Hipotiroidi hastalarında epikardiyal yağ doku kalınlığı ve karotis intima-media kalınlığının metabolik parametrelerle ilişkisi
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Tarih
2016
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info:eu-repo/semantics/openAccess
Özet
Giriş ve amaç: Hipotiroidizm; tiroid hormonlarının eksikliği sonucu metabolik proçeslerde yavaşlamayla kendini belli eden bir klinik sendromdur. Aşikar olsun subklinik olsun hipotiroidinin kardiyovasküler sistem üzerine birçok etkisi vardır. Epikardiyal yağ kalınlığı(EYK) ve Karotis intima-media kalınlığının (KIMK) kardiyovasküler hastalıklarla yakın ilişkisi yapılmış çalışmalar ortaya konulmuş ve erken ateroklerozun öngörüsünde bir belirteç olabilecekleri belirtilmiştir. Biz bu çalışmamızda hipotiroidili hastalarda EYK ve KIMK’nı saptamayı ve bunların tiroid hormonları, tiroid otoantikor titreleri ve metabolik parametre ile ilşkisini ortaya koymayı amaçladık. Materyal-metod: Bu çalışmaya 82 primer hipotiroidi tanılı hasta, 37 sağlıklı kontrol gubu olgusu dahil edildi. SKH grubu 8 erkek 42 kadın hasta; AH grubu 4 erkek 28 kadın hasta olmak üzere toplam 82 hipotiroidi idi. Çalışmaya bilinen kalp hastalığı, diyabetes mellitus, obezite (VKİ>30), hipertansiyon(TA>140/90) gibi sitemik hastalığı bulunan olgular dahil edilmedi. Olguların kilo, boy, vücut kitle indeksi, sistolik ve diastolik kan basınçları ölçüldü. TSH, FT3, FT4, antı-TPO, antı-TG, insülin, lipid değerleri, açlık glukozu, çalışıldı. EYK ve KIMK değerleri ölçüldü. EYK ve KIMK için korelasyon analizleri uygulandı. SPSS 18.0 bilgisayar programı kullanılarak çalışmanın istatistiksel değerlendirmesi yapıldı. P<0.05 istatistiksel olarak anlamlı kabul edildi. Bulgular: Yaş ortalamaları SKH grubu, AH grubu ve kontrol grubu için sırası ile 35.3±9.5, 37.4±9.6, 35.6±13.9 yıl olarak ölçüldü. SKH, AH ve KG grubunda erkek/kadın oranı sırası ile 8/42(19%), 4/28(14%), 6/31 (19%) idi. EYK ortalaması SKH, AH ve kontrol grubunda sırası ile 5.49±0.71 mm, 5.05±0.98 mm, 3,62±0,75 mm idi. AH ve SKH grupta KG’na göre EYK artmıştı (sırası ile p<0,001, p<0,001). AH ile SKH grup arasında ise EYK yönüyle anlamlı farklılık yoktu. SKH, AH ve kontrol grubunda KIMK ortalaması sırayla 0,59±0,12mm, 0.58±0.12 mm, 0.43±0.8 mm idi. AH ve SKH grupta KG’na göre KIMK artmıştı (sırası ile p<0,001, p<0,001 ). AH ile SKH grup arasında ise KIMK yönüyle anlamlı farklılık yoktu. SKH, AH ve kontol grupları kendi aralarında karşılaştırıldığında yaş, cinsiyet, VKI, APG, SKB, DKB, LDL, HDL, T-kol, TG açısından anlamlı fark saptanmadı. Korelasyon analizleri yapıldığında EYK ile yaş, antı-TPO, antı-TG ve TSH arasında pozitif; ST3 ve ST4 arasında negatif korelasyon vardı. KIMK ile ile yaş, antı-TPO, antı-TG ve TSH arasında pozitif; ST3 ve ST4 arasında negatif korelasyon saptandı. EYK ile KIMK arasında pozitif korelasyon vardı (p<0.001). Sonuç: EYK ve KIMK ölçümü hem AH hem de SKH hastalarda erken ateroskleroz için faydalı bir belirteç olarak kullanılabilir. Özellikle KIMK değeri artmış SKH hastalarda KVH riskini azalmak için tedavi edilmesi gerekir. Anahtar kelimeler: Hipotiroidi, epikardiyal yağ kalınlığı, karotis intima-media kalınlığı, kardiyovasküler hastalık
Introduction: Hypothyroidism is a clinical syndrome characterized by slowdown in the metabolic processes due to insufficiency of thyroid hormones. Whether overt or subclinical, Hypothyroidism has multiple effects on the cardiovascular system. Epicardial fat tissue (EFT) and and carotis intima-media thickness are closely related to cardiovascular disorders and atherosclerosis. Therefore it is expressed both of these rojections may be a useful marker to estimate early atherosclerosis. İn present study, we aim to detect EFT and CIMT levels in patients with hypothyroidism and to investigate the association of these indicators (EFT and CIMT) with serum thyroid hormones levels, thyroid autoantibody titers and metabolic parameters. Material-method: The study included 50 patients with SCH and 32 patients with overt hypothyroidism (OH) with HT as well as 37 healthy controls.. Patients with systemic diseases such as concurrent heart disease, diabetes mellitus, obesity (BMI>30 ) and hypertension (BP>140/90) were excluded from this study. Patients parameters; weight, height, BMI, systolic and diastolic blood pressure, lipid profile and homone levels such as TSH, FT3, FT4 were measured and recorded. Epicardial fat thickness and carotis intima media thickness were evaluated by echocardiography. Correlation analysis and linear regression analysis were performed for EFT and CIMT. In this study, SPSS 18.0 computer based-statistical program was used for estimation. Findings: Mean EFT was 5.49±0.71 mm, 5.05±0.98 mm and 3,62±0,75 mm in SCH, OH and control groups. EFT of OH and SKH patients were significantly high compared with control subjects (p< 0.001 and p<0.001, respectively). EFT did not differ significantly between the OH and SKH groups. Mean CIMT was 0,59±0,12mm, 0.58±0.12 mm ve 0.43±0.8 mm in SCH, OH and control groups. CIMT of OH and SKH patients were significantly high compared with control subjects (p< 0.001 and p<0.001, respectively). CIMT did not differ significantly between the OH and SKH groups.Age, sex, BMI, FPG, SBP, DBP, LDL, HDL, T-kol and TG levels were not differ significantly between three grups. Correlation analysis showed that EFT was significantly positively correlated with age, thyroid-stimulating hormone, antı-TPO, antı-TG and negatively correlated with free T4, free T3. like association of EFT, CIMT also was significantly positively correlated with age, thyroid-stimulating hormone, antı-TPO, antı-TG and negatively correlated with free T4, free T3. İn addition, there was positively correlation between EFT and CIMT (p<0.001). Result: Epicardial fat thickness and carotis intima-media thickness may be useful indicators of early atherosclerosis in SCH and OH patients with HT. In particular, SCH patients which has increased CIMT value should be treated to reduce risk of atherosclerosis. Keywords: Hypothyroidism, atherosclerosis, epicardial fat thickness, carotis intima-media thickness
Introduction: Hypothyroidism is a clinical syndrome characterized by slowdown in the metabolic processes due to insufficiency of thyroid hormones. Whether overt or subclinical, Hypothyroidism has multiple effects on the cardiovascular system. Epicardial fat tissue (EFT) and and carotis intima-media thickness are closely related to cardiovascular disorders and atherosclerosis. Therefore it is expressed both of these rojections may be a useful marker to estimate early atherosclerosis. İn present study, we aim to detect EFT and CIMT levels in patients with hypothyroidism and to investigate the association of these indicators (EFT and CIMT) with serum thyroid hormones levels, thyroid autoantibody titers and metabolic parameters. Material-method: The study included 50 patients with SCH and 32 patients with overt hypothyroidism (OH) with HT as well as 37 healthy controls.. Patients with systemic diseases such as concurrent heart disease, diabetes mellitus, obesity (BMI>30 ) and hypertension (BP>140/90) were excluded from this study. Patients parameters; weight, height, BMI, systolic and diastolic blood pressure, lipid profile and homone levels such as TSH, FT3, FT4 were measured and recorded. Epicardial fat thickness and carotis intima media thickness were evaluated by echocardiography. Correlation analysis and linear regression analysis were performed for EFT and CIMT. In this study, SPSS 18.0 computer based-statistical program was used for estimation. Findings: Mean EFT was 5.49±0.71 mm, 5.05±0.98 mm and 3,62±0,75 mm in SCH, OH and control groups. EFT of OH and SKH patients were significantly high compared with control subjects (p< 0.001 and p<0.001, respectively). EFT did not differ significantly between the OH and SKH groups. Mean CIMT was 0,59±0,12mm, 0.58±0.12 mm ve 0.43±0.8 mm in SCH, OH and control groups. CIMT of OH and SKH patients were significantly high compared with control subjects (p< 0.001 and p<0.001, respectively). CIMT did not differ significantly between the OH and SKH groups.Age, sex, BMI, FPG, SBP, DBP, LDL, HDL, T-kol and TG levels were not differ significantly between three grups. Correlation analysis showed that EFT was significantly positively correlated with age, thyroid-stimulating hormone, antı-TPO, antı-TG and negatively correlated with free T4, free T3. like association of EFT, CIMT also was significantly positively correlated with age, thyroid-stimulating hormone, antı-TPO, antı-TG and negatively correlated with free T4, free T3. İn addition, there was positively correlation between EFT and CIMT (p<0.001). Result: Epicardial fat thickness and carotis intima-media thickness may be useful indicators of early atherosclerosis in SCH and OH patients with HT. In particular, SCH patients which has increased CIMT value should be treated to reduce risk of atherosclerosis. Keywords: Hypothyroidism, atherosclerosis, epicardial fat thickness, carotis intima-media thickness
Açıklama
Anahtar Kelimeler
Hipotiroidi, Hypothyroidism, Epikardiyal yağ kalınlığı, Epicardial fat thickness, Kardiyovasküler hastalık, Carotis intima-media thickness, Atherosclerosis
