Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

Users Online : 47215

AbstractMaterial and MethodsResultsDiscussionAcknowledgementReferencesDOI and Others
Article in PDF How to Cite Citation Manager Readers' Comments (0) Audio Visual Article Statistics Link to PUBMED Print this Article Send to a Friend
Advertisers Access Statistics Resources

Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"

Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018

Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."

Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018

Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."

Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018

Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."

Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
On Sep 2018

Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."

Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata

Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
On Aug 2018

Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".

Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".

Dr. Mamta Gupta
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018

Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.

Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."

Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
On May 11,2011

Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."

Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
On April 2011

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.

Dr. Anuradha
On Jan 2020

Important Notice

Original article / research
Year : 2011 | Month : November | Volume : 5 | Issue : 7 | Page : 1347 - 1351 Full Version

Thyroid Hormone And Its Correlation With Age, Sex And Serum Lipid Levels In Hypothyroid And Euthyroid Sylheti Populations In Bangladesh

Published: November 1, 2011 | DOI:
Shakhinur Islam Mondal, Sudipta Arka Das, Arzuba Akter, Rakibul Hasan, Saimon Ahmad Talukdar, Md Salman Reza

1. MS, Genetic Engineering & Biotechnology Department, Shahjalal University of Science & Technology, Sylhet 3114, Bangladesh 2. BSc (HONS), Biochemistry and Molecular Biology Department, Dhaka University, Bangladesh 3. MS, Biochemistry and Molecular Biology Department, Shahjalal University of Science & Technology, Sylhet 3114, Bangladesh 4. MS, Genetic Engineering & Biotechnology Department, Shahjalal University of Science & Technology, Sylhet 3114, Bangladesh 5. MS, Genetic Engineering & Biotechnology Department, Shahjalal University of Science & Technology, Sylhet 3114, Bangladesh 6. MS, Genetic Engineering & Biotechnology Department, Shahjalal University of Science & Technology, Sylhet 3114, Bangladesh

Correspondence Address :
Shakhinur Islam Mondal
Assistant Professor, Genetic Engineering & Biotechnology
Department, Shahjalal University of Science & Technology, Sylhet
3114, Bangladesh
E-mail :
Telephone : +880-821-713491 (Ext-411)
Fax : +880-821-725050


Background: Hypothyroidism is defined as a deficiency of the thyroid hormone and an increase in the thyroid stimulating hormone (TSH) levels in patients, which has been associated with elevated levels of serum cholesterol in some populations. Sylhet has been described as the one of the wealthiest cities in Bangladesh and its population leads a life of relative luxury than in most other parts of the country. Lifestyle plays an important role in obesity, lipid profile, and thyroid profile related diseases, but no data are available regarding the thyroid status and the lipid profile in this Sylheti population. The aim of the present study was to assess whether hypothyroidism which was associated with abnormal lipid levels in the population of Sylhet, Bangladesh.

Materials and Methods: The data from adults older than 25 years, who did not previously have a diagnosis of hypothyroidism or those who were not taking thyroid replacement medication, were analyzed at the Women’s Medical College and Hospital, Sylhet. Thyroid stimulating hormone (TSH), thyroxine (T4), serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL) and triglyceride (TG) levels were measured.

Results: In this study, it was found that hypothyroidism was more common in women (p=0.039) and in the advanced age group (p=0.038). The persons who met the criteria for hypothyroidism had higher mean cholesterol levels (209.89 vs. 191.49 mg/dl, p=0.038) and higher rates of elevated cholesterol levels (60.5% vs. 40.4%, p=0.024) than the euthyroid control group, but there were no significant differences in their LDL or HDL levels. The mean TG levels (186.04 vs. 231.47 mg/dl, p=0.013) and the rates of the elevated TG levels (50.6% vs. 68.4%) were higher in the hypothyroid group.

Conclusion: Hypothyroidism appears to be associated with abnormalities in the serum cholesterol or triglyceride levels in the Sylheti population. There might be a potential link between hypothyroidism and cardiovascular diseases such as


Thyroid stimulating hormone, Hypothyroidism, Euthyroidism, Atherosclerosis

The thyroid is one of the largest endocrine glands of the body. The process of thyroid hormone synthesis begins in the hypothalamus. The hypothalamus releases the thyrotropin releasing hormone (TRH). The TRH travels through the bloodstream to the pituitary gland. The pituitary gland then releases the thyroid-stimulating hormone (TSH) into the blood. The TSH stimulates the thyroid gland to produce the two main thyroid hormones, thyroxine (T4) and triiodothyronine (T3).

It is well known that alterations in the thyroid function can result in changes in the composition and in the transport of lipoproteins (1). Specifically, the thyroid hormone stimulates the hepatic de novo cholesterol synthesis by inducing the HMG-CoA reductase that catalyzes the conversion of HMG-CoA to Mevalonate, which is the first step in the biosynthesis of cholesterol (2). This results in an enhanced intracellular cholesterol concentration in hyperthyroidism and a decreased one in hypothyroidism. Additionally, thyroid hormones activate the LDL receptors. The promoter of the LDL receptor gene contains a thyroid hormone responsive element (TRE) which allows T3 to upregulate the gene expression of the LDL receptor. Moreover, thyroid hormones stimulate the cholesteryl ester transfer protein (CETP), an enzyme which transports cholesteryl esters from HDL2 to the very low density lipoproteins (VLDL) and triglycerides in the opposite direction. Finally, thyroid hormones stimulate the lipoprotein lipase (LPL) which catabolizesthe triglyceride-rich lipoproteins and the hepatic lipase (HL), which hydrolyzes HDL2 to HDL3 (3).

There is a substantial evidence that overt hypothyroidism alters several of the traditional risk factors for cardiovascular disease. Hypercholesterolaemia in hypothyroidism, characterized by elevated levels of LDL-C and Apo B, is caused by a decreased catabolism of LDL due to a reduction in the number of LDL receptors on the liver cell surfaces (1). Hypothyroidism can also increase cardiovascular risk by causing diastolic hypertension. The potential mechanisms for reversible diastolic and systolic hypertension in hypothyroidism include increases in the peripheral vascular resistance (4) and arterial stiffness (5), respectively.

Studies have shown that 70% of the community in Sylhet relies on the remittance which is sent from relatives abroad and thus, the population leads a relatively luxurious lifestyle than in other parts of the country. However, to the best of our knowledge, no studies have examined whether a relationship exists between thyroid profile and lipid profile in this Sylheti population. The purpose of the present study was to explore the association between the thyroid hormones and the abnormal lipid profile, including that in cardiovascular diseases.

Material and Methods

This study was conducted at the Women’s Medical College and Hospital, Sylhet during December 2009 to May 2010. Samples werecollected from a total of 204 patients, including 38 hypothyroid and 166 euthyroid individuals and control individuals. Out of the 204 patients, 41.2% were males and 58.8% were females. The study was pre-approved by the ethical committee of the institution’s review board.

Exclusion criteria:
Persons having overt hypothyroidism or those taking medications which affected the thyroid function, such as thyroxine and antithyroid drugs and whose age were less than 25 years were excluded.

Sample collection and storage:
Blood samples were collected with a record of age and sex, from all of the subjects who came for the determination of hormones and the lipid profile. About 7-8 ml of peripheral blood was collected from each individual with the help of an expert. After the centrifugation of the collected blood, the serum samples were collected in microcentrifuge tubes and stored at -20Âş C. For long term storage, the serum samples were stored in a -80Âş C freezer. For each sample, the TSH, T4, total cholesterol (TC), TG, HDL and LDL levels were measured.

Thyroid Profile:
TSH and T4 were measured by using a direct ELISA method. TSH levels >4.20 μIU/mol and T4 levels <4.5 μg/dl were considered suggestive of hypothyroid.

Lipid Profile:
TC was measured by an enzymatic endpoint method (cholesterol oxidase/ peroxidase method). TG and HDL were measured by enzymatic colourimetric (GPO-POD) methods. The LDL levels were calculated by using Friedewald’s formula.

Statistical analysis:
The results were expressed as frequency (percentages) and mean ± SD (standard deviation). The data analyses were carried out by using the Statistical Package for Social Sciences (SPSS) (version 16.0 for Windows, SPSS Inc., Chicago, USA). For these two groups, the descriptive statistics were computed and bivariate comparisons by using Chi-square analysis and the F test for mean were made. The differences were considered as significant, with a p value which was < 0.05.


Of the 204 respondents included in the study, 38 (18.6%) were found to fit the criteria for hypothyroidism. The study was conducted on two groups of subjects: the hypothyroid group (n=38) and the euthyroid group (n= 166) (Table/Fig 1).

Data are presented as frequency (percentage) and mean ± SD for parametric value. Pearson Chi-Square-test was performed to analyze data. *p<0.05 is considered significant. n = Number of study population; TC = total cholesterol; TG = triglyceride; HDL = High density lipoprotein; LDL = Low density lipoprotein.

Out of the 38 hypothyroid subjects, 10 (26.3%) were males and 28 (73.7%) were females. On the other hand, out of the 166 euthyroid subjects, 74 (44.6%) subjects were males and 92 (55.4%) were females. There was a significant difference (p=0.039) in sex between these hypothyroid and euthyroid groups. Hypothyroidism was more common in women. In the hypothyroid group, 8 (21.1%),12(31.6%) and 18(47.4%) respondents and in the euthyroid group, 61(36.7%), 60(36.1%) and 45(27.1%) respondents were found to be in the young, middle aged and the elderly groups respectively. There was a significant difference (p=0.038) in age between these hypothyroid and euthyroid groups. Subclinical hypothyroidism was more common in the elderly.

The mean TC and TG levels in the hypothyroid group were significantly higher (191.49±45.95 vs. 209.89±60.38, p= 0.038 and 186.04±92.46 vs. 231.47±130.01, p= 0.013) as compared to those in the euthyroid group and these values were higher than the reference values. The HDL and LDL levels were higher in the hypothyroid group as compared to those in the euthyroid group (36.82±8.75 vs. 38.05±10.94, p=0.457 and 118.95±38.25 vs. 121.72±37.90, p=0.687), but not significantly and these values were within the reference range.

When these variables were dichotomized into high or low based on the hospital guidelines, it was observed that persons with hypothyroid were more likely to have elevated TC levels (60.5% vs. 40.4%, p = 0.024). It was also observed that persons with hypothyroidism were likely to have a significant elevation in their TG levels (68.4% vs. 50.6%; p = 0.047). No statistically significant differences were found between the euthyroid group and the hypothyroid group with respect to the percentage of respondents with HDL levels, or in LDL levels.


Thyroid disorders are known to influence lipid metabolism and are common in dyslipidaemic patients (6). These hormones appear to serve as a general pacemaker, accelerating the metabolic processes and they may also be associated with metabolic syndromes (7).

The serum cholesterol level generally varies inversely with the thyroid activity (8)(9). This condition is more common in the elderly (10)(11)(12). Also, women are more likely than men to develop thyroid disease (13)(14). In this study, the percentage of female subjects in the hypothyroid group was significantly higher than that of the male subjects (Table/Fig 2).

Moreover, the hypothyroid respondents were more commonly found in the elderly group rather than in the young or the middle aged groups (Table/Fig 3). These results corroborated with the findings of other research groups (13)(10)(14)(11)(12).

Serum total cholesterol was significantly increased in the hypothyroid subjects as compared to the euthyroid subjects (Table/Fig 4). Some other studies have also supported this finding (15) (16)(17). Specifically, the thyroid hormone stimulates the hepatic de novo cholesterol synthesis by inducing HMG-CoA reductase that catalyzes the conversion of HMG-Co A to Mevalonate, the first step in the biosynthesis of cholesterol (18).

Despite the reduced activity of HMG-CoA reductase, hypercholesterolaemia in hypothyroidism probably results from the reduced catabolism of lipoproteins, a phenomenon that may be explained by a decreased expression of lipoprotein receptors and LDL cholesterol (19). The magnitude of elevation in the serum cholesterol concentrations is correlated with the degree of hypothyroidism (20). Hypothyroid patients usually exhibit elevated levels of HDL, mainly due to the decreased activity of the cholesterol ester transfer protein (CETP), resulting in reduced transfer of cholesteryl esters from HDL to VLDL, thus increasing the HDL cholesterol levels. Furthermore, the decreased activity of hepatic lipase (HL) leads to the decreased catabolism of HDL2 HDL OR HDL2 Particles (7). In this study, it was found that the levels of LDL and HDL were elevated in the hypothyroid group as compared to those in the euthyroid group (Table/Fig 5). But no significant difference was found between these groups and the values remained within the reference range. This result corroborated the findings of a previous study (10). But other studies found significant elevations in the serum LDL concentrations in hypothyroid subjects (21).

The serum triglyceride levels were also higher in the subjects with hypothyroidism than in the euthyroid subjects [Table/Fig 2c] which concurred with the reports of a previous study (7). These changes were attributable to the decreased activity of lipoprotein lipase (LPL), which resulted in a decreased clearance of triglyceride-rich lipoproteins (18)(19),(20),(21). All these abnormalities resolved as the serum T4 concentration became norma (16). Furthermore, the clearance of the chylomicron remnants was found to be decreased in hypothyroidism (22).

It was also observed that the percentage of the hyperlipidaemia patients was more common in the hypothyroidism group for TC and TG. But no significant relation was found for HDL and LDL (Table/Fig 5).

Hypothyroidism has been generally considered as a cardiovascular risk factor in a majority of studies, mainly because of its association with elevated serum total and LDL cholesterol. Important associationshave been identified for other risk factors for atherosclerosis, including hyperhomocysteinaemia, elevated C-reactive protein (CRP) levels, coagulation abnormalities, endothelial dysfunction, and insulin resistance in individuals with overt hypothyroidism and, in some cases, subclinical hypothyroidism (23).

The present study indicated that hypothyroidism was associated with an abnormal lipid profile, especially with respect to the levels of TC and TG. Hence, persons suffering from hypothyroidism should make lifestyle and dietary adjustments to avoid future cardiovascular complications. A large-scale study is warranted to further validate the findings of the present study.


The authors are grateful to the Women’s Medical College and Hospital for providing the facilities to perform this study. We are grateful to the technologists who are working in the Biochemistry Department of the hospital, for helping with the sample collection. We are also thankful to Professor Susanta Kumar Das and Professor Yasmeen Haque (Department of Physics, Shahjalal University of Science and Technology, Sylhet-3114, Bangladesh) for their valuable discussions which were related to this research.


Duntas LH. Thyroid disease and lipids. Thyroid 2002; 12: 287-93.
Ness GC, Dugan RE, Lakshmanan MR, Nepokroeff CM, Porter JW. Stimulation of hepatic ™-hydroxy-methyl-glutaryl Coenzyme A reductase in hypophysectomized rats by L-triiodothyronine. Proc Natl Acad Sci USA 1973; 70: 3839-42.
Kussi T, Sacrinen P, Nikkila EA. Evidence for the role of hepatic endothelial lipase in the metabolism of plasma high density lipoprotein 2 in man. Atherosclerosis 1980; 36: 589-93.
Graettinger JS, Muenster JJ, Checchia CS, Grisson RL, Campbell JA. A correlation of clinical and haemodynamic studies in patients with [Table/Fig-2d]: Comparisons of four different parameters between hypothyroid and euthyroid groups: sex(a), age groups(b), mean values of lipid profile(c) and clinical range of TC and TG(d). hypothyroidism. J Clin Invest 1958; 9: 502–10.
Obuobie K, Smith J, Evans LM, John R, Davies JS, Lazarus JH. Increased central arterial stiffness in hypothyroidism. J Clin Endocrinol Metab 2002; 87:4662–66.
Navab, Morris MS, Bostom AG. The biochemical basis of the thyroid hormone action in the heart. Am J Med 1995; 88:626–30.
Lam KSL, Chan MK, Yeung RTT. High-density lipoprotein cholesterol, hepatic lipase and lipoprotein lipase activities in thyroid dysfunction – effects of the treatment. Quarterly J Med 1986; 229:513-21.
Bartley JC. Lipid metabolism and its diseases. In: Clinical Biochemistry of Domestic Animals. Editor: Kaneko JJ. 4th edition, Academic Press Inc, New York. USA 1989; 106-141.
Gueorguieva TM, Gueorguiev IP. Serum cholesterol concentration around parturition and in early lactation in dairy cows. RĂ©vue de MĂ©decine VĂ©tĂ©rinaire 1997; 148: 241-44.
Hueston WJ, Pearson WS. Subclinical Hypothyroidism and the Risk of Hypercholesterolemia. Annals of Family Medicine 2004; 2:351-55
Sawin CT, Castelli WP, Hershman JM, McNamara P, Bacharach P. The aging thyroid: thyroid deficiency in the Framingham study. Arch Intern Med 1985; 145:1386-88.
Tunbridge WM, Evered DC, Hall R, Appleton D, Brewis M, Clark F et al. The spectrum of thyroid disease in a community: the Whickham survey. Clin Endocrinol (Oxf) 1977; 7:481-83.
Nicoloff JT, LoPresti JS. Hypothyroidism. In RE Rakel, ET Bope, eds., Conn’s Current Therapy 2007, pp. 766–771. Philadelphia: Saunders Elsevier.
Danese MD, Landenson PW, Meinert CL, Powe NR. Effect of thyroxine therapy on serum lipoproteins in patients with mild thyroid failure: a quantitative review of the literature. J Clin Endocrinol Metab 2000; 85:2993-3001.
Jung CH, Sung KC, Shin HSS, Rhee EJ, Lee WY, Kim BS. Thyroid dysfunction and its correlation with cardiovascular risk factors such as lipid profile, hsCRP, and waist hip ratio in Korea. Korean Internal Medicine 2003; 18: 146-53.
Stone NJ. Secondary causes of hyperlipidemia. Med Clin North Am 1994; 78: 117-141.
O’Brien T, Dinneen SF, O’Brien PC, Palumbo PJ. Hyperlipidemia in patients with primary and secondary hypothyroidism. Mayo Clin Proc 1993; 68:860-866.
Nikkilia EA, Kekki M. Plasma triglyceride metabolism in thyroid disease. J Clin Invest 1972; 51:2103-14.
Thompson GR, Soutar AK, Spengel FA, Jadhav A, Gavigan SJ, Myant NB. Defects of receptor-mediated low density lipoprotein catabolism in homozygous familial hypercholesterolemia and hypothyroidism in vivo. Proc Natl Acad Sci 1981; 78:2591–95.
Dichek HL, Agrawal N, EI Andaloussi N, Qian K. Attenuated corticosterone response to chronic ACTH stimulation in hepatic lipase-deficient mice: evidence for a role for hepatic lipase in adrenal physiology. Am. J. Physiol. Endocrinol. Metab 2006; 290 (5): E908– 15.
Monsourian AR, Ghaemi E, Ahmadi AR, Marjani A, Saifi A. Bakhshandehnosrat S. Serum lipid level alterations in subclinical hypothyroid patients in Gorgan (South East of the Caspian Sea). Journal of Chinese Clinical Medicine 2008; 3(4):206-10.
Weintraub M, Grosskopf I, Trostanesky Y, Charach G, Rubinstein A, Stern N. Thyroxine replacement therapy enhances the clearance of chylomicron remnants in patients with hypothyroidism. J Clin Endocrinol Metab 1999; 84:2532-36.
Papaioannou GI, Lagasse M, Mather JF, Thompson PD. Treating hypothyroidism improves endothelial function. Metabolism 2004; 53: 278–79.

DOI and Others


JCDR is now Monthly and more widely Indexed .
  • Emerging Sources Citation Index (Web of Science, thomsonreuters)
  • Index Copernicus ICV 2017: 134.54
  • Academic Search Complete Database
  • Directory of Open Access Journals (DOAJ)
  • Embase
  • EBSCOhost
  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Google
  • Popline (reproductive health literature)