Role of Sub Clinical Hypothyroidism in Association with Adiponectin Levels Causing Insulin Resistance in Metabolic Syndrome: A Case Control Study.

INTRODUCTION: Metabolic Syndrome (Met S) is reported to be associated with sub clinical hypothyroidism (SCH). The aim of our study is to evaluate the role of SCH in association with adiponectin levels causing insulin resistance in metabolic syndrome. MATERIALS AND METHOD: We recruited 100 study subjects; out of which 50 were cases of Met S, which were further divided into two groups based on presence and absence of SCH and 50 were healthy controls. Serum insulin, serum T3, T4, TSH were measured by chemiluminisence based immunoassay and serum adiponectin was measured by ELISA. RESULTS: Mean TSH levels were significantly higher in Met S cases as compare to control. Out of 50 cases of Met S, 22 (44 %) had SCH. Mean serum adiponectin were significantly lower in Met S cases as compare to control. On Pearson's correlation analysis, TSH showed significant positive correlation with HOMA-IR and negative correlation with adiponectin levels. Strong association was found on the likelihood of low levels of adiponectin in Met S cases. CONCLUSIONS: Met S cases showed insulin resistance and underlying SCH. SCH in Met S may cause altered adipocytes physiology which is associated with decreased release of insulin sensitising adiponectin which may lead to insulin resistance and future development of type II DM and associated co morbidities. Therefore, Met S cases should be screened for SCH and adiponectin levels thereafter. Also, our recommendation is SCH should be treated appropriately to attenuate insulin resistance and development of type II DM in Met S.