Hipertiroid hastalarda tedavi öncesi ve sonrası lipid profili ile homosistein, leptin, fibrinojen ve C-reaktif protein düzeyleri

Abstract

Amaç: Bu çalışma hipertiroidizmli hastalarda tiroid hor­monlarının lipid profilini, eritrosit sedimentasyon hızını (ESR), serum total homosistein (t-hcy), leptin, fibrinojen ve C-reaktif protein (CRP) düzeylerini etkileyip etkileme­diğini tespit etmek için tasarlanmıştır. Gereç ve yöntem: Bu çalışma yaş ortalaması 41.8±2.4 yıl arasında olan 23 hipertiroid (3 erkek/ 20 kadın) ile gerçekleştirildi. Homosistein, leptin, fibrinojen, CRP, to­tal kolesterol (TK), yüksek dansiteli lipoprotein kolesterol (HDL-K), düşük dansiteli lipoprotein kolestrol (LDL-K)\'ün serum düzeyleri ve ESR ölçüldü ve vücut kütle indeksi (BMI) tedaviden önce ve sonra hesaplandı. Bulgular: Hipertiroid hastalarının tedavi öncesi t-hcy, TC, LDL-Kolesterol, HDL-Kolesterol düzeyleri ve BMI tedavi sonrası düzeylerden daha düşüktü (tüm değişkenler için, p

Keywords

• Hipertiroidi
• homosistein
• leptin
• lipid profii
• tedavi

Lipid profile and levels of homocysteine, leptin, fibrinogen and C-reactive protein in hyperthyroid patients before and after treatment

Abstract

Objectives: The present study was carried out to deter­mine whether thyroid hormones affect lipid profile and levels of erithrocyte sedimentation rate (ESR), serum total homocysteine (t-hcy), leptin, fibrinogen, C-reactive protein (CRP in patients with hyperthyroidism. Materials and methods: This study was carried out on 23 hyperthroid subjects (3 men / 20 women, mean age 41.8 ± 2.4 years). Serum levels of homocysteine, leptin, fibrinogen, CRP, total cholesterol (TC), high-density lipo­protein cholesterol (HDL-C), low-density lipoprotein cho­lesterol (LDL-C) and ESR were measured and body mass index (BMI) were calculated before and after treatment of hyperthyroidism. Results: Pretreatment t-hcy, TC, LDL-C, HDL-C levels and BMI of patients were significantly lower than those of the post-treatment (p

Keywords

• Hyperthyroidism
• homocysteine
• leptin
• lipid profile
• treatment

References

1. Faber J, Wiinberg N, Schifter S, Mehlsen J. Haemodynamic changes following treatment of subclinical and overt hyper- thyroidism. Eur J Endocrinol 2001;145:391-396.
2. Diekman MJ, Anghelescu N, Endert E, Bakker O, Wiersinga WM. Changes in plasma low-density lipoprotein (LDL) - and high-density lipoprotein cholesterol in hypo- and hyperthyroid patients are related to changes in free thy- roxine, not to polymorphisms in LDL receptor or choles- terol ester transfer protein genes. J Clin Endocrinol Metab 2000;85:1857-1862.
3. Wonn-Young L, Jung-Yul S, Eun-Jung R, Jeong-Sik P, Ki- Chul S, Sun-Woo K. Plasma CRP, Apolipoprotein A-1, Apolipoprotein B and Lp (a) levels according to thyroid function status. Arch Med Res 2004;35:540-545.
4. Chadarevian R, Bruckert E, Giral P, Turpin G. Relationship between thyroid hormones and fibrinogen levels. Blood Coagul Fibrinolysis 1999;10:481-486.
5. Diekman MJ, van der Put NM, Blom HJ, Tijssen JG, Wi- ersinga WM. Determinants of changes in plasma homo- cysteine in hyperthyroidism and hypothyroidism. Clin En- docrinol (Oxf) 2001;54:197-204.
6. Matsubara M, Yoshizawa T, Morioka T, Katayose S. Serum leptin and lipids in patients with thyroid dysfunction. J Ath- eroscler Thromb 2000;7:50-54.
7. Hofbauer LC, Heufelder AE. Coagulation disorders in thy- roid diseases. Eur J Endocrinol 1997;136:1-7.
8. Yarnell JW, Baker IA, Sweetnam PM, et al. Fibrinogen, vis- cosity, and white blood cell count are major risk factors for ischemic heart disease. The Caerphilly and Speedwell col- laborative heart disease studies. Circulation 1991;83:836- 844.

9. Rosengren A, Wilhelmsen L, Welin L, Tsipogianni A, Teger- Nilsson AC, Wedel H. Social influences and cardiovascular risk factors as determinants of plasma fibrinogen concentra- tion in a general population sample of middle aged men. BMJ 1990;10300(6725): 634-638.
10. Folsom AR, Wu KK, Davis CE, Conlan MG, Sorlie PD, Szklo M. Population correlates of plasma fibrinogen and factor VII, putative cardiovascular risk factors. Atheroscle- rosis 1991;91:191-205.
11. Takeda I, Kometani T. Emergency laboratory service in Shi- mane Prefectural Central Hospital (author’s transl) Rinsho Byori 1981;29:37-41.
12. Thompson SG, Fechtrup C, Squire E, et al. Antithrombin III and fibrinogen as predictors of cardiac events in pa- tients with angina pectoris. Arterioscler Thromb Vasc Biol 1996;16:357-362.
13. Anderson JL, Carlquist JF, Muhlestein JB, Horne BD, El- mer SP. Evaluation of C-reactive protein, an inflammatory marker, and infectious serology as risk factors for coronary artery disease and myocardial infarction. J Am Coll Cardiol 1998;32:35-41.
14. Mendall MA, Patel P, Ballam L, Strachan D, Northfield TC. C reactive protein and its relation to cardiovascular risk fac- tors: a population based cross sectional study. BMJ 1996; 312(7038):1061-1065.
15. Welch GN, Loscalzo J. Homocysteine and atherothrombo- sis. N Engl J Med 1998;338:1042-1050.
16. Catargi B, Parrot-Roulaud F, Cochet C, Ducassou D, Roger P, Tabarin A. Homocysteine, hypothyroidism, and effect of thyroid hormone replacement. Thyroid 1999;9:1163-1166.
17. Barbe F, Klein M, Chango A, et al. Homocysteine, folate, vitamin B12, and transcobalamins in patients undergoing successive hypo- and hyperthyroid states. J Clin Endocrinol Metab 2001; 86:1845-1846.
18. Boushey CJ, Beresford SA, Omenn GS, Motulsky AG. A quantitative assessment of plasma homocysteine as a risk factor for vascular disease. Probable benefits of increasing folic acid intakes. JAMA 1995;274:1049-1057.
19. Brattstrom L, Israelsson B, Tengborn L, Hultberg B. Ho- mocysteine, factor VII and antithrombin III in subjects with different gene dosage for cystathionine beta-synthase. J In- herit Metab Dis 1989;12:475-482.
20. Leonhardt U, Ritzel U, Schafer G, Becker W, Ramadori G. Serum leptin levels in hypo- and hyperthyroidism. J Endo- crinol 1998;157:75-79.
21. Halaas JL, Gajiwala KS, Maffei M, et al. Weight-reducing effects of the plasma protein encoded by the obese gene. Science 1995;269(5223):543-546
22. Papaspyrou-Rao S, Schneider SH, Petersen RN, Fried SK. Dexamethasone increases leptin expression in humans in vivo. J Clin Endocrinol Metab 1997;82:1635-1637.
23. Cusin I, Sainsbury A, Doyle P, Rohner-Jeanrenaud F, Jeanrenaud B. The ob gene and insulin. A relationship leading to clues to the understanding of obesity. Diabetes 1995;44:1467-1470.
24. Corbetta S, Englaro P, Giambona S, Persani L, Blum WF, Beck-Peccoz P. Lack of effects of circulating thyroid hor- mone levels on serum leptin concentrations. Eur J Endo- crinol 1997;137:659-663.
25. Oge A, Bayraktar F, Saygili F, Guney E, Demir S. TSH influences serum leptin levels independent of thyroid hor- mones in hypothyroid and hyperthyroid patients. Endocr J 2005;52:213-217.
26. Nedrebo BG, Ericsson UB, Nygard O, et al. Plasma total homocysteine levels in hyperthyroid and hypothyroid pa- tients. Metabolism 1998;47:89-93.
27. Nygard O, Vollset SE, Refsum H, Brattstrom L, Ueland PM. Total homocysteine and cardiovascular disease. J Intern Med 1999; 246: 425-454.
28. Demirbas B, Ozkaya M, Cakal E, et al. Plasma homo- cysteine levels in hyperthyroid patients. Endocr J 2004; 51: 121-125.
29. Toss H, Lindahl B, Siegbahn A, Wallentin L. Prognostic influence of increased fibrinogen and C-reactive protein levels in unstable coronary artery disease. FRISC Study Group. Fragmin during Instability in Coronary Artery Dis- ease. Circulation 1997;96:4204-4210.
30. Pasceri V, Willerson JT, Yeh ET. Direct proinflammatory effect of C-reactive protein on human endothelial cells. Cir- culation 2000;102:2165-2168.
31. Burggraaf J, Lalezari S, Emeis JJ, et al. Endothelial func- tion in patients with hyperthyroidism before and after treat- ment with propranolol and thiamazol. Thyroid 2001; 11: 153-160.
32. Erem C, Ersoz HO, Karti SS, et al. Blood coagulation and fibrinolysis in patients with hyperthyroidism. J Endocrinol Invest 2002; 25: 345-350.
33. Horne MK 3rd, Singh KK, Rosenfeld KG, et al. Is thyroid hormone suppression therapy prothrombotic? J Clin Endo- crinol Metab 2004; 89: 4469-4473.
34. Lin KH, Lee HY, Shih CH, et al. Plasma protein regulation by thyroid hormone. J Endocrinol 2003; 179: 367-377.
35. Shih CH, Chen SL, Yen CC, et al. Thyroid hormone recep- tor-dependent transcriptional regulation of fibrinogen and coagulation proteins. Endocrinology 2004;145:2804-2814.
36. Parle JV, Maisonneuve P, Sheppard MC, Boyle P, Franklyn JA. Prediction of all-cause and cardiovascular mortality in elderly people from one low serum thyrotropin result: a 10- year cohort study. Lancet 2001;358(9285):861-865.
37. Engler H, Riesen WF. Effect of thyroid function on concen- trations of lipoprotein(a). Clin Chem 1993;39:2466-2469.
38. Ponsin G, Vialle-Valentin C, Berthezene F. Alterations of high density lipoproteins induced by thyroid hormones in man and rat. Adv Exp Med Biol 1991;285:147-154.
39. Ruggiero FM, Cafagna F, Quagliariello E. Exchange of free cholesterol between plasma and erythrocytes from hyper- thyroid and hypothyroid rats in vitro.Lipids 1990;25:529- 533.
40. Staels B, Van Tol A, Chan L, Will H, Verhoeven G, Auwerx J. Alterations in thyroid status modulate apolipoprotein, he- patic triglyceride lipase, and low density lipoprotein recep- tor in rats. Endocrinology 1990;127:1144-1152.
41. Hoch FL. Lipids and thyroid hormones. Prog Lipid Res 1988;27:199-270.
42. Yoshida T, Momotani N, Hayashi M, Monkawa T, Ito K, Saruta T. Serum leptin concentrations in patients with thy- roid disorders. Clin Endocrinol (Oxf) 1998;48:299-302.
43. Zimmermann-Belsing T, Dreyer M, Holst JJ, Feldt-Ras- mussen U. The relationship between the serum leptin con- centrations of thyrotoxic patients during treatment and their total fat mass is different from that of normal subjects. Clin Endocrinol (Oxf) 1998;49:589-595.
44. Iglesias P, Alvarez Fidalgo P, Codoceo R, Diez JJ. Serum concentrations of adipocytokines in patients with hyperthy- roidism and hypothyroidism before and after control of thy- roid function. Clin Endocrinol (Oxf) 2003;59:621-629.
45. Pinkney JH, Goodrick SJ, Katz J, et al. Leptin and the pitu- itary-thyroid axis: a comparative study in lean, obese, hy- pothyroid and hyperthyroid subjects. Clin Endocrinol (Oxf) 1998;49:583-588.
46. Sesmilo G, Casamitjana R, Halperin I, Gomis R, Vilardell E. Role of thyroid hormones on serum leptin levels. Eur J Endocrinol 1998;139:428-430.