DOI: https://doi.org/10.53350/pjmhs211592890 ORIGINAL ARTICLE 2890 P J M H S Vol. 15, NO.9, SEP 2021 Biochemical Changes in Mild Hypothyroidism and its Affiliation with Dyslipidemia in Pakistan AYESHA ZUBAIR 1 , SABAHAT FATIMA 2 , SALEHA AKRAM NIZAMI 3 , ANAS KHALIL 4 , RABIA SATTAR 5 , BASHIR AHMED SHAHEEN 6 1 Senior Demonstrator, Department of Biochemistry, Islam Medical & Dental College Sialkot 2 Assistant Professor, Department of Biochemistry, Gujranwala Medical College, Gujranwala 3 Senior Demonstrator, Department of Biochemistry, Al Aleem Medical College Ferozpur Road, Lahore 4 Assistant Professor, Department of Biochemistry, Wah Medical College, Wah Cantt 5 Associate Professor, Department of Physiology, Sharif Medical & Dental College, Lahore 6 Assistant Professor, Institute of Biochemistry, Gulab Devi Educational Complex, Lahore Correspondence to Dr. Ayesha Zubair, Email: drayeshazubair@gmail.com Cell: 03361040227 ABSTRACT Background: Primary hypothyroidism is associated with the synthesis, metabolism and lipid abnormalities of thyroid hormones. Individuals with hypothyroidism have been shown to have high low density cholesterol and low high density cholesterol. In individuals with normal thyroid the association is usually observed between total cholesterol and thyroid stimulating hormone. Due to lipid abnormalities one group of experts is of the opinion that individuals with TSH ≤10 mIU/L having features of hypothyroidism should be started with thyroxine medication. Whereas, the other group does not support this idea making the topic controversial. In Pakistan the association between thyroid function and lipid abnormalities have so far not been studied which leaves a room for research at this topic. Aim: To explore the association between mild hypothyroidism and lipid abnormalities in Pakistani population. Methodology: This cross sectional study is carried out at Alfalah Welfare Medical Society, Lahore as part of their medical checkup, all the subjects gave written informed consent. The study was done from January 2021 to July 2021. Results: Thyroid function test of 2312 (85.4%) of the subjects was found to be normal. Subjects with mild hypothyroidism among Group-I were 324 (11.9%) whereas mild hypothyroidism in group-II were 36(1.3%). Triglyceride (3.99±0.80 compared to 3.79±0.70 mmol/L, p˂0.0001), low density lipoprot ein (2.59±0.60 compared to 2.29±0.39mmol/L, p˂0.0001) and high density lipoprotein was (1.10±0.14 compared to 1.14±0.15 mmol/L). Conclusion: In patients with mild hypothyroidism due to deranged lipid profile atherogenesis was observed. In continuation to it low high density lipoproteins were also observed in children and a raised triglyceride and low density lipoprotein in the adult population. On the other hand, in patients with mild hypothyroidism having low TSH levels no such abnormalities were observed. Keywords: Dyslipidemia, Subclinical Hypothyrodism, Thyroid INTRODUCTION The role of thyroid hormone in the synthesis, metabolism and lipid abnormalities is documented with primary hypothyroidism. Studies done previously has shown significant increase in total cholesterol and low density lipoprotein cholesterol in people with reported hypothyroidism. In those individuals with euthyroid there is an association of total cholesterol with thyroid stimulating hormone. A group of experts is of the opinion that individuals with TSH ≤10 mIU/L with clinical features of hypothyroidism should be started with thyroxine medication, the reason is due to lipid abnormalities. However, another group of experts do not support this idea and categorize it a controversial subject. In Pakistan thyroid function and lipid abnormalities have not been documented, even though this population is predisposed to atherogenic lipid profile. This study was undertaken focusing different age groups to ascertain abnormalities in lipid profile in subclinical mild hypothyroidism at different level of thyroid stimulating hormone. MATERIAL AND METHODS This cross sectional study is carried out at Alfalah Welfare Medical Society, Lahore as part of their medical checkup, all the subjects gave written informed consent. The study was done from January 2021 to July 2021. As a part of general health evaluation system this study is a sub component of this health system. Total subjects engaged in the study were 3230, written informed consent was signed by all the participates. Those participants with previous history of diabetes, hypertension, hepatic, renal or thyroid disease were excluded from the study. Remaining participants 2150 were included in the study which were further divided into two major groups based on the age of the individual. Group I included participants below 18 years of age and group II included participants above 18 years of age. Sample of blood was taken for analysis of T3, T4, TSH, lipid profile and antithyroid peroxidase antibodies (TPO). These major groups were further subdivided into subgroups. Subgroup-I Control group with normal thyroid function test. Subgroup-II Normal T4 level, TSH≤10.0 mIU/L. Subgroup-III Normal T4 level, TSHN10 mIU/L. Lipid profile was done on the same blood sample and reference values according to the manufacturer were considered normal, the kit used for analysis was Hitachi 902 fully automated biochemistry analyzer; Roche, Manheim, Germany.