Correlation Between Insulin Resistance and Homocysteine in Hypothyroid Patients

Abstract

Background: Hypothyroidism has been associated with disorders of glucose and insulin metabolism involving defective insulin secretion in response to glucose, hyperinsulinemia, altered peripheral glucose disposal and insulin resistance. Assessment of insulin resistance and homocysteine may help identifying subjects at high risk of Cardiovascular Disease (CVD). Aim and Objectives: The present study was designed to assess the susceptibility of hypothyroid patients to CVD by determining the relationship between Homocysteine (HCY) and Insulin Resistance (IR). Material and Methods: One hundred patients of hypothyroidism in the age group of 18-45 years was included in this cross sectional study. Homocysteine and insulin was estimated by ELISA method. Homeostasis Model of Assessment (HOMA) which is an index for IR was used to measure insulin resistance. Results: In the present study hypothyroid patients had several fold increase in insulin levels demonstrating IR by increased HOMA index and also increased homocysteine levels which may play an important role in pathogenesis of complications of thyroid hormone. In our study there was significant positive correlation between TSH and serum insulin values r = 0.447 and also homocysteine r = 0.302. We also found positive correlation between IR and homocysteine in hypothyroid patients with r = 0.295. Conclusion: Therefore to conclude our study emphasised the importance of TSH that is positively correlated with IR and homocysteine independent of thyroid hormones. Homocysteine and IR both are associated with endothelial dysfunction and are common mediators in the pathogenesis of accelerated atherosclerosis and cardiovascular complications.

Keywords

• Cardiovascular diseases
• Homocysteine
• Insulin resistance