HYPERHOMOCYSTEINEMIA IN PATIENTS WITH HYPOTHYROIDISM

Abstract

Objective: To determine the frequency of hyperhomocysteinemia in patients with hypothyroidism. Methods: A cross-sectional study was carried out in six months duration (September 15, 2024 to March 14, 2025) at the Department of Medicine, Bilawal Medical College (BMC) Hospital. A total of 138 patients between the ages of 20 and 60 years old who had a diagnosis of hypothyroidism (≥6 weeks) with complaints of fatigue, weakness, or dizziness participated in the study. Patients with other endocrinopathies or complicating medical treatments were not included. Hyperhomocysteinemia was defined as serum homocysteine >20 µmol/L. Demographic details, clinical features, and biochemistry were noted. Data were analyzed using SPSS. Univariate analyses were conducted using Chi-square and Fisher’s exact test for categorical variables, p ≤0.05 was considered significant statistically. Results: In 138 patients of hypothyroid, hyperhomocysteinemia was present in 88 (63.77%) cases. There were significant associations between hyperhomo-cysteinemia and sex (p=0.032), residence (p=0.041), hypertension (p=0.019), smoking history (p=0.044), obesity (p = 0.021, hyperlipidemia (P = 0.033), NAFLD (p = 0.025), and vitamin D deficiency (p = 0.015). There was no association between diabetes and low platelet count and they were not identified as either a risk factor or protective factor, but there may be an impact if prevalence is high. The mean levels of TSH, FT₄, FT₃, BMI and homocysteine were indicative of biochemical hypothyroidism and metabolic dysfunction. Conclusion: Hyperhomocysteinemia is a frequent metabolic disturbance in hypothyroid individuals associated significantly with several modifiable risk factors. Regularly screening for serum homocysteine in hypothyroid patients, particularly those with metabolic co-morbidities should be considered, in order to minimize the risk of cardiovascular complications.