Metabolic Syndrome in Hypothyroidism Leading to Type 2 Diabetes Mellitus: A Cross-sectional Study of Western Rajasthan

Aim: We aimed to diagnose latent diabetic hypothyroid patients presenting with symptoms of metabolic syndrome (MS) based on the Adult Treatment Panel-III (ATP-III) guidelines. Background: Type 2 diabetes mellitus (DM) coexisting with thyroid disorders is difficult to manage. With an ever-increasing incidence of both these disorders and an increasing risk of secondary complications due to their coexistence, newer correlative studies are needed for the early diagnosis of these diseases. Subjects and Methods: The present study was conducted on 100 healthy controls and 150 newly diagnosed hypothyroid patients. The patients were selected based on symptomatology and thyroid function tests. They were then analyzed for body mass index (BMI), blood pressure, fasting blood sugar (FBS), fasting serum insulin, homeostatic model assessment-insulin resistance (HOMA-IR), lipid profile, and apolipoprotein B (apo-B) and apolipoprotein (apo-A 1 ). Statistical Analysis: Analysis was done using the Students t test and Spearman's coefficient of correlation. Results: For hypothyroid patients who presented with raised BMI, diastolic hypertension and dyslipidemia were further investigated for underlying latent diabetes. Of the total hypothyroid patients, 53.3% had raised FBS, 48% had diastolic hypertension, 86.6% had hypertriglyceridemia and 66.67% patients fulfilled three conditions for MS as per the ATP-III guidelines. There was highly significant correlation of serum insulin and HOMA-IR with lipid fractions and cardiovascular disease (CVD) risk ratios (total cholesterol/high-density lipoprotein cholesterol) and apo-B/apo-A 1 in hypothyroid patients. Conclusion: All hypothyroid patients should be closely watched for presence of DM and MS for prevention of atherogenic dyslipidemia, which may lead to CVDs. The estimation of serum insulin, apo-A 1 and apo-B, along with the traditional lipid profile may be useful in such patients.