The effect of nutrition theraphy on the precursors of metabolic syndrome in hyperthryroidic and hypothyroidic patients

ABSTRACT Nazal Bardak Dirikli, The effect of nutrition theraphy on the precursors of metabolic syndrome in hyperthryroidic and hypothyroidic patients, Institute Of Health Sciences, Nutrition and Dietetics Programme, Doctorate Thesis, Ankara, 2015 Frequently clinically occured thyroid disorder is hypothyroidism. This disease occurs when the production and secretion of thyroxine (T4) and triiodothyronine (T3) hormones decreases and cause blood TSH level to increase. In hyperthyroidism the blood levels of T3 and T4 is normal but the thyrothyropine level decreases. Hypothyroidism occurs more frequently in women compared to men and older people compared to adolesents. This study was conducted to determine the medical nutrition thraphy effect on the parameters of metabolic syndrome in hypohyroidic and hyperthyroidic women patients. The study was carried on 120 female ages between 20-64 years old at Nazal Nutrition Center between August 2014 and October 2014. To these selected patients to determine the personal and disease information a questionnarie form is applied. In 3 month period a personal nutrition theraphy was applied. To analyse the nutrition habits of the patients food consumption frequency test, three day food consumption and nutrition habit questionnarie form were applied. The three day food consumption was requested at the beginning, end of the first month, end of the second month and at the end of the study. The anthropometric values were taken, some of the biochemical parametres were analysed and physical activity status were evaluated. The mean age of the patients was 43,36±11,36 years. The ratio of hypothyroidic patients is 84,6% and the ratio of the hyperthyroidic patients is 15.4%. The patients that are taken the theraphy are 78 patient of whom 52 (66.7%) is taken a medicine theraphy, 14 (17.9%) is taken a diet theraphy, 10 (12.8%) is taken both medicine and diet theraphy, 1 (0.8%) is taken physchological theraphy and 1 (0.8%) is taken insülin needle theraphy. Total of patients 69 (57.5%) are using iodised salt, 24 (20%) non-iodised salt, 25 (20.8%) diet salt, 2 (1.7%) rock salt. After treating the patients with nutrition theraphy blood parametric values (total cholesterol, low density lipoprotein, triglyceride) and the antropometric values (body weight, body fat percentage, body muscle weight, waist circumference) are both getting closer to the boundaries. At the beginning of the study the body mass index (BMI) of the hypothyroidic group is 30.44±5.67 kg/m² where as at the end of the study the value is 28.19±5.34 kg/m². In hyperthyroidic group the BMI at the beginning is 24.06±2.73 kg/m² where as at the end of the study the value is 22.69±2.54 kg/m². According to ATP III criterias the metabolic syndrome prevelance in hypothyroidic group is 75.2% where as in hyperthyroidic group thr prevelance is analysed as 15.8%. The correlation between the variables is calculated and a positive correlation is found between the start value of TSH and BMI (r = 0, 292, p< 0, 001), and also a positive correlation between last TSH value and BMI values. (r = 0,223, p<0,05). There is a significant correlation between insülin resistance (HOMA-IR) and the last BMI value. (r = 0,639, p<0, 001). Patients are evaluated for metabolic syndrome and seen that after 12 month of diet theraphy and seen that the related status are decreased, this is because of the decreased level of antropometric and biochemical values. Keywords: Metabolic syndrome, nutrition theraphy, hypothyroidism, hyperthyroidism, insulin resistance This study was approved by Baskent University Institutional Review Board and Ethics Commitee (Project no: KA 14/356) and supported by Baskent University Research Fund.