Carotid intima-media thickness and neutrophils/lymphocytes ratio in patients with overt and subclinical hypothyroidism

Abstract

Objective: Hypothyroidism, whether overt or subclinical, has multiple effects on the cardiovascular system. Neutrophil-lymphocyte (N/L) rate is closely related to cardiovascular disorders and atherosclerosis. Our study aimed to assess N/L rate and carotid artery intima-media thickness (CIMT) in patients with overt and subclinical hypothyroidism (SCH). Methods: The study included 36 patients with SCH and 28 patients with overt hypothyroidism (OH) as well as 30 healthy controls. CIMT, thyroid hormone levels, complete blood count and lipid parameters were measured in all subjects. Correlation analysis and linear regression analysis were performed for N/L rate. Results: Mean CIMT was 0.51 &plusmn; 0.15, 0.58 &plusmn; 0.16, 0.67 &plusmn; 0.24 mm in control, SCH, and OH groups, respectively. CIMT of OH patients was high compared with control subjects (P < 0.05). CIMT of SCH patients were not different compared with control subjects and OH patients (P > 0.05). It was no correlation that CIMT between N/L ratio (p > 0.05). Conclusion: Neutrophil-lymphocyte rate was not found to be useful indicator of early atherosclerosis in SCH and OH patients. J Clin Exp Invest 2013; 4 (4): 463-446

Keywords

• Hypothyroidism, carotid artery, intima media thickness, neutrophil lymphocyte ratio

Aşikar ve subklinik hipotiroidili hastalarda karotis arter intima media kalınlığı ve nötrofil lenfosit oranı

Öz

Amaç: Hipotiroidizmin ister aşikar ister subklinik olsun kardiyovasküler sistem üzerine çeşitli etkileri vardır. Nötrofil-lenfosit (N/L) oranı, kardiovasküler hastalıklar ve ateroskleroz ile ilişkili bulunmuştur. Biz çalışmamızda, aşikar ve subklinik hipotiroidili hastalarda karotis arter intimia media (KİM) kalınlığı ve N/L oranı arasındaki ilişkiyi değerlendirmeyi amaçladık. Yöntemler: Çalışmamız 36 subklinik hipotiroidi (SH) ve 28 aşikar hipotiroidi (AH) tanılı hasta ve 30 sağlıklı gönüllüyü içermektedir. Tüm vakaların KİM kalınlığı, tiroid hormon seviyeleri, tam kan sayımı ve lipit parametreleri ölçüldü. N/L oranları için korelasyon ve lineer regresyon analizleri uygulandı. Bulgular: Kontrol grubunda, SH ve AH\'li hastalarda ortalama KİM kalınlığı sırasıyla 0,51 &plusmn; 0,15, 0,58 &plusmn; 0,16, 0,67 &plusmn; 0,24 mm bulundu. AH\'li hastalarda KİM kalınlığı, sağlıklı gönüllülere göre daha yüksekti (p < 0,05). Ancak, SH\'li hastalarda KİM kalınlığı, diğer gruplardan farklı bulunmadı (p > 0,05). KİM kalınlığı ile N/L oranı arasında herhangi bir korelasyon saptanmadı (p < 0,05). Sonuç: Aşikar ve subklinik hipotroidisi bulunan hastalarda N/L oranları benzerdi ve aterosklerotik belirteçlerle ilişkisi saptanmadı.

Anahtar Kelimeler

• Hipotroidi, karotis arteri, intima-media kalınlığı, nötrofil/lenfosit oranı

References

1. Cappola AR, Ladenson PW. Hypothyroidism and ath- erosclerosis. J Clin Endocrinol Metab 2003; 88:2438- 2344.
2. Mitu F, Cojocaru E, Tamba B, Leon MM. Prevalence of cardiovascular diseases in patients with hypothyroid- ism. Rev Med Chir Soc Med Nat 2012;116:413-418.
3. Asik M, Sahin S, Ozkul F, et al. Evaluation of Epicardial Fat Tissue Thickness in Patients with Hashimoto Thy- roiditis. Clin Endocrinol 2013 doi: 10.1111/cen.12176.
4. Hak AE, Pols HA, Visser TJ, et al. Subclinical hypo- thyroidism is an independent risk factor for athero- sclerosis and myocardial infarction in elderly women: the Rotterdam Study. Annals of Internal Medicine 2000;15:270-278.
5. Vanderpump MP, Tunbridge WM, French JM, et al. The development of ischemic heart disease in relation to autoimmune thyroid disease in a 20-year follow-up study of an English community. Thyroid 1996;6:155- 160.
6. Polak JF, Pencina MJ, Pencina KM, et al. Carotid-wall intima-media thickness and cardiovascular events. New England Journal of Medicine 2011;21:213-221.
7. Kablak-Ziembicka A, Tracz W, Przewlocki T, et al. As- sociation of increased carotid intima-media thickness with the extent of coronary artery disease. Heart 2004; 90:1286-1290.
8. Valentina V.N., Marijan B., Chedo D., et al. Subclini- cal hypothyroidism and risk to carotid atherosclerosis. Arquivos Brasileiros de Endocrinologia & Metabologia 2011; 55:475-480.

9. Bhat T, Teli S, Rijal J, et al. Neutrophil to lymphocyte ratio and cardiovascular diseases. Rev Cardiovasc Ther 2013;1:55-59.
10. Park JJ, Jang HJ, Oh IY, et all. Prognostic value of neutrophil to lymphocyte ratio in patients presenting with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Thyroid disease and lipids. Thyroid 2002;12:287-293.
11. Nagasaki T, Inaba M, Henmi Y, et al. Decrease in ca- rotid intima-media thickness in hypothyroid patients after normalization of thyroid function. Clinical Endo- crinology 2003; 59:607-612.
12. Demirkol S, Balta S, Unlu M, et al. Neutrophils/Lym- phocytes Ratio in Patients With Cardiac Syndrome X and Its Association With Carotid Intima-Media Thick- ness. Clin Appl Thromb Hemost 2012 Nov 26. [Epub ahead of print]
13. Doğdu O, Akpek M, Yarlıoğlueş M, et al. Relationship between hematologic parameters and left ventricular systolic dysfunction in stable patients with multi-ves- sel coronary artery disease. Turk Kardiyol Dern Ars 2012;40:706-713.
14. Çil H, İslamoğlu Y, Yavuz C, et al. Nötrofil/lenfosit ora- nı ile koroner kollateral dolaşım arasındaki ilişki. J Clin Exp Invest 2012;3:29-32.