A Case Control Study to Evaluate the Levels of Vitamin D, Calcium, Parathyroid Hormone, Phosphate, and Demographic Characteristics of Patients with Hypothyroidism.

Abstract

Background Hypothyroidism is an important thyroid disorder resulted due to an imbalance in thehypothalamus-pituitary-thyroid axis and associated with inadequate secretion of the thyroid stimulating hormones (TSH). Due to increasing prevalence, hypothyroidism has become a public health problem worldwide. A very few studies have evaluated the status of Vitamin D, calcium, phosphate, and parathyroid hormone (PTH) in hypothyroidism. Objectives This study was aimed to evaluate the blood levels of Vitamin D, calcium, phosphate, and parathyroid hormone (PTH) in patients with hypothyroidism and compare with healthy controls.Methods Vitamin D, Ca, Ph, and PTH levels were estimated in the serum samples by Electro-chemiluminescence method using Cobas e411 from Roche Company.Patients with hypothyroidism (n=195) referred to the Endocrine and Diabetes Center lab, Endocrine and Diabetes Center in Nassiriyahfor investigations were recruited in the study. Healthy controls (n=205) were those who came for periodic regular follow-up. Results There were 24 (12.3%) males and 171 (87.7 %) females among the patients.The mean age of the patients was 39.12±12.26 years. There was no statistically significant difference in the age and BMI between the cases and the controls. The serum Vit D and Ca levels were significantly lower in the patients as compared to the controls (p<0.001). However, there was no statistically significant difference in the serum Phosphate levels between the patients and controls (p=0.32). The serum PTH levels, however, was significantly higher in the patients as compared to the controls (p<0.001).There was no significant difference in the gender distribution between the patients and the controls (p=0.87). Occupation, BMI categories (p=0.04), Vitamin D (p<0.001), Calcium (p<0.001), Phosphate (p=0.004), and PTH (p=0.004) status significantly varied between cases and controls. The previously diagnosed patients with a mean duration of disease, 27.83 (minimum=2, maximum=144)monthshad significantly higher levels of Vitamin D (p=0.01), calcium (p=0.003), and phosphate levels (p=0.004) as compared to the newly diagnosed patients. Conclusion Hypothyroidism is associated withhypovitaminosis D, hypocalcemia, and elevated PTH levels.Therefore, patients with hypothyroidism should be regularly evaluated for the levels of Vitamin D, calcium, and PTH for better management of secondary complications in hypothyroidism.