The Concentration of Serum Lipids and Protein Electrophoresis Fractions in Thyroid Disease Patients

  • Kim, Chong-Ho (Department of Clinical Laboratory Science, Wonkwang Health Science University) ;
  • Park, Seung-Taeck (School of Medicine, Wonkwang University) ;
  • Park, Seok-Tae (Department of Laboratory Medicine, Fresbyterian Medical Center) ;
  • Kim, Jong-Ho (Department of Nuclear Medicine, Fresbyterian Medical Center) ;
  • Kang, Young-Tae (Department of Biomedical Laboratory Science, Mokpo Science College)
  • Received : 2010.03.04
  • Accepted : 2010.03.24
  • Published : 2010.03.31

Abstract

We analyzed and compared the concentration of total cholesterol (CHOL), high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol and triglyceride (TG) in serum and the serum protein electrophoresis fractions of thyroid disease patients. In comparison with the average of reference, our data showed that the average concentration of CHOL, LDL cholesterol and TG in hyperthyroidism patients were decreased significantly, but HDL cholesterol was increased significantly. In hypothyroidism patients, CHOL, HDL cholesterol, LDL cholesterol and TG were all increased significantly. In comparison of the concentration of lipids in each patient to reference range, 28.3% of hyperthyroidism patients showed abnormally low level of total cholesterol. In the patients with hypothyroidism, the percentage of patients showed abnormally high level of CHOL, HDL cholesterol, LDL cholesterol and TG were 37.7%, 10%, 68.8% and 49.1%, respectively. In our studies of serum protein electrophoresis, the average of ${\alpha}_2$-globulin and $\gamma$-globulin in hyperthyroidism patients were increased and $\beta$-globulin was decreased significantly. In hypothyroidism patients, the average of $\gamma$-globulin was increased and $\beta$-globulin was decreased significantly. In comparison of protein fractions of each patient to reference range, 38.3% and 50.0% of hyperthyroidism patients showed abnormally high levels of ${\alpha}_2$-globulin and $\gamma$-globulin, but 73.3% of patients showed abnormally low level of $\beta$-globulin. In hypothyroidism patients, 70.4% of patients were abnormally decreased in $\beta$-globulin and 63.9% of patients were abnormally increased in $\gamma$-globulin. These data suggest that the concentrations of CHOL, HDL cholesterol, LDL cholesterol and TG are not critical data for clinical interpretation of hyperthyroidism, but the levels of them are useful for interpretation of hypothyroidism patients. Our results of serum protein electrophoresis suggest that the concentration of serum protein electrophoresis fractions can be useful to understand the thyroid disease.

Keywords

References

  1. Baskin HJ, Cobin RH, Duick DS, Gharib H, GuttIer RB, Kaplan MM, Segal RL. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation of treatment of hyperthyroidism and hypothyroidism. Endocr Pract. 2002. 8: 457-467. https://doi.org/10.4158/1934-2403-8.6.457
  2. Bianco AC, Salvatore D, Gereben B, Berry MJ, Larsen PR. Biochemistry, cellular and molecular biology, and physiological roles of the iodothyronine selenodeiodinases. Endocr Re. 2002. 23 (1): 38-89. https://doi.org/10.1210/er.23.1.38
  3. Burtis CA, Ashwood ER. Tietz textbook of Clinical Chemistry. 2006. pp584-590. W.B. Saunders Company. Philadelpia, USA. Cappola AR, Ladenson PW. Hypothyroidism and atherosclerosis. J Clin Endocrinol Metab. 2003. 88: 2438-2444. https://doi.org/10.1210/jc.2003-030398
  4. Cappola AR, Ladenson PW. Hypothyroidism and atherosclerosis. J Clin Endocrinol Metab. 2003. 88: 2438-2444. https://doi.org/10.1210/jc.2003-030398
  5. Danese MD, Ladenson PW, Meinert CL, Powe NR. Clinical review 115: 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. https://doi.org/10.1210/jc.85.9.2993
  6. Ekholm R, Bjorkman U. Glutathione peroxidase degrades intracellular hydrogen peroxide and thereby inhibits intracellular protein iodination in thyroid epithelium. Endocrinology. 1997. 138 (7): 2871-2878. https://doi.org/10.1210/en.138.7.2871
  7. Fatourechi V. Subclinical hypothyroidism: an update for primary care physicians. Mayo Clin Proc. 2009. 84 (1): 65-71. https://doi.org/10.4065/84.1.65
  8. Fong TL, McHutchison JG, Reynolds TB. Hyperthyroidism and hepatic dysfunction. A case series analysis. J Clin Gastroenterol. 1992. 14: 240-244. https://doi.org/10.1097/00004836-199204000-00010
  9. Gharib H, Tuttle RM, Baskin HJ, Fish LH, Singer PA, McDermott MT. Subclinical thyroid dysfunction: a joint statement on management from the American Association of Clinical Endocrinologists, the American Thyroid Association, and the Endocrine Society. Endocr Pract. 2004. 10 (6): 497-501. https://doi.org/10.4158/EP.10.6.497
  10. Hak AE, Pols HA, Visser TJ, Drexhage HA, Hofman A, Witteman Jc. Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam Study. Ann Intern Med. 2000. 132: 270-278.
  11. Harlan WR, Laszlo J, Bogdonoff MD, Estes EH. Alterations in free fatty acid metabolism in endocrine disorders. Part I: effect of thyroid hormone. J Clin Endocrinol Metab. 1963. 23: 33-40. https://doi.org/10.1210/jcem-23-1-33
  12. Havel RJ, Goldstein JL, Brown MS. Lipoproteins and lipid transport. In: Bondy PK, Rosenberg LE, eds. Metabolic control and disease. 8th ed. Philadelphia: 1980. pp393-494. W.B. Saunders Company. Philadelpia, USA.
  13. Hubner U, Englisch C, Werkmann H, Butz H, Georgs T, Zabransky S, Hermnann W. Continuous age-dependent reference ranges for thyroid hormones in neonates, infants, children and adolescents established using the ADVIA Centaur Analyzer. Clin Chern Lab Med. 2002. 40: 1040-1047. https://doi.org/10.1515/CCLM.2002.182
  14. Jeppsson JO, Laurell CB, Franzen B. Agarose Gel Electrophoresis. Clin Chem. 1979. 25: 629-631.
  15. Kannel WB, Castelli WP, Gordon T, McNamara PM. Serum cholesterol, lipoproteins and the risk of coronary heart disease. Ann Intem Med. 1971. 74: 1-12. https://doi.org/10.7326/0003-4819-74-1-1
  16. Kannel WB, Dawber TR, Friedman GD, Glennon WE, McNamara PM. Risk factors in coronary heart disease. An evaluation of several serum lipids as predictors of coronary heart disease. Ann Intem Med. 1964. 61: 888-99. https://doi.org/10.7326/0003-4819-61-5-888
  17. Keys A. Coronary heart disease-the global picture. Atherosclerosis. 1975. 22: 149-192. https://doi.org/10.1016/0021-9150(75)90001-5
  18. Kvetny J, Heldgaard PE, Bladbjerg EM, Gram J. Subclinical hypothyroidism is associated with a low-grade inflammation, increased triglyceride levels and predicts cardiovascular disease in males below 50 years. Clin Endocrinol (Oxf). 2004. 61: 232-238. https://doi.org/10.1111/j.1365-2265.2004.02088.x
  19. Lewandrowski K. Clinical Chemistry. 2002. pp 552-557. Lippincott Williams and Wilkins. Philadelpia, USA.
  20. Lim VS. Thyroid function in patients with chronic renal failure. Am J Kidney Dis. 2001. 38: 80-84. https://doi.org/10.1053/ajkd.2001.27410
  21. Lo JC, Chertow GM, Go AS, Hsu CY. Increased prevalence of subclinical and clinical hypothyroidism in persons with chronic kidney disease. Kidney Int. 2005. 67: 1047-1052. https://doi.org/10.1111/j.1523-1755.2005.00169.x
  22. Maty EL, Peter AM. Effect of hyperthyroidism and hypothyroidism on lipid and. Biochem J. 1981. 196: 247-255. https://doi.org/10.1042/bj1960247
  23. Oetting A, Yen PM. New insights into thyroid hormone action. Best Pract Res Clin Endocrinol Metab. 2007. 21: 193-208. https://doi.org/10.1016/j.beem.2007.04.004
  24. Sawin CT, Castelli WP, Hershman JM, McNamara P, Bacharach P. The aging thyroid: thyroid deficiency in the Framingham study. Arch Intern Med. 1985. 145: 1386-1388. https://doi.org/10.1001/archinte.145.8.1386
  25. Surks MI, Hollowell JG. Age-specific distribution of serum thyrotropin and antithyroid antibodies in the US population: implications for the prevalence of subclinical hypothyroidism. J Clin Endocrinol Metab. 2007. 92 (12): 4575-4582. https://doi.org/10.1210/jc.2007-1499
  26. Tibbling G. Glycerol turnover in hyperthyroidism. Clin Chim Acta. 1969. 24: 121-130. https://doi.org/10.1016/0009-8981(69)90148-X
  27. Zoccali C, Tripepi G, Cutrupi S, Pizzini P, Mallamaci F. Low triiodothyronine: a new facet of inflammation in endstagerenal disease. J Am Soc Nephrol. 2005. 16: 2789-2795. https://doi.org/10.1681/ASN.2005040356