Prevalence of Sub-Clinical and Clinical Patients with Metabolic Syndrome

INTRODUCTION: Metabolic syndrome is a multifactorial disorder associated with development of cardiovascular, neurological, immunological, renal and endocrine disease. Metabolic Syndrome is rapidly becoming the primary cause for morbidity and mortality in the industrialized world surpassing infection, trauma and smoking related disorders. Though spontaneous association of multiple metabolic abnormalities were identified decades ago, Gerald M.Reaven introduced the concept of syndrome X where, impaired insulin action could constitute the common ground for hypertension, dyslipidemia and diabetes mellitus1. However he does not include obesity which was commonly associated with the syndromic condition. AIM OF THE STUDY: 1. To screen patients with DM/ SHT / obesity for features of metabolic syndrome as per NCEP ATP III guidelines. 2. To study prevalence of thyroid dysfunction in patients with metabolic syndrome. 3. To emphasize the need of thyroid function test in patients with metabolic syndrome whether necessary or not. MATERIALS AND METHODS: With the aim of studying the prevalence subclinical hypothyroidism and clinical hypothyroidism in patients with metabolic syndrome as per NCEP ATP-III guidelines in Govt. Stanley Medical College hospital over a period of ten months from January 2008 to October 2008 this study was conducted. METHODOLOGY: The selection of patients for the study was made as follows: •Patients attending hypertension, diabetology and general OPD where screened for components of metabolic syndrome • Those patients who fit into the criteria of MS where screened for thyroid function test. • Other parameters of target organ damage which appears as a complication of metabolic syndrome where screened for creatinine, ECG,ECHO for those with ECG changes, liver functions tests and abdomen ultrasound for those with liver symptoms and CT-scan brain for those with TIA symptoms. OBSERVATIONS: Fifty metabolic syndrome patients attending hypertension clinic, diabetology OP and medicine OP were randomly screened. The same population consist of 25 males and 25 females. These patients were divided into three sub-groups based on the TSH values. TSH 20 mU/l as clinical hypothyroidism. SUMMARY AND CONCLUSION: 50 patients (25 males and 25 females) with metabolic syndrome attending medicine, diabetes and hypertension OPD in Stanley medical college where analysed for thyroid dysfunction. · The prevalence of subclinical hypothyroidism and clinical hypothyroidism were 28% and 6% respectively which is far higher than in general population. · There is slightly higher prevalence of female patient developing thyroid dysfunction than males. · Those patients with subclinical hypothyroidism (raised TSH) had subnormal levels of freeT4. · Thyroid dysfunction causes variations in the lipid profile. Since our study shows significant proportion of patient with metabolic syndrome had thyroid dysfunction and clinical manifestation like hypertension, abnormal lipid profile and obesity coexist in both, it is mandatory to screen thyroid function for patients with metabolic syndrome