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

Year 2010, Volume: 37 Issue: 1, 1 - 7, 01.03.2010

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

References

  • 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.
  • 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.
  • 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.
  • Chadarevian R, Bruckert E, Giral P, Turpin G. Relationship between thyroid hormones and fibrinogen levels. Blood Coagul Fibrinolysis 1999;10:481-486.
  • 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.
  • 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.
  • Hofbauer LC, Heufelder AE. Coagulation disorders in thy- roid diseases. Eur J Endocrinol 1997;136:1-7.
  • 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.
  • 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.
  • 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.
  • Takeda I, Kometani T. Emergency laboratory service in Shi- mane Prefectural Central Hospital (author’s transl) Rinsho Byori 1981;29:37-41.
  • 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.
  • 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.
  • 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.
  • Welch GN, Loscalzo J. Homocysteine and atherothrombo- sis. N Engl J Med 1998;338:1042-1050.
  • 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.
  • 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.
  • 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.
  • 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.
  • Leonhardt U, Ritzel U, Schafer G, Becker W, Ramadori G. Serum leptin levels in hypo- and hyperthyroidism. J Endo- crinol 1998;157:75-79.
  • 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
  • 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.
  • 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.
  • 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.
  • 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.
  • Nedrebo BG, Ericsson UB, Nygard O, et al. Plasma total homocysteine levels in hyperthyroid and hypothyroid pa- tients. Metabolism 1998;47:89-93.
  • Nygard O, Vollset SE, Refsum H, Brattstrom L, Ueland PM. Total homocysteine and cardiovascular disease. J Intern Med 1999; 246: 425-454.
  • Demirbas B, Ozkaya M, Cakal E, et al. Plasma homo- cysteine levels in hyperthyroid patients. Endocr J 2004; 51: 121-125.
  • 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.
  • Pasceri V, Willerson JT, Yeh ET. Direct proinflammatory effect of C-reactive protein on human endothelial cells. Cir- culation 2000;102:2165-2168.
  • 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.
  • Erem C, Ersoz HO, Karti SS, et al. Blood coagulation and fibrinolysis in patients with hyperthyroidism. J Endocrinol Invest 2002; 25: 345-350.
  • Horne MK 3rd, Singh KK, Rosenfeld KG, et al. Is thyroid hormone suppression therapy prothrombotic? J Clin Endo- crinol Metab 2004; 89: 4469-4473.
  • Lin KH, Lee HY, Shih CH, et al. Plasma protein regulation by thyroid hormone. J Endocrinol 2003; 179: 367-377.
  • 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.
  • 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.
  • Engler H, Riesen WF. Effect of thyroid function on concen- trations of lipoprotein(a). Clin Chem 1993;39:2466-2469.
  • 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.
  • 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.
  • 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.
  • Hoch FL. Lipids and thyroid hormones. Prog Lipid Res 1988;27:199-270.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.

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

Year 2010, Volume: 37 Issue: 1, 1 - 7, 01.03.2010

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

References

  • 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.
  • 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.
  • 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.
  • Chadarevian R, Bruckert E, Giral P, Turpin G. Relationship between thyroid hormones and fibrinogen levels. Blood Coagul Fibrinolysis 1999;10:481-486.
  • 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.
  • 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.
  • Hofbauer LC, Heufelder AE. Coagulation disorders in thy- roid diseases. Eur J Endocrinol 1997;136:1-7.
  • 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.
  • 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.
  • 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.
  • Takeda I, Kometani T. Emergency laboratory service in Shi- mane Prefectural Central Hospital (author’s transl) Rinsho Byori 1981;29:37-41.
  • 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.
  • 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.
  • 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.
  • Welch GN, Loscalzo J. Homocysteine and atherothrombo- sis. N Engl J Med 1998;338:1042-1050.
  • 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.
  • 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.
  • 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.
  • 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.
  • Leonhardt U, Ritzel U, Schafer G, Becker W, Ramadori G. Serum leptin levels in hypo- and hyperthyroidism. J Endo- crinol 1998;157:75-79.
  • 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
  • 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.
  • 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.
  • 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.
  • 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.
  • Nedrebo BG, Ericsson UB, Nygard O, et al. Plasma total homocysteine levels in hyperthyroid and hypothyroid pa- tients. Metabolism 1998;47:89-93.
  • Nygard O, Vollset SE, Refsum H, Brattstrom L, Ueland PM. Total homocysteine and cardiovascular disease. J Intern Med 1999; 246: 425-454.
  • Demirbas B, Ozkaya M, Cakal E, et al. Plasma homo- cysteine levels in hyperthyroid patients. Endocr J 2004; 51: 121-125.
  • 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.
  • Pasceri V, Willerson JT, Yeh ET. Direct proinflammatory effect of C-reactive protein on human endothelial cells. Cir- culation 2000;102:2165-2168.
  • 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.
  • Erem C, Ersoz HO, Karti SS, et al. Blood coagulation and fibrinolysis in patients with hyperthyroidism. J Endocrinol Invest 2002; 25: 345-350.
  • Horne MK 3rd, Singh KK, Rosenfeld KG, et al. Is thyroid hormone suppression therapy prothrombotic? J Clin Endo- crinol Metab 2004; 89: 4469-4473.
  • Lin KH, Lee HY, Shih CH, et al. Plasma protein regulation by thyroid hormone. J Endocrinol 2003; 179: 367-377.
  • 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.
  • 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.
  • Engler H, Riesen WF. Effect of thyroid function on concen- trations of lipoprotein(a). Clin Chem 1993;39:2466-2469.
  • 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.
  • 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.
  • 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.
  • Hoch FL. Lipids and thyroid hormones. Prog Lipid Res 1988;27:199-270.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
There are 46 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Articles
Authors

Emine Sütken This is me

Aysen Akalın This is me

Filiz Özdemir This is me

Ömer Çolak This is me

Publication Date March 1, 2010
Submission Date March 2, 2015
Published in Issue Year 2010 Volume: 37 Issue: 1

Cite

APA Sütken, E., Akalın, A., Özdemir, F., Çolak, Ö. (2010). Lipid profile and levels of homocysteine, leptin, fibrinogen and C-reactive protein in hyperthyroid patients before and after treatment. Dicle Tıp Dergisi, 37(1), 1-7.
AMA Sütken E, Akalın A, Özdemir F, Çolak Ö. Lipid profile and levels of homocysteine, leptin, fibrinogen and C-reactive protein in hyperthyroid patients before and after treatment. diclemedj. March 2010;37(1):1-7.
Chicago Sütken, Emine, Aysen Akalın, Filiz Özdemir, and Ömer Çolak. “Lipid Profile and Levels of Homocysteine, Leptin, Fibrinogen and C-Reactive Protein in Hyperthyroid Patients before and After Treatment”. Dicle Tıp Dergisi 37, no. 1 (March 2010): 1-7.
EndNote Sütken E, Akalın A, Özdemir F, Çolak Ö (March 1, 2010) Lipid profile and levels of homocysteine, leptin, fibrinogen and C-reactive protein in hyperthyroid patients before and after treatment. Dicle Tıp Dergisi 37 1 1–7.
IEEE E. Sütken, A. Akalın, F. Özdemir, and Ö. Çolak, “Lipid profile and levels of homocysteine, leptin, fibrinogen and C-reactive protein in hyperthyroid patients before and after treatment”, diclemedj, vol. 37, no. 1, pp. 1–7, 2010.
ISNAD Sütken, Emine et al. “Lipid Profile and Levels of Homocysteine, Leptin, Fibrinogen and C-Reactive Protein in Hyperthyroid Patients before and After Treatment”. Dicle Tıp Dergisi 37/1 (March 2010), 1-7.
JAMA Sütken E, Akalın A, Özdemir F, Çolak Ö. Lipid profile and levels of homocysteine, leptin, fibrinogen and C-reactive protein in hyperthyroid patients before and after treatment. diclemedj. 2010;37:1–7.
MLA Sütken, Emine et al. “Lipid Profile and Levels of Homocysteine, Leptin, Fibrinogen and C-Reactive Protein in Hyperthyroid Patients before and After Treatment”. Dicle Tıp Dergisi, vol. 37, no. 1, 2010, pp. 1-7.
Vancouver Sütken E, Akalın A, Özdemir F, Çolak Ö. Lipid profile and levels of homocysteine, leptin, fibrinogen and C-reactive protein in hyperthyroid patients before and after treatment. diclemedj. 2010;37(1):1-7.