International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - Vol 08 Issue 09, May, 2016

Pages: 48-52

Date of Publication: 12-May-2016


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LEPTIN: A DRIVING FORCE BEHIND THYROID PROBLEMS

Author: Singla Gesu, Bedi GK, Sandhu HS, Vij Chittranjan

Category: Healthcare

Abstract:Introduction: Apart from diabetes mellitus, thyroid dysfunction is one of the most common endocrine disorders encountered in adults, affecting up to 10% of the UK population Leptin is a 16kDa protein hormone that plays a key role in regulating energy intake and energy expenditure, including appetite and metabolism.
Aim: The aim of this study was to estimate thyroid hormones and Serum Leptin levels in patients with thyroid disorders and to find their correlation with each other.
Material and Methods: 50 diagnosed patients of thyroid disorders and 30 healthy controls were recruited in our study. Serum Leptin Levels, Serum T3, T4, TSH levels were estimated in both cases and controls using ELISA method.
Results: There was significant negative correlation between Serum Leptin and Serum T3. There was no significant but negative correlation between Serum Leptin and Serum T4. A very significant positive correlation was seen between Serum TSH and Serum Leptin levels.
Conclusion: Leptin problems are a driving force behind thyroid problems. Leptin triggers the decreased production of thyroid hormones. Improving leptin problems and losing weight will improve thyroid function.

Keywords: Leptin, Thyroid, TSH- Thyroid Stimulating Hormone, T4- Thyroxine, T3- Triiodothyronine

Full Text:

INTRODUCTION
Thyroid dysfunction is one of the most common endocrine disorders encountered in adults. The two most common thyroid diseases are inadequate thyroid function i.e. hypothyroidism and excessive thyroid function i.e. hyperthyroidism. [1] Thyroid hormones are essential for the regulation of important processes involved in thermogenesis, energy consumption and many other metabolic reactions. Leptin, the ob gene product is a peptide hormone, secreted by adipocytes. [2] It circulates at levels proportional to body fat. Leptin enters the central nervous system in proportion to plasma concentration. It controls food intake and energy expenditure by acting on receptors in mediobasal hypothalamus. [3] In human, leptin concentrations are elevated in the obese when compared with lean subjects, and their levels are positively correlated to the degree of obesity. In addition administration of leptin to rats deprived of food corrected many of the neuroendocrine changes (e.g. the decrease in the release of thyroid hormone) that occur as a result of food deprivation. [4] There are three general ways in which alterations of the leptin regulatory loop could lead to obesity. a) Failure to produce leptin as occur in ob/ob mice, would result in obesity b) inappropriately low leptin secretion for a given fat mass c) Obesity could result from relative or absolute insensitivity to leptin at its site of action. [5] Both thyroid hormones and leptin have effects on similar aspects of body homeostasis, but their potential interaction is controversial. [2]

Aims and Objectives
1. To study the serum leptin levels in various disorders of thyroid gland.

2. To evaluate thyroid hormone levels in various disorders of thyroid gland.

3. To study the correlation of serum leptin with thyroid hormones in various disorders of thyroid gland.

MATERIALS AND METHODS
The present study was conducted in Department of Biochemistry at Govt. Medical College, Patiala on 50 diagnosed cases of thyroid disorder referred by Department of Medicine, Rajindra Hospital, Patiala from October, 2011 to May, 2012. For comparison 30 age and gender matched healthy individuals constituted the control group. Patients with history of any drug intake, history of any infection/illness, pregnant females, diabetic patients, cancer including thyroid cancer were excluded from the study. Informed consent of all subjects and detailed history were taken at the beginning of the study. Fasting venous blood samples were collected under all aseptic conditions, and subsequently, Serum Leptin Levels, Serum T3 , T4 , TSH levels were estimated in both cases and controls. Serum Leptin, Serum T3 , T4 , TSH were estimated by ELISA method. ERBA-thyrokit was used for Serum.T3 , T4 and TSH whereas AviBion Human Leptin ELISA Kit [6] was used for Serum Leptin. Although the patients were known cases of thyroid disorders but when their hormonal status was assessed they were divided into 3 categories: euthyroid, hypothyroid and hyperthyroid. Out of the 50 cases, 20 cases were of euthyroidism, 20 cases were of hypothyroidism and 10 cases were of hyperthyroidism.

Statistical Analysis
Statistical analysis was performed using Statistical Package for Social Sciences (SPSS).Means and Standard Deviations (SD) were calculated for all parameters. The independent sample t-test was used to compare the means of different variables in the two groups. In addition, the Pearson correlation coefficient (r) was used for correlation analysis. P value <0.05 was considered significant.

RESULTS
The mean age in the present study was 42.2±15.30 years (Table I). There were 40 females and 10 males and male: female ratio was 1:4(Table II). Although the patients were known cases of thyroid disorders but when their hormonal status was assessed they were divided into 3 categories: euthyroid, hypothyroid and hyperthyroid. Out of the 50 cases, 20 cases were of euthyroidism, 20 cases were of hypothyroidism and 10 cases were of hyperthyroidism (Table IV). Serum T3 , T4 , TSH and Serum Leptin was measured in both study and control group and their correlation was studied with statistical analysis (Table III,V). There was significant negative correlation between Serum Leptin and Serum T3 (Table VI).There was insignificant but negative correlation between Serum Leptin and Serum T4 (Table VI). There was a statistically very significant positive correlation between Serum Leptin and Serum TSH (Table VI). There were total 20 (40%) cases of euthyroidism out of total 50(100%) cases. Among those 20(40%) cases, 12(60%) were having normal leptin levels, 6(30%) cases were having increased leptin levels and 2(10%) cases were having decreased leptin levels. In total 20 (40%) cases of hypothyroidism, 4(20%) were having normal leptin levels, 14(70%) cases were having increased leptin levels and 2(10%) cases were having decreased leptin levels. In total 10 (10%) cases of hyperthyroidism cases, 2(20%) cases were having normal leptin levels and 8(80%) cases were having decreased leptin levels (Table VII).

DISCUSSION
Mean age for the study group was 42.2±15.30years and for control group was 36.07±14.24 years. There was no significant difference in the mean age of patients among the two groups. Yoshida et al observed the mean age of 38.4±1.8 years in his study. [10] Tene Perez et al found the mean age of 35 years in his study. [11] In this study there were 40 females and 10 males and male: female ratio was 1:4. Zimmermann Belsing et al had a similar type of sex distribution among his patients i.e. 2 males and 8 females.[9] In the present study, there was significant (p=0.026) but negative correlation (r=-0.314) between Serum Leptin and Serum T3 . Al-shoumer et al gave significant (p=0.003) negative correlation between Serum Leptin and Serum T3 . [4] Azza M Abdu Allah also reported negative correlation between Serum Leptin and Serum T3 with significant p value (p=0.000). [12]The possible reason for significant p value between Serum Leptin and Serum T3 may be that the T3 induced alternation in adipocyte sensitivity to catecholamines can give rise to altered serum leptin levels (decreased in hyper thyroid patients).[7] There was no significant but negative correlation between Serum Leptin and Serum T4 . A study by Ozata et al supported the present study and gave the negative but insignificant correlation between Serum Leptin and SerumT4 .[13] Hseih et al reported significant negative correlation between Serum Leptin and Serum T4. [14] The reason is that leptin affects thyroid deiodinase activities with activation of T4 to T3 conversion. [8,9] There was positive and very significant correlation between Serum Leptin and Serum TSH levels. Iacobellis et al gave the positive correlation between Serum Leptin and Serum TSH with significant p value (p=0.01). [15] Siemienska et al shows the positive correlation between S. Leptin and S. TSH with significant p value (p<0.01).[16] Azza M. Abdu Allah et al did a similar study and gave positive correlation between Serum Leptin and Serum TSH with significant p value (p<0.01).[12] The reason for significant correlation between Serum Leptin and Serum TSH is because TSH receptors have been identified in adipose tissues and therefore we cannot deny the possibility that TSH might directly regulate leptin gene expression. [7]

CONCLUSION
The present study shows that Serum Leptin levels were raised in most of the hypothyroid patients and decreased in majority of hyperthyroid patients suggesting that leptin triggers the decreased production of thyroid hormones. Leptin problems are a driving force behind thyroid problems. Problems in the leptin are often the primary cause of many hypothyroid symptoms in overweight individuals. There is relationship between leptin and thyroid gland probably via an influence of leptin on negative feedback of thyroid hormones as well as influence on thermogenesis. Improving leptin problems and losing weight will improve thyroid function. But surely a larger study group is required to prove this relationship.

References:

1. Constanti A, Bartke A, Khardori R. The Thyroid Gland. In: Taylor and Francis. Basic Endocrinology for Students of Pharmacy and Allied Health Sciences. Harwood Academic Publishers 4th edn.Singapore: 2005;59-61.

2. Baig M, Karira KA, Ahmed A, Zaidi P, Niaz K, Kamal S. Serum Leptin level in Hyperthyroid Female Patients. Journal of Pakistan Medical Association. 2003;53(5):176-81.

3. Williams KW, Scott MM, Elmquist JK. From observation to experimentation: leptin action in the mediobasal hypothalamus. Am. J. Clin. Nutr. 2009;89(3):985S–990S.

4. Al-Shoumer KA, Vasanthy BA, Makhlouf HA, Al-Zaid MM. Leptin levels in Arabs with primary hyperthyroidism. Ann Saudi Med. 2000;20(2):113-8.

5. Friedman JM and Halaas JL. Leptin and the regulation of body weight in mammals. Nature Macmillan Publishers Ltd 1998;395:766.

6. AviBion Human Leptin ELISA Kit, User Manual. Available at:http://www.anibiotech.fi/anibiotech/pdfs/Orgenium-Leptin_ User Manual Rev1.09.pdf

7. Janson A, Karlsson FA, Micha-Johansson G, Bolme P, Brönnegård M, Marcus C. Effects of stimulatory and inhibitory thyrotropin receptor antibodies on lipolysis in infant adipocytes. J Clin Endocrinol Metab. 1995;80(5):1712-1712.

8. Reinehr T. Obesity and thyroid function. Mol Cell Endocrinol 2010;316:165-171.

9. Zimmermann-Belsing T, Brabant G, Holst JJ, Feldt-Rasmussen U. Circulating leptin and thyroid dysfunction. Eur J Endocrinol. 2003;149(4):257-71.

10. Yoshida T, Momotani N, Hayashi M, Monkawa T, Ito K, Saruta T. Serum leptin concentrations in patients with thyroid disorders. Clin Endocrinol (Oxf). 1998;48(3):299-302.

11. Tene Pérez CE, Revilla-Monsalve MC, Amato D, Escobedo de la Peña J, Galván R, Millán-Guerrero RO. Correlation between serum leptin levels and insulin sensitivity in diffuse toxic goiter. Endocr Res. 2004;30(1):19-27.

12. Azza M. Abdu-Allah, Riham G. Mahfouz, Seham A. Khodeer, Walid A. Shehab-Eldin, Mostafa El Nagar. Study of Resistin and Leptin in patients with Thyroid Dysfunction. Journal of American Science, 2011;7(3):569-76.

13. Ozata M, Ozisik G, Bingol N, Corakci A, Gundogan MA. The effects of thyroid status on plasma leptin levels in women. J Endocrinol Invest. 1998;21(6):337-41.

14. Hsieh CJ, Wang PW, Wang ST, Liu RT, Tung SC, Chien WY et al. Serum leptin concentrations of patients with sequential thyroid function changes. Clin Endocrinol (Oxf) 2002;57(1):29-34.

15. Iacobellis G, Ribaudo MC, Zappaterreno A, Iannucci CV, Leonetti F. Relationship of thyroid function with body mass index, leptin, insulin sensitivity and adiponectin in euthyroid obese women. Clin Endocrinol (Oxf). 2005;62(4):487-91.

16. Siemi?ska L, Wojciechowska C, Kos-Kuda B, Marek B, Kajdaniuk D, Nowak M et al. Serum concentrations of leptin, adiponectin, and interleukin-6 in postmenopausal women with Hashimoto’s thyroiditis. Endokrynol Pol. 2010;61(1):112-6.




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Awards, Research and Publication incentive Schemes by IJCRR

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One article from every issue is selected for the ‘Best Article Award’. Authors of selected ‘Best Article’ are rewarded with a certificate. IJCRR Editorial Board members select one ‘Best Article’ from the published issue based on originality, novelty, social usefulness of the work. The corresponding author of selected ‘Best Article Award’ is communicated and information of award is displayed on IJCRR’s website. Drop a mail to editor@ijcrr.com for more details.

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This award is instituted to encourage women researchers to publish her work in IJCRR. Women researcher, who intends to publish her research work in IJCRR as the first author is eligible to apply for this award. Editorial Board members decide on the selection of women researchers based on the originality, novelty, and social contribution of the research work. The corresponding author of the selected manuscript is communicated and information is displayed on IJCRR’s website. Under this award selected women, the author is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.

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‘Emerging Researcher Award’ is instituted to encourage student researchers to publish their work in IJCRR. Student researchers, who intend to publish their research or review work in IJCRR as the first author are eligible to apply for this award. Editorial Board members decide on the selection of student researchers for the said award based on originality, novelty, and social applicability of the research work. Under this award selected student researcher is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.


Best Article Award

A Study by Badritdinova MN et al. entitled "Peculiarities of a Pain in Patients with Ischemic Heart Disease in the Presence of Individual Combines of the Metabolic Syndrome" is awarded Best Article for Vol 12 issue 24
A Study by Sindhu Priya E S et al. entitled "Neuroprotective activity of Pyrazolone Derivatives Against Paraquat-induced Oxidative Stress and Locomotor Impairment in Drosophila melanogaster" is awarded Best Article for Vol 12 issue 23
A Study by Habiba Suhail et al. entitled "Effect of Majoon Murmakki in Dysmenorrhoea (Usre Tams): A Standard Controlled Clinical Study" is awarded Best Article for Vol 12 issue 22
A Study by Ghaffar UB et al. entitled "Correlation between Height and Foot Length in Saudi Population in Majmaah, Saudi Arabia" is awarded Best Article for Vol 12 issue 21
A Study by Leow Jun Xian and Siti Sarah Binti Maidin entitled "Sleep Well: Mobile Application to Address Sleeping Problems" is awarded Best Article for Vol 12 issue 20
A Study by Avijit Singh et al. entitled "Comparison of Post Operative Clinical Outcomes Between “Made in India” TTK Chitra Mechanical Heart Valve Versus St Jude Mechanical Heart Valve in Valve Replacement Surgery" is awarded Best Article for Vol 12 issue 19
A Study by Sonali Banerjee and Mary Mathews N. entitled "Exploring Quality of Life and Perceived Experiences Among Couples Undergoing Fertility Treatment in Western India: A Mixed Methodology" is awarded Best Article for Vol 12 issue 18
A Study by Jabbar Desai et al. entitled "Prevalence of Obstructive Airway Disease in Patients with Ischemic Heart Disease and Hypertension" is awarded Best Article for Vol 12 issue 17
A Study by Juna Byun et al. entitled "Study on Difference in Coronavirus-19 Related Anxiety between Face-to-face and Non-face-to-face Classes among University Students in South Korea" is awarded Best Article for Vol 12 issue 16
A Study by Sudha Ramachandra & Vinay Chavan entitled "Enhanced-Hybrid-Age Layered Population Structure (E-Hybrid-ALPS): A Genetic Algorithm with Adaptive Crossover for Molecular Docking Studies of Drug Discovery Process" is awarded Best article for Vol 12 issue 15
A Study by Varsha M. Shindhe et al. entitled "A Study on Effect of Smokeless Tobacco on Pulmonary Function Tests in Class IV Workers of USM-KLE (Universiti Sains Malaysia-Karnataka Lingayat Education Society) International Medical Programme, Belagavi" is awarded Best article of Vol 12 issue 14, July 2020
A study by Amruta Choudhary et al. entitled "Family Planning Knowledge, Attitude and Practice Among Women of Reproductive Age from Rural Area of Central India" is awarded Best Article for special issue "Modern Therapeutics Applications"
A study by Raunak Das entitled "Study of Cardiovascular Dysfunctions in Interstitial Lung Diseas epatients by Correlating the Levels of Serum NT PRO BNP and Microalbuminuria (Biomarkers of Cardiovascular Dysfunction) with Echocardiographic, Bronchoscopic and HighResolution Computed Tomography Findings of These ILD Patients" is awarded Best Article of Vol 12 issue 13 
A Study by Kannamani Ramasamy et al. entitled "COVID-19 Situation at Chennai City – Forecasting for the Better Pandemic Management" is awarded best article for  Vol 12 issue 12
A Study by Muhammet Lutfi SELCUK and Fatma COLAKOGLU entitled "Distinction of Gray and White Matter for Some Histological Staining Methods in New Zealand Rabbit's Brain" is awarded best article for  Vol 12 issue 11
A Study by Anamul Haq et al. entitled "Etiology of Abnormal Uterine Bleeding in Adolescents – Emphasis Upon Polycystic Ovarian Syndrome" is awarded best article for  Vol 12 issue 10
A Study by Arpita M. et al entitled "Estimation of Reference Interval of Serum Progesterone During Three Trimesters of Normal Pregnancy in a Tertiary Care Hospital of Kolkata" is awarded best article for  Vol 12 issue 09
A Study by Ilona Gracie De Souza & Pavan Kumar G. entitled "Effect of Releasing Myofascial Chain in Patients with Patellofemoral Pain Syndrome - A Randomized Clinical Trial" is awarded best article for  Vol 12 issue 08
A Study by Virendra Atam et. al. entitled "Clinical Profile and Short - Term Mortality Predictors in Acute Stroke with Emphasis on Stress Hyperglycemia and THRIVE Score : An Observational Study" is awarded best article for  Vol 12 issue 07
A Study by K. Krupashree et. al. entitled "Protective Effects of Picrorhizakurroa Against Fumonisin B1 Induced Hepatotoxicity in Mice" is awarded best article for issue Vol 10 issue 20
A study by Mithun K.P. et al "Larvicidal Activity of Crude Solanum Nigrum Leaf and Berries Extract Against Dengue Vector-Aedesaegypti" is awarded Best Article for Vol 10 issue 14 of IJCRR
A study by Asha Menon "Women in Child Care and Early Education: Truly Nontraditional Work" is awarded Best Article for Vol 10 issue 13
A study by Deep J. M. "Prevalence of Molar-Incisor Hypomineralization in 7-13 Years Old Children of Biratnagar, Nepal: A Cross Sectional Study" is awarded Best Article for Vol 10 issue 11 of IJCRR
A review by Chitra et al to analyse relation between Obesity and Type 2 diabetes is awarded 'Best Article' for Vol 10 issue 10 by IJCRR. 
A study by Karanpreet et al "Pregnancy Induced Hypertension: A Study on Its Multisystem Involvement" is given Best Paper Award for Vol 10 issue 09
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List of Awardees

A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" from Vol 13 issue 06 received Emerging Researcher Award


Awardees of COVID-19 Research

Woman Researcher Award

A Study by Neha Garg et al. entitled "Optimization of the Response to nCOVID-19 Pandemic in Pregnant Women – An Urgent Appeal in Indian Scenario" published in Vol 12 issue 09

A Study by Sana Parveen and Shraddha Jain entitled "Pathophysiologic Enigma of COVID-19 Pandemic with Clinical Correlates" published in Vol 12 issue 13

A Study by Rashmi Jain et al. entitled "Current Consensus Review Article on Drugs and Biologics against nCOVID-19 – A Systematic Review" published in Vol 12 issue 09

Emerging Researcher Award

A Study by Madhan Jeyaraman et al. entitled "Vitamin-D: An Immune Shield Against nCOVID-19" published in Vol 12 issue 09

Study by Dheeraj Kumar Chopra et al. entitled "Lipid-Based Solid Dispersions of Azilsartan Medoxomil with Improved Oral Bioavailability: In Vitro and In Vivo Evaluation" published in Vol 12 issue 19


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