|LETTER TO EDITOR
|Year : 2016 | Volume
| Issue : 1 | Page : 46-47
Atherogenic index: A potential cardiovascular risk marker in coexisting hypothyroidism and diabetes mellitus at diagnosis
Purvi Purohit, Praveen Sharma
Department of Biochemistry, AIIMS, Jodhpur, Rajasthan, India
|Date of Web Publication||16-Jun-2016|
Assistant Professor, Department of Biochemistry, All India institute of Medical Sciences Jodhpur, Rajasthan
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Purohit P, Sharma P. Atherogenic index: A potential cardiovascular risk marker in coexisting hypothyroidism and diabetes mellitus at diagnosis. J Obes Metab Res 2016;3:46-7
|How to cite this URL:|
Purohit P, Sharma P. Atherogenic index: A potential cardiovascular risk marker in coexisting hypothyroidism and diabetes mellitus at diagnosis. J Obes Metab Res [serial online] 2016 [cited 2019 Jun 27];3:46-7. Available from: http://www.jomrjournal.org/text.asp?2016/3/1/46/184174
Thyroid disorders and diabetes mellitus (DM) coexist with a frequency greater than chance can predict as has been debated in the editorial.  Both disorders are potential causes of dyslipidemia and cardiovascular disease (CVD) risk, as its well-known lipid profile consists of a group of biochemical tests often used in predicting, diagnosing, and treating lipid-related disorders including DM and hypothyroidism leading to atherosclerosis.  Hyperlipidemias are of interest to the physician in the context of risk factors for ischemic heart disease and peripheral vascular disease. A strong association between the risk of coronary artery diseases (CAD), high levels of low-density lipoprotein (LDL) cholesterol, and low levels of high-density lipoprotein cholesterol (HDL-C) has been well established.  Similarly, high levels of triglycerides have been associated with an increased incidence of CAD. A lot of work has been done on the relationship between triglyceride (TG) and HDL-C, and it has been shown that the ratio of TG to HDL-C was a strong predictor of myocardial infarction.  Universally, atherogenic index of plasma (AIP) calculated as log (TG/HDL-C) has been used by some practitioners as a significant predictor of atherosclerosis. 
However, there is scant data on coexisting hypothyroidism and DM at diagnosis in Indian female subjects.  We aimed to evaluate dyslipidemia and atherogenicity of hypothyroid females with and without coexisting DM at diagnosis. We observed that the hypothyroid females (average age: 44.56 years) have raised body mass index, hypertension, and dyslipidemia. On screening these females for DM, 43% of females were newly diagnosed diabetics. On comparison of the atherogenic index of hypothyroid females with healthy controls (average age 44 years), there was a significantly raised atherogenic index in the hypothyroid females. Further, the females with coexisting DM and hypothyroidism at diagnosis had greater atherogenic index as compared to those without coexisting DM. A correlation analysis of the atherogenic index showed a highly significant association with insulin resistance, systolic and diastolic blood pressure in females with coexisting hypothyroidism, and DM, but not in females with only hypothyroidism. Similar reports of association of AI with oxidized LDL in hypothyroidism have been reported earlier;  however, ours is the first report on female hypothyroid patients with and without DM. Besides, the routine CVD risk ratios, i.e., total cholesterol to HDL and apoB to apoA 1 were also significantly raised in the females with coexisting hypothyroidism and DM than in those with only hypothyroidism.
Thus, our results indicate that AIP is better correlated with CVD risk parameters in hypothyroid females with DM than in females with only hypothyroidism. Thus, AI of plasma can be an important parameter for the risk assessment of atherosclerosis in hypothyroid females at diagnosis. We also suggest a regular monitoring of fasting blood sugar in hypothyroid females to screen underlying diabetes.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Vaidya R. Association of thyroid dysfunction and diabetes mellitus: Is the co-existence incidental? J Obes Metab Res 2014;1:83-4.
Brites FD, Bonavita CD, Cloës M, Yael MJ, Fruchart JC, Castro GR, et al. VLDL compositional changes and plasma levels of triglycerides and high density lipoprotein. Clin Chim Acta 1998;269:107-24.
Castelli WP. Cholesterol and lipids in the risk of coronary artery disease - The Framingham heart study. Can J Cardiol 1988;4 Suppl A:5A-10A.
Gaziano JM, Hennekens CH, O'Donnell CJ, Breslow JL, Buring JE. Fasting triglycerides, high-density lipoprotein, and risk of myocardial infarction. Circulation 1997;96:2520-5.
Purohit P, Sharma P. Metabolic syndrome in hypothyroidism leading to type 2 diabetes mellitus: A cross-sectional study of Western Rajasthan. J Obes Metab Res 2014;1:105-11.
Saini V, Singh K, Kataria M, Yadav A, Singh R. Atherogenic index of plasma and oxidised LDL in overt hypothyroidism in North Indian female population. Biochem Anal Biochem 2013;2:141.