Metabolic Changes Enhance the Cardiovascular Risk with Differentiated Thyroid Carcinoma - A Case Control Study from Manipal Teaching Hospital of Nepal

Objective: To evaluate several metabolic changes in patients with differentiated thyroid carcinoma (DTC ) which enhance cardiovascular risk in the western region of Nepal. Materials and Methods: This hospital based case control study was carried out using data retrieved from the register maintained in the Department of Biochemistry of the Manipal Teaching Hospital, Pokhara, Nepal between $1^{st}$ January, 2009 and $31^{st}$ December, 2011. The variables collected were age, gender, BMI, glucose, insulin, HbA1C, CRP, fibrinogen, total cholesterol, triglycerides, HDL, LDL, VLDL, f-T3, f-T4, TSH. One way ANOVA was used to examine statistical significance of differences between groups, along with the Post Hoc test LSD for comparison of means. Results: fT3 values were markedly raised in DTC cases ($5.7{\pm}SD1.4$) when compared to controls ($2.2{\pm}SD0.9$). Similarly, fT4 values were also moderately raised in cases of DTC ($4.9{\pm}SD1.3$ and $1.7{\pm}SD0.9$). In contrast, TSH values were lowered in DTC cases ($0.39{\pm}SD0.4$) when compared to controls ($4.2{\pm}SD1.4$). Mean blood glucose levels were decreased while insulin was increased and HDL reduced ($39.5{\pm}SD4.7$ as compared to the control $43.1{\pm}SD2.2$). Conclusion: Cardiovascular risk may be aggravated by insulin resistance, a hypercoagulable state, and an atherogenic lipid profile in patients with differentiated thyroid cancer.