Linear Analysis of Autonomic Activity and Its Correlation with Creatine Kinase-MB in Overt Thyroid Dysfunctions
- 40 Downloads
Autonomic activity may be deranged in thyroid dysfunctions and may lead to cardiovascular morbidity and mortality. Myopathy is a common manifestation in thyroid disorders and may be associated with raised serum creatine kinase (CK). We hypothesized that cardiovascular abnormality in thyroid dysfunction may manifest as raised CK-MB. This study was designed to investigate the correlation of CK and its isoform CK-MB with thyroid profile and linear parameters of heart rate variability (HRV). The study was conducted on 35 hypothyroid and hyperthyroid patients each, and 25 age-matched healthy controls. Autonomic activity was assessed by simple short term 5-min HRV. Biochemical evaluation of serum thyroid profile, CK-NAC and CK-MB were estimated in all the subjects. Our results demonstrated low HRV in hypo- as well as hyperthyroid patients. We observed significantly higher serum CK levels in hypothyroid patients when compared to hyperthyroids and controls. However, no significant differences were observed in CK-MB levels in the three groups. Significant positive correlation of CK with TSH and negative correlation with some HRV parameters (LF power, HF power, total power, SDNN, RMSSD) was observed in hypothyroid patients. Whereas correlation of CK-MB with thyroid profile as well as HRV parameters was non-significant in all the groups. Based on the CK and CK-MB findings and their correlation, we conclude that the cardiovascular changes seen in thyroid dysfunctions may primarily be due to autonomic imbalance without apparent cardiac muscle involvement. Whereas, raised CK levels indicate predominantly skeletal muscle involvement in hypothyroid patients.
KeywordsHeart rate variability Hypothyroidism Hyperthyroidism Creatine kinase Correlation
Compliance with Ethical standards
The study was commenced after obtaining ethical clearance from the Institutional Ethics Committee and has followed all Ethical standards.
Conflict of interest
All the authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 8.Tietz NW. Text book of clinical chemistry. Philadelphia: WB Saunders Co.; 1986. p. 678–86.Google Scholar
- 11.Tietz NW. Clinical Guide to laboratory tests. Philadelphia: WB Saunders Co; 1995. p. 95.Google Scholar
- 14.Syamsunder AN, Pal P, Pal GK, Kamalanathan CS, Parija SC, Nanda N, et al. Decreased baroreflex sensitivity is linked to the atherogenic index, retrograde inflammation, and oxidative stress in subclinical hypothyroidism. Endocr Res. 2017;42:49–58. doi: 10.1080/07435800.2016.1181648.CrossRefPubMedGoogle Scholar
- 16.Xing H, Shen Y, Chen H, Wang Y, Shen W. Heart rate variability and its response to thyroxine replacement therapy in patients with hypothyroidism. Chin Med J (Engl). 2001;114:906–8.Google Scholar
- 18.Mushtaq S, Tilak M, Rashid MR, Shinde S, Phalak P. Biochemical evaluation of myopathy in patients of hypothyroidism. Indian J Basic Appl Med Res. 2014;3:364–72.Google Scholar
- 21.Prakash A, Lal AK, Negi KS. Serum creatine kinase activity in thyroid disorders. JK Sci. 2007;9:25–6.Google Scholar