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Balamurugan V, Maradi R, Joshi V, Shenoy BV, Goud MB. Dyslipidaemia and inflammatory markers as the risk predictors for cardiovascular disease in newly diagnosed premenopausal hypothyroid women. J Med Biochem 2023; 42:58-66. [PMID: 36819139 PMCID: PMC9920932 DOI: 10.5937/jomb0-37007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 07/01/2022] [Indexed: 11/02/2022] Open
Abstract
Background Hypothyroidism can predispose systolic and diastolic cardiac dysfunction, increased peripheral vascular resistance, endothelial dysfunction, altered coagulopathy, and dyslipidemia resulting in atherosclerosis. Thyroid hormones can influence homocysteine metabolism by regulating the methylenetetrahydrofolate reductase (M THR). So, this study aimed to compare the markers homocysteine, high sensitive C-reactive protein (hs-CRP), and Atherogenic Indices (AI) between newly diagnosed hypothyroid and euthyroid premenopausal women. Methods 80 Female patients between 20 and 45 years were enrolled in this study and were equally divided into cases and controls group. Laboratory tests included: i) Serum T3, T4, TSH was measured using electrochemiluminescence, ii) lipid profile, homocysteine, and hs-CRP were measured for all the participants. Atherogenic indices: Castelli risk indices I&II, Atherogenic coefficient (AEC), and Atherogenic Index of Plasma (AIP) were calculated using formulas. A comparison between the study groups was made by using the Independent t-test and Mann-Whitney U test. p-value < 0.05 was considered significant. Results The hypothyroid group had significantly higher levels of homocysteine (p= 0.014), and hs-CRP (hs-CRP> 3.0 mg/L, 70% of participants have intermediate to high risk for a cardiovascular event) and elevated BMI compared to participants in the euthyroid group. Atherogenic indices (p< 0.001) was significantly increased in the hypothyroid participants' group. TC, TG , and LDL were significantly elevated in the hypothyroid group but did not show any association with systolic and diastolic blood pressure. Conclusions Premenopausal women with hypothyroidism have a greater predisposition for cardiovascular disease compared to euthyroid.
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Affiliation(s)
- Vaideki Balamurugan
- Manipal Academy of Higher Education, Kasturba Medical College, Manipal, India
| | - Ravindra Maradi
- Manipal Academy of Higher Education, Kasturba Medical College, Manipal, India
| | - Vivek Joshi
- Drexel University College of Medicine, Wyomissing, PA, USA
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Zhou L, Song K, Luo W. Association between circulating resistin levels and thyroid dysfunction: A systematic review and meta-analysis. Front Endocrinol (Lausanne) 2023; 13:1071922. [PMID: 36686437 PMCID: PMC9845899 DOI: 10.3389/fendo.2022.1071922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/12/2022] [Indexed: 01/05/2023] Open
Abstract
Background As a product of adipose tissue, resistin exceeds other adipokines in its role in regulating appetite, energy expenditure, insulin sensitivity, inflammation, and immunity, similar to thyroid hormones. This study aimed to evaluate the association between resistin levels and thyroid dysfunction and to explore variations in circulating resistin levels before and after treatment for thyroid dysfunction. Methods This study was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. A comprehensive search of PubMed, Embase, and Cochrane databases was conducted until June 15, 2022, with no start date restriction, according to the preregistered protocol (PROSPERO-CRD42022336617). RevMan version 5.4 and R software package version 4.2.0 were used for statistical analyses. Results Fourteen studies with 1716 participants were included in this study. The findings of the meta-analysis confirmed that the resistin levels of patients with thyroid dysfunction were significantly higher than those of the euthyroid function control group (mean difference [MD] = 2.11, 95% confidence interval [CI] = 1.11-3.11, P < 0.00001). Furthermore, the resistin levels of patients with hyperthyroidism (MD = 3.23, 95% CI = 0.68-5.79, P = 0.01) and subclinical hypoidism (MD = 1.37, 95% CI = 0.31-2.42, P = 0.01) were significantly higher than those of euthyroid controls. The resistin levels of patients with thyroid dysfunction after treatment were significantly lower than those before treatment (MD = 1.00, 95% CI = 0.34-1.65, P = 0.003), especially in patients with hyperthyroidism (MD = 2.16, 95% CI = 1.00-3.32, P = 0.0003). Correlation analysis confirmed a positive correlation between resistin levels and free triiodothyronine (FT3) levels in patients with thyroid dysfunction (r = 0.27578, P = 0.001). Conclusions Our meta-analysis demonstrates that resistin levels are significantly higher in patients with thyroid dysfunction, and the resistin levels after treatment in patients with thyroid dysfunction are significantly lower than those before treatment. Correlation analysis shows a positive correlation between resistin levels and FT3 levels in patients with thyroid dysfunction. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022336617.
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Affiliation(s)
- Lin Zhou
- Department of Postgraduate, Qinghai University, Xining, China
- Department of Endocrinology, Qinghai Provincial People’s Hospital, Xining, China
| | - Kang Song
- Department of Endocrinology, Qinghai Provincial People’s Hospital, Xining, China
| | - Wei Luo
- Department of Endocrinology, Qinghai Provincial People’s Hospital, Xining, China
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Causal Association of Thyroid Signaling with C-Reactive Protein: A Bidirectional Mendelian Randomization. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:8954606. [PMID: 35996695 PMCID: PMC9392607 DOI: 10.1155/2022/8954606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 07/23/2022] [Accepted: 07/27/2022] [Indexed: 01/08/2023]
Abstract
Methods Based on the latest genome-wide association study summary data, bidirectional two-sample Mendelian randomization (MR) was employed to detect the causal relationship and effect direction between TSH, fT4, and CRP. Furthermore, in view of obesity being an important risk factor of CVD, obesity trait waist-hip ratio (WHR) and body mass index (BMI) were treated as the research objects in MR analyses for exploring the causal effects of TSH and fT4 on them, respectively. Results Genetically increased CRP was associated with increased TSH (β = −0.02, P = 0.011) and with increased fT4 (β = 0.043, P = 0.001), respectively, but there was no evidence that TSH or fT4 could affect CRP. In further analyses, genetically increased TSH was associated with decreased WHR (β = −0.02, P = 3.99e − 4). Genetically increased WHR was associated with decreased fT4 (β = −0.081, P = 0.002). Genetically increased BMI was associated with increased TSH (β = 0.03, P = 0.028) and with decreased fT4 (β = −0.078, P = 1.05e − 4). Causal associations of WHR and BMI with thyroid signaling were not supported by weighted median analysis in sensitivity analyses. Conclusion TSH and fT4 were increased due to the higher genetically predicted CRP. WHR was decreased due to the higher genetically predicted TSH. These findings will provide reference for the prevention and treatment of inflammation and metabolic syndrome.
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Treister-Goltzman Y, Yarza S, Peleg R. Lipid profile in mild subclinical hypothyroidism: systematic review and meta-analysis. Minerva Endocrinol (Torino) 2022; 46:428-440. [PMID: 35078310 DOI: 10.23736/s2724-6507.20.03197-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Only severe subclinical hypothyroidism (SSCH) with TSH above 10 mIU/L is considered a risk factor of hyperlipidemia and cardiovascular disease. The results of published papers on mild subclinical hypothyroidism (MSCH) with TSH below10 mIU/L are contradictory. The objective of the study was to conduct a systematic review and meta-analysis on lipid profiles in a population of patients with MSCH (TSH10> mIU/L and normal T3, T4) in comparison with euthyroid subjects. EVIDENCE ACQUISITION The electronic databases PubMed, CIANHL, Scopus, and Web of Science were searched systematically between August 20, 2018 and September 15, 2018, without limitation on the date of publication or the language. Titles, abstracts and articles were reviewed to identify papers that evaluated lipid profiles in patients with MSCH compared to euthyroid. EVIDENCE SYNTHESIS A systematic review of the studies and a meta-analysis using R software (version 3.6.1) were performed. Thirty-five case control and cohort studies were included in the meta-analysis. Total cholesterol (TC), low density lipoprotein (LDL), and triglycerides (TG) were significantly higher and high-density lipoprotein (HDL) was significantly lower in MSCH patients compared to euthyroid individuals. Mean differences (MD) [95% CI] were 12.75 [6.02, 19.48], 10.95 [6.37, 15.54], 19.27 [10.90, 27.64], and -1.81 [-3.38, -0.23], respectively. No significant difference was observed for very low-density lipoproteins (VLDL), apolipoprotein A1 (apoA1), or apolipoprotein B (apoB). The studies were of fair to good quality. CONCLUSIONS MSCH is associated with an increase in major atherogenic lipoproteins and should be viewed as a cardiovascular risk factor.
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Affiliation(s)
- Yulia Treister-Goltzman
- Department of Family Medicine and Siaal Research Center for Family Practice and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel - .,Clalit Health Services, Southern District, Israel -
| | - Shaked Yarza
- Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel
| | - Roni Peleg
- Department of Family Medicine and Siaal Research Center for Family Practice and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Clalit Health Services, Southern District, Israel
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Akın A, Unal E, Yildirim R, Ture M, Balik H, Haspolat YK. Left and right ventricular functions may be impaired in children diagnosed with subclinical hypothyroidism. Sci Rep 2020; 10:19711. [PMID: 33184320 PMCID: PMC7661521 DOI: 10.1038/s41598-020-76327-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 07/27/2020] [Indexed: 11/09/2022] Open
Abstract
Subclinical hypothyroidism (SH) may influence both ventricular functions. The aim of this study was to evaluation the findings of Tissue Doppler Imaging (TDI) and other echocardiography modalities in children with SH. We compared left ventricular mass index (LVMI) and TDI parameters of patients with SH and children with euthyroidism. Subclinical hypothyroidism was diagnosed when thyroid stimulating hormone level was higher than the reference value of the laboratory (> 4.2 mIU/L) and free thyroxine level was in normal range. The study included a group of 35 patients with SH and a control group of 38 children with euthyroidism (mean age was 7.6 ± 3.5 years and 9.0 ± 2.4 years, respectively). LVMI was significantly higher in the patient group (p = 0.005). TDI parameters including mitral septal ejection time was lower (p = 0.003) and mitral septal myocardial performance index was higher (p = 0.009) in the patient group. Right ventricular TDI revealed that tricuspid lateral E/Ea and tricuspid septal E/Ea were higher (p = 0.015 and p = 0.024, respectively) and tricuspid septal Ea/Aa and ejection time were lower (p = 0.018 and p = 0.017, respectively) in the patient group. SH may lead to increase LVMI. Left ventricular systolic and diastolic TDI parameters (lower mitral septal ejection time, higher mitral septal myocardial performance index) as well as right ventricular systolic (lower tricuspid septal ejection time) and diastolic (higher tricuspid septal and lateral E/Ea, lower tricuspid septal Ea/Ea) functions may be also impaired in children with subclinical hypothyroidism. TDI is a useful method used for the assessment of the effect of SH on cardiac functions.
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Affiliation(s)
- Alper Akın
- Department of Pediatric Cardiology, Dicle University Faculty of Medicine, Sur, Diyarbakır, Turkey.
| | - Edip Unal
- Department of Pediatric Endocrinology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Ruken Yildirim
- Department of Pediatric Endocrinology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Mehmet Ture
- Department of Pediatric Cardiology, Dicle University Faculty of Medicine, Sur, Diyarbakır, Turkey
| | - Hasan Balik
- Department of Pediatric Cardiology, Dicle University Faculty of Medicine, Sur, Diyarbakır, Turkey
| | - Yusuf Kenan Haspolat
- Department of Pediatric Endocrinology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
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Al-Ofi EA. Implications of inflammation and insulin resistance in obese pregnant women with gestational diabetes: A case study. SAGE Open Med Case Rep 2019; 7:2050313X19843737. [PMID: 31041103 PMCID: PMC6477763 DOI: 10.1177/2050313x19843737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Accepted: 03/18/2019] [Indexed: 12/21/2022] Open
Abstract
Background Obesity is one of the leading pregnancy risks for both the mother and the neonate. The prevalence of gestational diabetes mellitus has been increasing, especially with the increase in obesity in reproductive-aged women. A high body mass index, a sedentary lifestyle, a previous macrosomic infant, polycystic ovary syndrome and hypothyroidism are the main risk factors for gestational diabetes mellitus. Early gestational diabetes mellitus detection in high-risk individuals is a useful method for preventing further complications and/or preventing this disease by improving the patient's lifestyle. Case presentation A morbidly obese woman with a high body mass index (>36) at 24 weeks gestational age presented with several gestational diabetes mellitus risk factors. Her glucose tolerance test verified gestational diabetes mellitus, and, incidentally, her C-reactive protein level was elevated without obvious reason. Her plasma levels of inflammatory cytokines had also been assessed and were exaggerated. After lifestyle intervention, including weight management, the patient's inflammatory mediators, including her C-reactive protein level, dropped. Therefore, this study aimed to identify the relationship between the patient's inflammation and obesity. Conclusion Antenatal C-reactive protein screening could be used throughout pregnancy to predict inflammation from high-risk pregnant women. This case scenario describes the interrelationships between inflammation, insulin resistance and adipokines, as well as the contributions of hypothyroidism and polycystic ovary syndrome. Further research should emphasise the relationships between inflammation and obesity in pregnancy.
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Affiliation(s)
- Ebtisam Aziz Al-Ofi
- Department of Physiology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Nakova VV, Krstevska B, Kostovska ES, Vaskova O, Ismail LG. The effect of levothyroxine treatment on left ventricular function in subclinical hypothyroidism. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2018; 62:392-398. [PMID: 30304103 PMCID: PMC10118736 DOI: 10.20945/2359-3997000000052] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 10/11/2017] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Treatment of subclinical hypothyroidism (ScH), especially the mild form of ScH, is controversial because thyroid hormones influence cardiac function. We investigate left ventricular systolic and diastolic function in ScH and evaluate the effect of 5-month levothyroxine treatment. SUBJECTS AND METHODS Fifty-four patients with newly diagnosed mild ScH (4.2 <TSH < 10.0 mU/L) and 30 euthyroid subjects matched by age were analysed. Laboratory analyses and an echocardiography study were done at the first visit and after 5 months in euthyroid stage in patients with ScH. RESULTS Compared to healthy controls, patients with ScH had a lower E/A ratio (1.03 ± 0.29 vs. 1.26 ± 0.36, p < 0.01), higher E/e' sep. ratio (762 ± 2.29 vs. 6.04 ± 1.64, p < 0.01), higher myocardial performance index (MPI) (0.47 ± 0.08 vs. 0.43 ± 0.07, p < 0.05), lower global longitudinal strain (GLS) (-19.5 ± 2.3 vs. -20.9 ± 1.7%, p < 0.05), and lower S wave derived by tissue Doppler imaging (0.077 ± 0.013 vs. 0.092 ± 0.011 m/s, p < 0.01). Levothyroxine treatment in patients with ScH contributed to higher EF (62.9 ± 3.9 vs. 61.6 ± 4.4%, p < 0.05), lower E/e' sep. ratio (6.60 ± 2.06 vs. 762 ± 2.29, p < 0.01), lower MPI (0.43 ± 0.07 vs. 0.47 ± 0.08%, p < 0.01), and improved GLS (-20.07 ± 2.7 vs. -19.55 ± 2.3%, p < 0.05) compared to values in ScH patients at baseline. Furthermore, in all study populations (ScH patients before and after levothyroxine therapy and controls), TSH levels significantly negatively correlated with EF (r = -0.15, p < 0.05), E/A (r = -0.14, p < 0.05), GLS (r = -0.26, p < 0.001), and S/TDI (r = -0.22, p < 0.01) and positively correlated with E/e' sep. (r = 0.14, p < 0.05). CONCLUSION Patients with subclinical hypothyroidism versus healthy individuals had subtle changes in certain parameters that indicate involvement of systolic and diastolic function of the left ventricle. Although the values of the parameters were in normal range, they were significantly different compared to ScH and the control group at baseline, as well as to the ScH groups before and after treatment.The results of our study suggest that patients with ScH must be followed up during treatment to assess improvement of the disease. Some of the echocardiography obtained parameters were reversible after levothyroxine therapy.
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Affiliation(s)
| | - Brankica Krstevska
- University Clinic of Endocrinology, Diabetes and Metabolic Disorders, Medical Faculty, Skopje, R. Macedonia
| | | | - Olivija Vaskova
- Institute of Patophysiology and Nuclear Medicine, Medical Faculty, Skopje, R. Macedonia
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Pandrc MS, Ristić A, Kostovski V, Stanković M, Antić V, Milin-Lazović J, Ćirić J. The Effect of Early Substitution of Subclinical Hypothyroidism on Biochemical Blood Parameters and the Quality of Life. J Med Biochem 2017; 36:127-136. [PMID: 28680356 PMCID: PMC5471645 DOI: 10.1515/jomb-2017-0007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 01/29/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Subclinical hypothyroidism (SCH) is defined as high TSH and normal thyroxine. Data on the effects of early substitution by levothyroxine on psychophysical health in SCH are still not consistent enough to support its introduction. METHODS Clinical parameters, biochemical data and quality of life (Short Form 36 questionnaire) were measured before the intervention and 3 months after the euthyroid state had been achieved in SCH patients. RESULTS Significant reduction in body weight (p=0.030), systolic and diastolic blood pressure (p=0.024, p=0.019), homocysteine (p<0.001), leukocytes and neutrophils (p=0.011, p=0.001), INR (p=0.049), K levels (p=0.040, p=0.013), HbA1c (p=0.001), fasting insulin (p<0.001) and insulin resistance measured by HOMA index (p<0.001), lipid parameters (total cholesterol (p<0.001), LDL-cholesterol (p<0.001), triglycerides (p=0.007), apoB (p=0.022), Lp(a) (p<0.001), LDL/HDL (p=0.008), LAP (p=0.04) and apoB/apoA1 ratios (p<0.023)), TSH (p<0.001) and tAbs (p<0.001) was recorded. Frequency of fatty liver (20% to 2.9%, p=0.016), hyperlipidemia (85% to 65.7%, p=0.001) and metabolic syndrome (34.3% to 2.9%, p=0.070) significantly decreased. A statistically significant positive association was found between the average dose of levothyroxine and changes in physical functioning (r=0.391, p=0.020), vitality (r=0.393, p=0.020), mental health (r=0.374, p=0.027) and overall dimensions of mental health (r=0.376, p=0.026). With increasing doses of levothyroxine, the previously listed scores of SF 36 grew (r=0.296, p=0.084). CONCLUSIONS Early substitution of SCH improved the many clinical and biochemical parameters related to cardiovascular risk. Quality of life was also improved, and correlated only with thyroxine doses suggesting an indirect relationship between the degree of hypothyroidism and quality of life.
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Affiliation(s)
- Milena S Pandrc
- Department of Internal Medicine, Military Medical Academy, Belgrade, Serbia
| | - Anđelka Ristić
- Department of Urgent Internal Medicine, Military Medical Academy, Belgrade, Serbia
| | - Vanja Kostovski
- Clinic for Thoracic Surgery, Military Medical Academy, Belgrade, Serbia
| | - Marko Stanković
- Primary Medical Centre »Dr Simo Milošević«, Belgrade, Serbia
| | - Vladimir Antić
- Department of Radiology, Military Medical Academy, Belgrade, Serbia
| | - Jelena Milin-Lazović
- Institute for Medical Statistics and Informatics, Clinical Center of Serbia, Belgrade, Serbia
| | - Jasmina Ćirić
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, University of Belgrade School of Medicine, Belgrade, Serbia
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Abbas AM, Sakr HF. Effect of magnesium sulfate and thyroxine on inflammatory markers in a rat model of hypothyroidism. Can J Physiol Pharmacol 2016; 94:426-32. [PMID: 26854732 DOI: 10.1139/cjpp-2015-0247] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Inflammation is a major risk factor for cardiovascular complications. Magnesium sulfate (MgSO4) has anti-inflammatory actions. Therefore we investigated the effects of levothyroxine and MgSO4 on inflammatory markers as C-reactive protein (CRP), interleukin-6, tumor necrosis factor-α (TNF-α), intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule-1 (VCAM-1) in hypothyroid rats. Sixty male rats were divided into 6 groups; normal, normal + MgSO4, hypothyroidism, hypothyroidism + levothyroxine, hypothyroidism + MgSO4, and hypothyroidism + levothyroxine + MgSO4. Thyroxine, triiodothyronine, and thyroid-stimulating hormone (TSH), CRP, interleukin-6, TNF-α, ICAM-1, and VCAM-1 were measured in all rats. Hypothyroidism significantly increased TSH, CRP, interleukin-6, TNF-α, ICAM-1, and VCAM-1 and decreased triiodothronine and thyroxine. Treatment of hypothyroid rats with levothyroxine or MgSO4 significantly decreased CRP, interleukin-6, TNF-α, ICAM-1, and VCAM-1. Combined therapy of hypothyroid rats with levothyroxine and MgSO4 significantly decreased CRP, interleukin-6, TNF-α, ICAM-1, and VCAM-1 compared with hypothyroid rats either untreated or treated with levothyroxine or MgSO4. This study demonstrates that hypothyroid rats have chronic low grade inflammation, which may account for increased risk of cardiovascular diseases. Combined levothyroxine and MgSO4 is better than levothyroxine or MgSO4 alone in alleviating the chronic low grade inflammatory status and therefore reducing the risk of cardiovascular diseases in hypothyroid animals.
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Affiliation(s)
- Amr M Abbas
- Department of Medical Physiology, Faculty of Medicine, Mansoura University, PO Box: 35516, Mansoura, Egypt.,Department of Medical Physiology, Faculty of Medicine, Mansoura University, PO Box: 35516, Mansoura, Egypt
| | - Hussein F Sakr
- Department of Medical Physiology, Faculty of Medicine, Mansoura University, PO Box: 35516, Mansoura, Egypt.,Department of Medical Physiology, Faculty of Medicine, Mansoura University, PO Box: 35516, Mansoura, Egypt
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Akbaba G, Berker D, Isık S, Tuna MM, Koparal S, Vural M, Yılmaz FM, Topcuoglu C, Guler S. Changes in the before and after thyroxine treatment levels of adipose tissue, leptin, and resistin in subclinical hypothyroid patients. Wien Klin Wochenschr 2015; 128:579-85. [PMID: 26394780 DOI: 10.1007/s00508-015-0865-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 09/01/2015] [Indexed: 01/04/2023]
Abstract
BACKGROUND Subclinical hypothyroidism (SH) occurs when serum thyroid stimulating hormone (TSH) concentrations are raised and serum thyroid hormone concentrations are normal. The effect of SH on the proinflammatory adipose cytokine releasing visceral adipose tissue (VAT) is not clear. The aim of this study is to identify the difference between the pre and posttreatment levels of VAT, leptin, and resistin in SH patients. METHODS There were 51 SH patients and 43 age- and gender-matched healthy subjects included in the study. Thyroid functions, biochemical tests, leptin, resistin, and visceral and subcutaneous fat measurements were made. The measurements were repeated in the SH group in the third month following L-thyroxin treatment. RESULTS Initially, high sensitivity C-reactive protein, carotid artery intima-media thickness (mm), leptin, and resistin levels were significantly higher in the SH group compared to the controls, while the other parameters were similar. While no correlation was observed between TSH levels and adipokines, a positive correlation was detected between waist circumference and leptin levels (r = 0.549, p < 0.01). Visceral adipose tissue was positively correlated to age, waist circumference, and leptin levels, but negatively correlated to free thyroxin (T4) levels (r = 0.419, p = 0.009; r = 0.794, p < 0.01; r = 0.515, p < 0.01 and r = - 0.416, p = 0.009, respectively). A significant decrease was observed in VAT volume, leptin, and resistin levels of SH patients following levothyroxine treatment. Conclusion The reduced VAT volume, leptin, and resistin levels in SH patients following treatment may support the idea that TSH affects adipose tissue functions.
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Affiliation(s)
- Gulhan Akbaba
- Department of Internal Medicine, Endocrinology and Metabolism, Mugla Sıtkı Kocman University School of Medicine, Mugla, Turkey.
| | - Dilek Berker
- Clinics of Endocrinology and Diseases of Metabolism, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Serhat Isık
- Clinics of Endocrinology and Diseases of Metabolism, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Mazhar Muslum Tuna
- Clinics of Endocrinology and Diseases of Metabolism, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Suha Koparal
- Clinics of Radiology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Murat Vural
- Clinics of Radiology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Fatma Meric Yılmaz
- Clinics of Biochemistry, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Canan Topcuoglu
- Clinics of Biochemistry, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Serdar Guler
- Clinics of Endocrinology and Diseases of Metabolism, Ankara Numune Education and Research Hospital, Ankara, Turkey
- Faculty of Medicine, Department of Endocrinology and Diseases of Metabolism, Hitit University, Corum, Turkey
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11
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Marchiori RC, Pereira LAF, Naujorks AA, Rovaris DL, Meinerz DF, Duarte MMMF, Rocha JBT. Improvement of blood inflammatory marker levels in patients with hypothyroidism under levothyroxine treatment. BMC Endocr Disord 2015; 15:32. [PMID: 26100072 PMCID: PMC4476077 DOI: 10.1186/s12902-015-0032-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Accepted: 06/12/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND There are several specific inflammatory and oxidative correlates among patients with hypothyroidism, but most studies are cross-sectional and do not evaluate the change in parameters during the treatment. The aim of this study was to investigate the effect of levothyroxine replacement therapy on biomarkers of oxidative stress (OS) and systemic inflammation in patients with hypothyroidism. METHODS In this prospective open-label study, 17 patients with recently diagnosed primary hypothyroidism due to Hashimoto's thyroiditis who were not taking levothyroxine were included. The following parameters were measured before and at 6 and 12 months of levothyroxine treatment with an average dose of 1.5 to 1.7 μg/kg/day: thyroid-stimulating hormone (TSH), free thyroxine (FT4), high-sensitivity C-reactive protein (hs-CRP), interleukin 1 (IL-1), IL-6, IL-10, interferon gamma (INF-γ), tumor necrosis factor alpha (TNF-α), thiobarbituric acid-reactive substances (TBARS), activity of aminolevulinic acid dehydratase (δ-ALA-D), nonprotein and total thiol (NP-SH and T-SH) groups, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG). Generalized estimating equation (GEE) modeling was used to analyze the effects of LRT (at pre-treatment, 6 months and 12 months) on those variables. The hypothyroidism status (i.e., overt or subclinical hypothyroidism) was included as a confounder in all analyses. An additional GEE post hoc analysis was made to compare time points. RESULTS There was a significant decrease in TSH over time (P < 0.0001), (initial levels were on average 32.4 μIU/mL and 10.5 μIU/mL at 12 months). There was a significant increase in FT4 (P < 0.0001) (initial levels were on average 0,8 ng/dL and 2.7 ng/dL at 12 months). There were significant changes in interleukin levels over time, with a significant increase in IL-10 (P < 0.0001) and significant decreases in IL-1 (P < 0.0001), IL-6 (P < 0.0001), INF-γ (P < 0.0001) and TNF-α (P < 0.0001). No significant difference in hs-CRP over time was observed (P < 0.284). There was a significant reduction in NP-SH (P < 0.0001). CONCLUSIONS This study observed significant changes in the inflammatory profile in hypothyroid patients under treatment, with reduction of pro-inflammatory cytokines and elevation of anti-inflammatory cytokine. In these patients, a decrease in low-grade chronic inflammation may have clinical relevance due to the known connection between chronic inflammation, atherosclerosis and cardiovascular events.
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Affiliation(s)
- Roseane C Marchiori
- Departamento de Clinica Médica, Centro de Ciencias da Saude, Universidade Federal de Santa Maria, Av. Roraima n° 1000, Cidade Universitaria, Camobi, Santa Maria, RS, Brazil.
| | - Luiz A F Pereira
- Departamento de Clinica Médica, Centro de Ciencias da Saude, Universidade Federal de Santa Maria, Av. Roraima n° 1000, Cidade Universitaria, Camobi, Santa Maria, RS, Brazil.
| | - Alexandre A Naujorks
- Serviço de Metodos Graficos, Hospital Universitario de Santa Maria, Universidade Federal de Santa Maria, Av. Roraima n° 1000, Cidade Universitaria, Camobi, Santa Maria, RS, Brazil.
| | - Diego L Rovaris
- Departamento de Genetica, Instituto de Biociencias, Universidade Federal do Rio Grande do Sul, Av. Bento Gonçalves, 9500, Porto Alegre, Brazil.
| | - Daiane F Meinerz
- Departamento de Bioquímica e Biologia Molecular, Centro de Ciencias Naturais e Exatas, Universidade Federal de Santa Maria, Av. Roraima n° 1000, Cidade Universitaria, Camobi, Santa Maria, RS, Brazil.
| | - Marta M M F Duarte
- Ciencias da Saude, Universidade Luterana do Brasil (ULBRA), campus Santa Maria, BR 287, Km 252, Trevo Maneco Pedroso, Boca do Monte, Santa Maria, RS, Brazil, Cx. Postal 21834.
| | - João B T Rocha
- Departamento de Bioquímica e Biologia Molecular, Centro de Ciencias Naturais e Exatas, Universidade Federal de Santa Maria, Av. Roraima n° 1000, Cidade Universitaria, Camobi, Santa Maria, RS, Brazil.
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12
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Roy S, Banerjee U, Dasgupta A. Protective Role of Bilirubin Against Increase in hsCRP in Different Stages of Hypothyroidism. Indian J Clin Biochem 2015; 31:43-9. [PMID: 26855487 DOI: 10.1007/s12291-015-0495-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Accepted: 03/23/2015] [Indexed: 12/22/2022]
Abstract
In conjunction with thyroxine, bilirubin may play an important role for regulation of hsCRP level and a consequent pro-inflammatory condition in hypothyroidism. In present study we evaluated the dependence of hsCRP changes on total bilirubin (BT) and fT4 level in thirty overt (OH) and thirty subclinical hypothyroidism (SH). Serum BT, hsCRP, thyroxine and TSH were measured in both groups and compared with forty control subjects. Serum values of TSH, hsCRP showed raised (P < 0.001 for both) values with lower levels for fT4 and BT (P < 0.001 and 0.03 respectively) in hypothyroid patients compared to the controls. ANOVA showed significant increments in TSH and hsCRP values with decreases in fT4 among the control, SH and OH groups respectively (P < 0.001). BT values showed decrease in OH group only in comparison to controls (P = 0.04). Regression analysis revealed that hsCRP was negatively dependent on fT4 (β = -0.35, P = 0.002) and serum bilirubin (β = -0.40 and P < 0.001 respectively). Univariate general linear model analysis showed this dependence persisted even when carried out distinctly in SH and OH groups separately (P < 0.001). TSH did not show any significant predictive value on the hsCRP level in either of these two tests. From these analyses we suggest that serum hsCRP is closely integrated to a lowered synthesis of bilirubin and fT4 in hypothyroid patients. Furthermore, this causal relationship is not only limited to overt but also extends to the SH.
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Affiliation(s)
- Suparna Roy
- Department of Biochemistry, Calcutta National Medical College, 32, Gorachand Road, Kolkata, 700014 India
| | - Ushasi Banerjee
- Department of Biochemistry, Calcutta National Medical College, 32, Gorachand Road, Kolkata, 700014 India
| | - Anindya Dasgupta
- Department of Biochemistry, Calcutta National Medical College, 32, Gorachand Road, Kolkata, 700014 India
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Hajje G, Saliba Y, Itani T, Moubarak M, Aftimos G, Farès N. Hypothyroidism and its rapid correction alter cardiac remodeling. PLoS One 2014; 9:e109753. [PMID: 25333636 PMCID: PMC4198123 DOI: 10.1371/journal.pone.0109753] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 09/06/2014] [Indexed: 01/12/2023] Open
Abstract
The cardiovascular effects of mild and overt thyroid disease include a vast array of pathological changes. As well, thyroid replacement therapy has been suggested for preserving cardiac function. However, the influence of thyroid hormones on cardiac remodeling has not been thoroughly investigated at the molecular and cellular levels. The purpose of this paper is to study the effect of hypothyroidism and thyroid replacement therapy on cardiac alterations. Thirty Wistar rats were divided into 2 groups: a control (n = 10) group and a group treated with 6-propyl-2-thiouracil (PTU) (n = 20) to induce hypothyroidism. Ten of the 20 rats in the PTU group were then treated with L-thyroxine to quickly re-establish euthyroidism. The serum levels of inflammatory markers, such as C-reactive protein (CRP), tumor necrosis factor alpha (TNF-α), interleukin 6 (IL6) and pro-fibrotic transforming growth factor beta 1 (TGF-β1), were significantly increased in hypothyroid rats; elevations in cardiac stress markers, brain natriuretic peptide (BNP) and cardiac troponin T (cTnT) were also noted. The expressions of cardiac remodeling genes were induced in hypothyroid rats in parallel with the development of fibrosis, and a decline in cardiac function with chamber dilation was measured by echocardiography. Rapidly reversing the hypothyroidism and restoring the euthyroid state improved cardiac function with a decrease in the levels of cardiac remodeling markers. However, this change further increased the levels of inflammatory and fibrotic markers in the plasma and heart and led to myocardial cellular infiltration. In conclusion, we showed that hypothyroidism is related to cardiac function decline, fibrosis and inflammation; most importantly, the rapid correction of hypothyroidism led to cardiac injuries. Our results might offer new insights for the management of hypothyroidism-induced heart disease.
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Affiliation(s)
- Georges Hajje
- Laboratoire de Recherche en Physiologie et Physiopathologie, Faculté de Médecine, Pôle Technologie Santé, Université Saint Joseph, Beirut, Lebanon
| | - Youakim Saliba
- Laboratoire de Recherche en Physiologie et Physiopathologie, Faculté de Médecine, Pôle Technologie Santé, Université Saint Joseph, Beirut, Lebanon
| | - Tarek Itani
- Institut National de Pathologie, Baabda, Lebanon
| | - Majed Moubarak
- Laboratoire de Recherche en Physiologie et Physiopathologie, Faculté de Médecine, Pôle Technologie Santé, Université Saint Joseph, Beirut, Lebanon
| | | | - Nassim Farès
- Laboratoire de Recherche en Physiologie et Physiopathologie, Faculté de Médecine, Pôle Technologie Santé, Université Saint Joseph, Beirut, Lebanon
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Alsawy BM, El-Damarawi MA. Effect of Diabetes Mellitus and Its Control on Myocardial Contractile Function in Rats. Open Access Maced J Med Sci 2014. [DOI: 10.3889/oamjms.2014.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM: This work was done to study the effect of both types of diabetes mellitus (DM) on myocardial contractility in rats. Also, we investigated the role of treatment of DM with insulin and rosiglitazone (used as treatment for type 1 and type 2 DM respectively) in improvement of myocardial dysfunction in diabetic rats.METHODS: The study included 50 male Wistar albino rats, divided into 5 groups: control (group I), streptozotocin induced type 1 DM (group II), fructose induced type 2 DM (group III), insulin treated type 1 diabetic rats (group IV) and rosiglitazone treated type 2 diabetic rats (group V). At the end of the study, retro-orbital blood samples were withdrawn and blood glucose, plasma triglyceride (TG), total cholesterol (TC) and thyroid hormones levels were measured. Rats were then anesthetized and their hearts were excised and connected to Langendorff apparatus to perform mechanical cardiac performance tests including heart rate (HR), left ventricular developed pressure (LVDP) and maximum rate of pressure rise (+dp/dt).RESULTS: Data of the study showed that relative to control group, there was significant increase in blood glucose, plasma TG and TC levels while, thyroid hormones and myocardial performance parameters showed significant decrease in both type 1 and type 2 diabetic rats. Treatment of type 1 diabetic rats with insulin and type 2 with rosiglitazone resulted in significant decrease in blood glucose, plasma TG and TC levels associated with significant improvement in thyroid hormones and myocardial performance parameters. The results also showed that insulin treatment of type 1 was more effective in ameliorating all parameters than treatment of type 2 by rosiglitazone.CONCLUSION: We concluded that the induction of both types of diabetes resulted in decreased myocardial performance parameters. The treatment of type 1 and type 2 diabetes by insulin and oral rosiglitazone respectively improved to a great extent the altered metabolism and mechanical myocardial parameters, with more improving effect of insulin in type 1 than rosiglitazone in type 2 DM.
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Liu XL, He S, Zhang SF, Wang J, Sun XF, Gong CM, Zheng SJ, Zhou JC, Xu J. Alteration of lipid profile in subclinical hypothyroidism: a meta-analysis. Med Sci Monit 2014; 20:1432-41. [PMID: 25124461 PMCID: PMC4144946 DOI: 10.12659/msm.891163] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Previous studies yielded controversial results about the alteration of lipid profiles in patients with subclinical hypothyroidism. We performed a meta-analysis to investigate the association between subclinical hypothyroidism and lipid profiles. MATERIAL AND METHODS We searched PubMed, Cochrane Library, and China National Knowledge Infrastructure articles published January 1990 through January 2014. Dissertation databases (PQDT and CDMD) were searched for additional unpublished articles. We included articles reporting the relationship between subclinical hypothyroidism and at least 1 parameter of lipid profiles, and calculated the overall weighted mean difference (WMD) with a random effects model. Meta-regression was used to explore the source of heterogeneity among studies, and the Egger test, Begg test, and the trim and fill method were used to assess potential publication bias. RESULTS Sixteen observational studies were included in our analysis. Meta-analysis suggested that the serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and total triglyceride levels were significantly increased in patients with subclinical hypothyroidism compared with euthyroidism individuals; the WMD were 12.17 mg/dl, 7.01 mg/dl, and 13.19 mg/dl, respectively (P<0.001 for all). No significant difference was observed for serum high-density lipoprotein cholesterol (HDL-C). Match strategy was the main source of heterogeneity among studies in TC and LDL-C analysis. Potential publication bias was found in TC and LDL-C analysis by the Egger test or Begg test and was not confirmed by the trim and fill method. CONCLUSIONS Subclinical hypothyroidism may correlate with altered lipid profile. Previous studies had limitations in the control of potential confounding factors and further studies should consider those factors.
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Affiliation(s)
- Xiao-Li Liu
- Molecular Biology Lab, Shenzhen Center for Chronic Disease Control, Shenzhen, China (mainland)
| | - Shan He
- Molecular Biology lab, Shenzhen Center for Chronic Disease Control, Shenzhen, China (mainland)
| | - Shao-Fang Zhang
- Department of Social Health, Shenzhen Luohu People's Hospital, Shenzhen, China (mainland)
| | - Jun Wang
- Physicochemical Lab, Shenzhen Center for Chronic Disease Control, Shenzhen, China (mainland)
| | - Xiu-Fa Sun
- Department of Nutrition and Food Hygiene, Huazhong University of Science and Technology, Wuhan, China (mainland)
| | - Chun-Mei Gong
- Molecular biology lab, Shenzhen Center for Chronic Disease Control, Shenzhen, China (mainland)
| | - Shi-Jie Zheng
- Molecular Biology Lab, Shenzhen Center for Chronic Disease Control, Shenzhen, China (mainland)
| | - Ji-Chang Zhou
- Molecular Biology Lab, Shenzhen Center for Chronic Disease Control, Shenzhen, China (mainland)
| | - Jian Xu
- Department of Health Control, Shenzhen Center for Chronic Disease Control, Shenzhen, China (mainland)
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Assessment of serum apelin and lipocalin-2 levels in patients with subclinical hypothyroidism. ANNALES D'ENDOCRINOLOGIE 2014; 75:10-4. [PMID: 24582591 DOI: 10.1016/j.ando.2013.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 11/22/2013] [Accepted: 12/26/2013] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Subclinical hypothyroidism is the precursor to hypothyroidism because it has a tendency to transform into hypothyroidism. Subclinical hypothyroidism is considered one of the risk factors causing metabolic syndrome. Metabolic syndrome can be characterized by plasma levels of apelin and lipocalin-2, both released from adipocytes. In the present study, we aimed to measure serum apelin and lipocalin-2 levels of patients with subclinical hypothyroidism and compare them with serum apelin and lipocalin-2 levels from healthy individuals. METHODS This was a cross-sectional study. A total of 80 subjects were enrolled in the study and divided into two groups: Group A included 39 patients (females, n=34) diagnosed with subclinical hypothyroidism, and Group B (the control group) comprised 41 healthy volunteers (females, n=38). Serum samples were obtained from each participant for the measurement of apelin and lipocalin-2. These were then stored at minus 80°C until the time of analysis, when serum apelin and lipocalin-2 levels of the two groups were compared. RESULTS Patients with subclinical hypothyroidism (Group A and Group B subjects [healthy controls]) were comparable with respect to gender, age, and body mass index (BMI) (P=0.412, P=0.863, and P=0.269, respectively), nor was there a statistically significant difference between groups in terms of apelin and lipocalin-2 levels (P=0.87, and P=0.67, respectively). Apelin levels showed a positive and significant correlation with BMI (P=0.034). Serum lipocalin-2 levels showed significant positive correlations with BMI and creatinine levels (P=0.002, and P=0.025, respectively). CONCLUSION In the present study, no significant difference of serum apelin and lipocalin-2 levels was observed between patients with subclinical hypothyroidism and healthy control subjects. Positive correlations were found, however, between serum apelin level and BMI as well as between serum lipocalin-2 and BMI and creatinine levels.
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Erturk A, Cure E, Parlak E, Cure MC, Yuce S, Kizilkaya B. Serum resistin levels may be new prognostic factor of crimean-congo hemorrhagic fever. Int J Clin Exp Med 2014; 7:3536-42. [PMID: 25419394 DOI: pmid/25419394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 09/20/2014] [Indexed: 02/07/2023]
Abstract
Crimean-Congo hemorrhagic fever (CCHF) virus can cause potentially fatal infections in humans. During this disease, cytokines are intensive released. Resistin which is a good marker of inflammation is an adipocytokine released from adipose tissue. We aimed to investigate whether serum resistin level in patients with CCHF has a prognostic value in predicting recovery time. Twenty men and 22 women (a total of 42 CCHF patients) and a similar age group of 40 healthy individuals (16 men and 24 women) were included in the study. Hematologic tests, serum resistin level, C-reactive protein (CRP) and others biochemical values of all the two group subjects were evaluated. Multivariate logistic regression analysis was performed. Resistin level of patients with CCHF was higher than the controls (1252.6±864.7 ng/ml vs. 824.1±224.6 ng/ml, p=0.003). There was strongly association among recovery time, increased resistin level (p < 0.001), prothrombin time (PT) (p < 0.001), INR (p < 0.001), decreased white blood cell count (WBC) (p=0.012) and lower platelet counts (p=0.007). Serum resistin level is significantly elevated in CCHF patients. Resistin level may be a good prognostic factor to predict recovery time in patients with CCHF.
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Affiliation(s)
- Ayse Erturk
- Department of Infectious Disease, School of Medicine, Recep Tayyip Erdogan University Rize, Turkey
| | - Erkan Cure
- Department of Internal Medicine, School of Medicine, Recep Tayyip Erdogan University Rize, Turkey
| | - Emine Parlak
- Department of Infectious Disease, School of Medicine, Ataturk University Erzurum, Turkey
| | - Medine Cumhur Cure
- Department of Biochemistry, School of Medicine, Recep Tayyip Erdogan University Rize, Turkey
| | - Suleyman Yuce
- Department of Internal Medicine, School of Medicine, Recep Tayyip Erdogan University Rize, Turkey
| | - Bayram Kizilkaya
- Department of Internal Medicine, School of Medicine, Recep Tayyip Erdogan University Rize, Turkey
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Ilic S, Tadic M, Ivanovic B, Caparevic Z, Trbojevic B, Celic V. Left and right ventricular structure and function in subclinical hypothyroidism: the effects of one-year levothyroxine treatment. Med Sci Monit 2013; 19:960-8. [PMID: 24217559 PMCID: PMC3829699 DOI: 10.12659/msm.889621] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The aim of this study was to investigate left ventricular (LV) and right ventricular (RV) structure, function, and mechanics in patients with subclinical hypothyroidism (SHT), and to evaluate the effect of a 1-year levothyroxine treatment. MATERIAL AND METHODS We compared 45 untreated women with subclinical hypothyroidism and 35 healthy control women matched by age. All the subjects underwent laboratory analyses, which included a thyroid hormone levels (free T3, free T4, and TSH) test, and a complete 2-dimensional echocardiographic study. All the SHT patients received levothyroxine therapy and were followed for a year after euthyroid state was achieved. RESULTS The LV mass index in the SHT participants before and after replacement therapy was significantly higher than in controls. In the SHT patients before the treatment, LV diastolic function and global function estimated by the Tei index were significantly impaired, whereas the LV systolic function was decreased. The results show that LV mechanics was significantly impaired in the SHT patients at baseline. Additionally, the SHT participants before levothyroxine substitution had increased RV wall thickness and significantly impaired RV diastolic and global function in comparison with the controls or the SHT subjects after the treatment. Furthermore, RV mechanics was also significantly deteriorated in the SHT patients before the treatment. CONCLUSIONS Subclinical hypothyroidism significantly affected LV and RV structure, systolic, diastolic and global function, and LV and RV mechanics. Levothyroxine replacement therapy significantly improved cardiac structure, function, and mechanics in the SHT patients.
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Affiliation(s)
- Sanja Ilic
- Department of Endocrinology, University Clinical Hospital Center "Dr Dragisa Misovic", Belgrade, Serbia
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