Evaluation of mineral status in hypothyroidism in a tertiary care centre
DOI:
https://doi.org/10.18203/2320-6012.ijrms20200254Keywords:
Hypothyroidism, Magnesium, Serum calcium, Thyroid stimulating hormone, ZincAbstract
Background: Hypothyroidism is known to be the commonest form of endocrine disorders and has been linked with disturbances in various minerals metabolism. Calcium, phosphorus and magnesium and trace element zinc are required for many enzymes in various metabolic pathways which are directly or indirectly regulated by thyroid hormones. Aim and objectives of the study was to estimate serum zinc, calcium, magnesium and phosphorus in hypothyroid patients, with the objectives to evaluate any relationship with TSH and to compare them with euthyroid controls.
Methods: The analytical cross-sectional study included 50 hypothyroid subjects with TSH levels >4.5 mcg IU/mL and 50 euthyroid subjects of 20-50 years in RMCH, Bareilly. TSH was estimated by ECLIA, serum calcium and phosphorus were estimated by autoanalyzer and serum zinc & magnesium by the kit method using semi autoanalyzer. All the biochemical parameters were expressed as median with Interquartile Range (IQR). Mann-Whitney test was applied to compare the parameters of cases and control. Spearman’s rank correlation coefficient 2-tailed was used to correlate the parameters among the cases.
Results: A significantly decreased level of serum calcium and increased level of serum magnesium and phosphorus were observed in hypothyroid cases. A significant negative correlation between TSH and serum calcium while a significant positive correlation of serum magnesium and phosphorus with TSH was observed.
Conclusions: The indexed study indicates the significant effect of overt or subclinical hypothyroidism over the mineral status of the body which may have inconsistent effect over the various metabolism and enzymes and thereby clinical manifestations.
References
Tapiero H, Tew KD. Trace elements in human physiology and pathology: zinc and metallothioneins. Biomed Pharma. 2003 Nov 1;57(9):399-411.
Unnikrishnan AG, Menon UV. Thyroid disorders in India: An epidemiological perspective. Ind J Endocrinol Metab. 2011 Jul;15(2):S78.
Unnikrishnan AG, Kalra S, Sahay RK, Bantwal G, John M, Tewari N. Prevalence of hypothyroidism in adults: An epidemiological study in eight cities of India. Ind J Endocrinol Metab. 2013 Jul;17(4):647.
Huerta MG, Roemmich JN, Kington ML, Bovbjerg VE, Weltman AL, Holmes VF, et al. Magnesium deficiency is associated with insulin resistance in obese children. Diab Care. 2005 May 1;28(5):1175-81.
Al-Hakeim HK. Serum levels of lipids, calcium and magnesium in women with hypothyroidism and cardiovascular diseases. J Lab Phys. 2009 Jul;1(2):49.
Ertek S, Cicero AF, Caglar O, Erdogan G. Relationship between serum zinc levels, thyroid hormones and thyroid volume following successful iodine supplementation. Hormones. 2010 Jul 1;9(3):263-8.
Mariani LH, Berns JS. The renal manifestations of thyroid disease. J Am Soci Nephrol. 2012 Jan 1;23(1):22-6.
Feigerlova E, Klein M, Angelousi A, Groza L, Leheup B, Weryha G. Thyroid Disorders and Bone Mineral Homeostasis. Thyroid Hormone. Tech, Open Access. 2012 Jul 18:251-76.
McCaffrey C, Quamme GA. Effects of thyroid status on renal calcium and magnesium handling. Canad J Compara Med. 1984 Jan;48(1):51.
Kavitha MM, Pujar S, Hiremath CS. Shankar Prasad, Mahanthesh Evaluation of serum electrolytes in hypothyroid patients. Med Pulse-Inter Med J August. 2014;1(8):393-5.
Gohel MG, Shah AM, Makadia JS. A study of serum calcium, magnesium and phosphorous level in hypothyroidism patients. Inter J Med Health Sci. 2014;3(4):308-12.
Sridevi D, Dambal AA, Sidrah AS, Padaki SK. A study of serum magnesium, calcium and phosphorus in hypothyroidism. Age (Years). 2016;35(8.85):35-68.
Shivaleela MB, Poornima RT, Jayaprakash Murthy DS. Serum calcium and phosphorus levels in thyroid dysfunction. Ind J Funda Applied Life Sci. 2012;2(2):179-83.
Murgod R, Soans G. Changes in electrolyte and lipid profile in hypothyroidism. InterJ Life Sci Pharma Res. 2012 Jul;2(3):185-94.
Bharti A, Shrestha S, Rai R, Singh MK. Assessment of serum minerals and electrolytes in thyroid patients. Inter J Advan Sci Res. 2015;1(06):259-63.
Kumar V, Prasad R. Molecular basis of renal handling of calcium in response to thyroid hormone status of rat. Biochimica Biophysica Acta (BBA)-Mol Basis Dis. 2002 Apr 24;1586(3):331-43.
Abbas MM, Mahmoud AH, El-Desouky W. Biochemical changes in serum lipid fractions, calcium, magnesium and phosphorus levels in women with subclinical hypothyroidism. Nature Sci. 2013;11(5):113-8.
Schwarz C, Leichtle AB, Arampatzis S, Fiedler GM, Zimmermann H, Exadaktylos AK, et al. Thyroid function and serum electrolytes: does an association really exist?. Swiss Med Weekly. 2012 Sep 17;142(3738).
Suneel B, Nagendra DR, Aparna RR, Balakrishna D, Naidu JN. Mineral Status in Thyroid Disorder (Hypo and Hyper). Int J Appl Biol Pharm. 2011;2(4):423-9.
Bouillon R, De Moor P. Parathyroid function in patients with hyper-or hypothyroidism. J Clin Endocrinol Metab. 1974 Jun 1;38(6):999-1004.
Mamatha BV, Chandrakanth KH, Kashinath RT, Rakshita MN. Assessment of mineral status in subclinical hypothyroidism patients - A case control study. International J Clin Biochem Res. 2019 Jan-Mar;6(1):32-5.
Susanna TY, Sagayaraj A, Shashidhar KN, Gomathi M, Mahesh V. A correlative study of thyroid profile and mineral status in patients with hypothyroidism-a hospital-based case control study. Asian J Pharm Clin Res. 2016;9:292-4.
Kasim Baltaci A, Belviranli M. Serum levels of calcium, selenium, magnesium, phosphorus, chromium, copper and iron–their relation to zinc in rats with induced hypothyroidism. Acta Clin Croatica. 2013 Jun 1;52(2.):151-6.
Baloch S, Memon AR, Hayat AS, Masood N. Evaluation of serum copper and zinc in hypothyroidism patients. J Sci Technol. 2013;3:316-8.
Ertek S, Cicero AF, Caglar O, Erdogan G. Relationship between serum zinc levels, thyroid hormones and thyroid volume following successful iodine supplementation. Hormones. 2010 Jul 1;9(3):263-8.
Bellisola G, Brätter P, Cinque G, Francia G, Galassini S, Gawlik D, et al. The TSH-dependent variation of the essential elements iodine, selenium and zinc within human thyroid tissues. J Trace Elements Med Biol. 1998 Nov 1;12(3):177-82.
Civitareale D, Saiardi A, Falasca P. Purification and characterization of thyroid transcription factor 2. Biochem J. 1994;304:981-85.
Dhawan D, Singh Baweja M, Dani V. Zinc sulphate following the administration of iodine-131 on the regulation of thyroid function, in rats. Hell J Nucl Med. 2007 Oct 16;10(3):167-71.
