July - September 2023, Volume 19, Issue 3

Demirhan S, Polat O, Mert M

The Relationship between TSH Levels, Thyroid Autoantibodies and Atherogenic Index of Plasma, AST to Platelet Ratio Index Score, and Fibrosis 4 Index in Patients with Hypothyroidism

Acta Endo (Buc) 2023, 19 (3): 333-338
doi: 10.4183/aeb.2023

Context. Thyroid hormones have metabolic effects such as relationship between hypothyroidism and atherosclerosis. Objective. Evaluate the effects of hypothyroidism on Non-Alcoholic Fatty Liver Disease and atherosclerosis by using AIP, APRI score, FIB-4 indices. Material and Methods. 1370 patients with hypothyroidism who applied to the Endocrinology and Metabolism outpatient clinic between 01.01.2017-30.12.2021 were included the study. Pregnants, patients with a history of thyroid carcinoma, cardiovascular and liver diseases were excluded. TSH, fT4, Anti TPO, Anti TG, thrombocyte, ALT, AST, HDL, Triglyceride values of the cases were analyzed and atherogenic index of plasma (AIP), AST to Platelet Ratio Index (APRI) and Fibrosis-4 (FIB-4) indices were calculated. Results. 1170 (85.4%) of the cases were female.The age of those who had high risk of AIP was found to be higher than those with low and moderate risk (p=0.001; p=0.003; p<0.01). The ages of those who had low-risk FIB-4 Index were found to be lower than those with moderate risk and high risk (p=0.001; p=0.001; p<0.01). A positive relationship was detected between APRI and FIB-4 (r=0.681; p=0.001; p<0.01).AIP increased as TSH increased in hypothyroid patients. No significant correlations were detected between TSH, APRI, and the FIB-4 Index. No significant differences were detected between AIP, APRI, FIB-4, and thyroid autoantibodies. Conclusion. In hypothyroid patients, the AIP index increased with age and the increase in TSH. A strong relationship was detected between AIP and TSH . For this reason, we think that keeping TSH within the normal range with regular follow-ups and treatment in patients with hypothyroidism will reduce the risk of atherosclerosis.

Keywords: Hypothyroidism, AIP, NAFLD, APRI Score, FIB-4 Index, Autoimmunity.

Correspondence: Ozlem Polat MD, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Family Medicine, Post code: 31147, Bakirkoy, Istanbul, Turkey, E-mail: drozlems@hotmail.com