroid hormone is important for pro insulin expression and translation, providing the evidence that, effects of thyroid hormones on carbohydrate metabolism also include the control of proinsulin gene expression, the possible role of thyroid hormones on insulin secretion. Keywords: FBS: Fasting blood sugar, HbA1C: Glycated Haemoglobin, HOMA IR: Homeostatic Model Assessment –Insulin Resistance, HOMA-B: Homeostatic Model Assessment- Beta cell secretion, TSH: Thyroid Stimulating Hormone, PPBG – Post Prondial Blood Glucose.

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