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 basedcase control study was carried out using data retrieved from the register maintained in the Department ofBiochemistry of the Manipal Teaching Hospital, Pokhara, Nepal between 1st January, 2009 and 31st 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 significanceof differences between groups, along with the Post Hoc test LSD for comparison of means.
Results: fT3 valueswere markedly raised in DTC cases (5.7±SD1.4) when compared to controls (2.2±SD0.9). Similarly, fT4 valueswere also moderately raised in cases of DTC (4.9±SD1.3 and 1.7 ±SD0.9). In contrast, TSH values were loweredin DTC cases (0.39±SD0.4) when compared to controls (4.2 ±SD 1.4). Mean blood glucose levels were decreasedwhile insulin was increased and HDL reduced (39.5±SD4.7 as compared to the control 43.1±SD2.2).
Conclusion:Cardiovascular risk may be aggravated by insulin resistance, a hypercoagulable state, and an atherogenic lipidprofile in patients with differentiated thyroid cancer.