Abstract:
Diseases of the thyroid are common, affecting some 5% of the population,
predominantly females. The thyroid axis is involved in the regulation of cellular
differentiation and metabolism in virtually all nucleated cells, so that disorders of
thyroid function have diverse manifestation.
The pathophysiology of many thyroid diseases relates to TSH, T3 and T4.
The TSH level is the most sensitive index of thyroid function. Hyperthyroidism
especially as Thyrotoxicosis is the hyper-metabolic condition connected by way of
eminent levels of free thyroxine (fT4), free triiodothyronine (fT3), or both of them.
Hypothyroidism is an ordinary endocrine disorder ensuing from shortage of
thyroid hormone. It is frequently the key progression in which the thyroid glands
fabricate inadequate quantity of thyroid hormone.
As these disorders may severely affect the patients at almost all levels of
physical, mental, metabolic and social conditioning that could be extendable to
even death status. Not only this, but these diseases may become long lasting and
can bring bad impact on socio-economic status of their concerned families as well.
To elucidate some of these major relations, while keeping in view the
various selected demographic details (age, gender and locality etc) of included
patients, this study aims at understanding the relation between thyroid dysfunction
and functioning of certain major organs of human body i.e kidney and liver. It also
aims at studying the influence of thyroid mal function on lipid profile including
total cholesterol, triacylglycerol, LDL-C, HDL-C, VLDL-C.
To execute, the study was ethically permitted by the ethical committee of
Post Graduate Medical Institute (PGMI) Hayatabad Medical Complex Peshawar,
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and was conducted in the Institute of Radioactive Nuclear Medicine (IRNUM)
Peshawar, Pakistan. Blood samples of all included patients were analysed in
Pakistan Medical Research Centre (PMRC), Khyber Medical College Peshawar,
Pakistan.
A total of 600 cases were chosen of 214, 195 and 191 each Euthyroid,
Hypothyroid and Hyperthyroid patients, respectively from the Institute of
Radioactive Nuclear Medicine (IRNUM) Peshawar, Pakistan. A well designed
proforma was used to record patients sample No, name, age, sex, address, clinical
diagnosis etc:
The blood samples of all included patients were collected, followed by
their analysis for required parametric evaluation included with complete lipid
profile, serum creatinine and alanine transaminase in comparison to T3, T4 and
TSH of all respectively assessed patients. During this study, the results obtained
regarding the demographical aspects of the patients revealed that female gender
has categorically significantly high percentage of occurrence of thyroid
abnormality as compared to male (75.8 % vs. 24.2 %). Similarly, it has been
observed that in case of euthyroidism, hyperthyroidism and hypothyroidism, the
comparative number of cases of occurrence between female vs male gender were
162 vs. 52, 158 vs. 37 and 155 vs. 56, respectively.
In consideration to the nature of abnormality of thyroid disorder, it has
been observed that patients of euthyroidism i-e., 214 were more than 191 and 195
for hypothyroidism and hyperthyroidism, respectively. Results regarding locality
distribution of the patients depicted that majority of those belongs to the local
population of Peshawar and Charsadda region. Importantly, the data showed that
significant percentage of patients was from Afghanistan.
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Furthermore, results regarding age distribution of the included subjects
showed that these thyroid disorders mostly exist among age group of 31-40 years,
which may be the most effective age limit for productivity and where the above
mentioned hormonal changes and associated activity become at peak. Results
regarding locality distribution of the patients depicted that majority of those
belongs to local population of Peshawar and Charsadda region.
In consideration to the impact of type of thyroid disorder on the level of
respective parameter of lipid profile, the results revealed that there was reduction
of blood cholesterol level and HDL in patients suffering from hyperthyroidism as
compared to euthyroidism. The Aims and objectives of the study were to evaluate
the prevalence of thyroid dysfunction in male and female subjects of different age
groups and to establish the relation between locality of the considered patients and
thyroid disorder.
The specific objective is to study the association between sub clinical
hypothyroidism and hyper cholesterolaemia, and to determine the link of different
degrees of thyroid dysfsunction with kidney and liver function.
The data were finally imported in SPSS version 20.0 for analysis. The
student’s “t” test is being used to find out the significance between two values, in
various diseased groups. Frequencies, p-value, and other descriptive analysis were
computed to calculate the mean and standard deviation of different parameters.
Coefficient of correlation (r) was also calculated using SPSS version 16.00
as a soft ware statistical package. The correlation value (r-value) was calculated
between two parameters i-e EU, hyper, and hypo with serum Lipid profile, CTN
and serum ALT respectively.