Asian Pacifc Journal of Cancer Prevention, Vol 13, 2012 2335 DOI:http://dx.doi.org/10.7314/APJCP.2012.13.5.2335 Metabolic Changes and Cardiovascular Risk with Thyroid Carcinoma in Nepal Asian Pacifc J Cancer Prev, 13, 2335-2338 Introduction Thyroid carcinoma is a general endocrine malignancy worldwide second just to ovarian cancer. It is the seventh most frequent cancer affecting women, accounting for just about 1% of the entire diagnosed cancers and about 91.5% of the malignancies of head and neck. Increased incidence of thyroid cancer will augment the morbidity and mortality due to its associated metabolic changes and risk factors (Moore et al., 2010). Differentiated thyroid cancer (DTC) accounts for 98% of thyroid cancer, with neoplasm arise from the follicular and parafollicular cells (Kebebew & Clark, 2000). Twenty thousand new cases are diagnosed per year in the United States (Rossing et al., 2000). Prevalence rates of thyroid cancers in women were greater than in men due to hormonal and reproductive factors with a male to female ratio of 1:3 (Akbari et al., 2011). There is no trustworthy information about the occurrence or prototype of thyroid cancer and associated risk factors in Nepal and consequently an effort was made to appraise the situation based on hospital data which is the single source in the western province of Nepal (Binu 1 Department of Biochemistry, 2 Department of Community Medicine, Nepalese Army Institute of Health Sciences, Kathmandu, Manipal College of Medical Sciences, Pokhara, Nepal *For correspondence: drmittala@gmail.com Abstract Objective: To evaluate several metabolic changes in patients with differentiated thyroid carcinoma (DTC ) which enhance cardiovascular risk in the western region of Nepal. Materials and Methods: This hospital based case control study was carried out using data retrieved from the register maintained in the Department of Biochemistry of the Manipal Teaching Hospital, Pokhara, Nepal between 1 st January, 2009 and 31 st December, 2011. The variables collected were age, gender, BMI, glucose, insulin, HbA1C, CRP, fbrinogen, total cholesterol, triglycerides, HDL, LDL, VLDL, f-T3, f-T4, TSH. One way ANOVA was used to examine statistical signifcance of differences between groups, along with the Post Hoc test LSD for comparison of means. Results: fT3 values were markedly raised in DTC cases (5.7±SD1.4) when compared to controls (2.2±SD0.9). Similarly, fT4 values were also moderately raised in cases of DTC (4.9±SD1.3 and 1.7 ±SD0.9). In contrast, TSH values were lowered in DTC cases (0.39±SD0.4) when compared to controls (4.2 ±SD 1.4). Mean blood glucose levels were decreased while insulin was increased and HDL reduced (39.5±SD4.7 as compared to the control 43.1±SD2.2). Conclusion: Cardiovascular risk may be aggravated by insulin resistance, a hypercoagulable state, and an atherogenic lipid profle in patients with differentiated thyroid cancer. Keywords: Cardiovascular risk - differentiated thyroid carcinoma - Nepal RESEARCH COMMUNICATION Metabolic Changes Enhance the Cardiovascular Risk with Differentiated Thyroid Carcinoma - A Case Control Study from Manipal Teaching Hospital of Nepal Ankush Mittal 1 *, Bibek Poudel 1 , Dipendra Raj Pandeya 1 , Satrudhan Pd Gupta 1 , Brijesh Sathian 2 , Shambhu Kumar Yadav 1 et al., 2007). A crucial factor in the outcome of cancer patients is co-morbidity. The co-morbidity has an effect on the appearance and identifcation of symptoms, and may have extrapolative signifcance. The foremost metabolic disparity takes place in lipid metabolism especially in the papillary thyroid carcinoma (Yao et al., 2011). Even modest distorted thyroid status purportedly impinges on serum cholesterol levels, glucose, insulin levels, and ventricular function. In Differentiated thyroid carcinoma (DTC), vague raise in fT4, fT3 levels can persuade an enhancement in insulin secretion and a decline in HDL- cholesterol levels, which are adverse developments. In addition, the momentous converse correlation among fbrinogen and suppressed TSH levels, show the way to increase in cytokines, fbrinogen and the endothelial release of von Willebrand factor, seems to document a greater cardiovascular threat in DTC patients. All the variations in biochemical parameters and hemodynamic system in differentiated thyroid carcinoma enhance the cardiovascular risk (Bauer et al., 2007). Our aim was to evaluate several metabolic changes in patients of DTC which enhances cardiovascular risk in western region of Nepal.