SCREENING OR AGGRESSIVE CASE FINDING FOR HYPOTHYROID PATIENTS. WHAT IS THE EVIDENCE??
Backgound: Hypothyroidism enhances atherosclerosis in multiple ways. Carotid intima media thickness(C’IMI) as measured by B-Mode ultrasound and color Doppler is a risk determinant of atheroscierosis. hsC’RP is a marker of inflammation and has been incriminated as a risk Jiictorforfuture cardiovascular events. Our study aims at generating evidence Jbr increased risk of cardiovascular risk factors in hypothyroid patients and thus needfor population- based screening for hypothyroidism. Methods: We included 25 consecutive patients in to each of two groups of our study (n=50,) Hypothyroid group had patients with Thyroid stimulating hormone (TSH,) > I0miu/l, subclinical hjpothyroid (SCH) group patients with TSH 6-1 0miu/l. We compared CIMT and hsCRP in 2 groups along with other atherosclerotic risk factors. Results : We found that in the subclinical hypothyroid patients the mean value of total cholesterol (TC)(208.8,84±6.14). LDL-C levels (157.88±33.51), total cholesterol/ LDL cholesterol ratio(5.29±131), LDL cholesterol ratio” HDL cholesterol ratio (3.93±l.25) and plasma hsCRP (2.13±0. 69) levels were higher than the normal values. In hypothyroid patients we found that these values and the CIMT values were statistically signficantly higher than the subclinical hypothyroid patients, in addition diastolic hypertension (95.84±11.06) and higher than normal waist-hip ratio (1.03±0.19) was also seen in hypothyroid group. CIMT and hsCRP also showed positive correlation with other atherosclerotic risk factors. (Waist-hip ratio, diastolic hypertension andLDL cholesterol) Conclusion : Cardiovascular risk factors were increased in sub clinical as well as in clinical hypothyroidism so efforts should be made to detect andtreat hypothyroidism at an early stage by aggressive casefinding in high risk population.