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The Evaluation of Epicardial Fat Thickness and Carotid Intima-Media Thickness in the Patients with Subclinical and Overt Hypothyroidism

Year 2019, , 145 - 150, 30.06.2019
https://doi.org/10.16899/jcm.577187

Abstract

Bacgrounds: The studies conducted have shown that epicardial fat
thickness (EFT) and Carotid intima-media thickness (CIMT) are  closely associated with cardiovascular
diseases and that this may be an indicator for the prediction of early
atherosclerosis.
In this study, we have attempted
to identify EFT and CIMT in patients with hypothyroidism and to reveal the
relationship between them and thyroid hormones.

Material and method: 82 patients diagnosed with primary hypothyroidism and
37 patients from healthy control group were included in the study. The
subclinic hypothyroidism group (SH) was made up of 50 patients; the overt
hypothyroidism group (OH) was composed of 32 patients. Cases’ thyroid-stimulating hormone (TSH), FT3, FT4, thyroperoxidase antibodies (anti-tpo) and
anti-tiroglobulin antibodies (anti-tg) were
studied. Their EFT and CIMT values were measured. The statistical analysis was
applied to EFT and CIMT.

Results: Compared with the CG, the thickness of epicardial fat tissue increased
in OH and SH groups (p<0,001, p<0,001 respectively). In terms of EFT,
there was no significant difference between OH and SH groups. Compared with the
CG, the mean CIMT increased in OH and SH (p<0,001, p<0.001 respectively),
but there was no significant difference between OH and SH in terms of CIMT. In
addition, there was a positive correlation between EFT and CIMT (p<0.001).







 Conclusions: The measurement of EFT and CIMT can be used as a
marker for the diagnosis of early atherosclerosis both in OH and in SH
patients. Because the thickness of EFT and CIMT increased in patients with SH
who are debated as to whether they should be treated, it leads us to think that
these patients should be treated in order to reduce the risk of cardiovascular
diseases in these patients.

References

  • 1. Cooper DS, ladenson PW: Greenspans’ basic and clinical Endocrinology. 9th Edition chapter 7, 2011: 180–97
  • 2. Cooper DS, Subclinical thyroid disease: A clinician’s perspective. Ann Intern Med, 1998; 129: 135-38
  • 3. Veltri F, Rocha FO, Willems D et al. Prevalence of thyroid dysfunction andautoimmunity in the older population and implications of age-specific reference ranges. Clinica Chimica Acta, 2017; 465: 34-39
  • 4. Iacobellis G, Willens HJ, Barbaro G, Sharma AM. threshold values of high risk echocardiographic epicardial fat thickness. Obesity (Silver Spring) 2008; 16(4): 887-92.
  • 5. Kablak-Ziembicka A, Tracz W, Przewlocki T, et al. Association of increased carotid intima-media thickness with the extent of coronary artery disease. Heart 2004; 90:1286-1290.
  • 6. Charles H, Hennekens, MD, Dr PH. Increasing burden of cardiovascular disease. Current knowledge and future firections for research on risc factors. Circulation 1998; 97: 1095-1102.
  • 7. Mazurek T, Zhang L, Zalewski A, Mannion JD, Diehl JT, Arafat H, et al. Human epicardial adipose tissue is a source of inflammatory mediators. Circulation 2003;108:2460-6.
  • 8. Baker AR, Silva NF, Quinn DW, Harte AL, Pagano D, Bonser RS, et al. Human epicardial adipose tissue expresses a pathogenic profile of adipocytokines in patients with cardiovascular disease. Cardiovasc Diabetol 2006;13:1
  • 9. Cappola, A.R. & Ladenson, P.W. (2003) Hypothyroidism and atherosclerosis. Journal of Clinical Endocrinology and Metabolism, 88, 2438–2444.
  • 10. Ochs N, Auer R, Bauer DC, et al. Meta-analysis: subclinical thyroid dysfunctionand the risk for coronary heart disease and mortality. Ann Intern Med 2008; 148:832-45
  • 11. Monzani F, Caraccio N, Kozakowa M, et al. Effect of levothyroxine replacement on lipid profile and intima media thickness in hypothyroidism: a double blind, placebo controlled study. J Clin Endocrinol Metab. 2004 May; 89(5):2099-1063.
  • 12. Iacobellis G, Corradi D, Sharma AM. Epicardial adipose tissue: anatomic, biomolecular and clinical relationships with the heart. Nat Clin Pract Cardiovasc Med 2005;2: 536-43. 13. Jeong JW, Jeong MH, Yun KH, Oh SK, Park EM, Kim YK, et al. Echocardiographic epicardial fat thickness and coronary artery disease. Circ J 2007; 71: 536-9.
  • 14. 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
  • 15. Korkmaz L, Sahin S, Akyuz AR, Ziyrek M, Anaforoglu I, Kose M, Erkan H, Ağaç MT, Acar Z. Epicardial adipose tissue increased in patients with newly diagnosed subclinical hypothyroidism. Med Princ Pract. 2013;22(1):42-6
  • 16. Santos OC, Silva NA, Vaisman M, Turano MD, Dytz MG, Huber GA, Braulio VB, Teixeira PF. Evaluation of epicardial fat tissue thickness as a marker of cardiovascular risk in patients with subclinicalhypothyroidism. J Endocrinol Invest. 2015 Apr;38(4):421-7
  • 17. Mamiya S, Hagiwara M, Inoue S, Hidaka H: Thyroid hormones inhibit platelet function and myosin light chain kinase. J Biol Chem 1989; 264: 8575–8579.
  • 18. Nagasaki T, Inaba M, Henmi Y, et al. Decrease in ca¬rotid intima-media thickness in hypothyroidism patients after normalization of thyroid function. Clinical Endocrinology 2003; 59: 607-612
  • 19. Taddei S, Caraccio N, Virdis A, Dardano A, Versari D, Ghiadoni L, Ferrannini E, Salvetti A, Monzani F (2006) Low-grade systemic inflammation causes endothelial dysfunction in patients with Hashimoto’ s thyroiditis. J Clin Endocrinol Metab 91: 5076-5082
  • 20. Kvetny J, Heldgaard PE, Bladbjerg EM, Gram J (2004) Subclinical hypothyroidism is associated with a lowgrade inflammation, increased triglyceride levels and predicts cardiovascular disease in males below 50 years. Clin Endocrinol (Oxf) 61: 232-238
  • 21. Ciccone, M.M., De Pergola, G., Porcelli, M.T., et al. (2010) Increased carotid IMT in overweight and obese women affected 22. Cakir, E., Dogan, M., Topaloglu, O., et al. (2013) Subclinical atherosclerosis and hyperandrogenemia are independent risk factors for increased epicardial fat thickness in patients with PCOS and idiopathic hirsutism. Atherosclerosis, 226, 291–295
  • 23. Sengul, C., Cevik, C., Ozveren, O., et al. (2011) Echocardiographic epicardial fat thickness is associated with carotid intima-media thickness in patients with metabolic syndrome. Echocardiography, 28, 853–858
Year 2019, , 145 - 150, 30.06.2019
https://doi.org/10.16899/jcm.577187

Abstract

References

  • 1. Cooper DS, ladenson PW: Greenspans’ basic and clinical Endocrinology. 9th Edition chapter 7, 2011: 180–97
  • 2. Cooper DS, Subclinical thyroid disease: A clinician’s perspective. Ann Intern Med, 1998; 129: 135-38
  • 3. Veltri F, Rocha FO, Willems D et al. Prevalence of thyroid dysfunction andautoimmunity in the older population and implications of age-specific reference ranges. Clinica Chimica Acta, 2017; 465: 34-39
  • 4. Iacobellis G, Willens HJ, Barbaro G, Sharma AM. threshold values of high risk echocardiographic epicardial fat thickness. Obesity (Silver Spring) 2008; 16(4): 887-92.
  • 5. Kablak-Ziembicka A, Tracz W, Przewlocki T, et al. Association of increased carotid intima-media thickness with the extent of coronary artery disease. Heart 2004; 90:1286-1290.
  • 6. Charles H, Hennekens, MD, Dr PH. Increasing burden of cardiovascular disease. Current knowledge and future firections for research on risc factors. Circulation 1998; 97: 1095-1102.
  • 7. Mazurek T, Zhang L, Zalewski A, Mannion JD, Diehl JT, Arafat H, et al. Human epicardial adipose tissue is a source of inflammatory mediators. Circulation 2003;108:2460-6.
  • 8. Baker AR, Silva NF, Quinn DW, Harte AL, Pagano D, Bonser RS, et al. Human epicardial adipose tissue expresses a pathogenic profile of adipocytokines in patients with cardiovascular disease. Cardiovasc Diabetol 2006;13:1
  • 9. Cappola, A.R. & Ladenson, P.W. (2003) Hypothyroidism and atherosclerosis. Journal of Clinical Endocrinology and Metabolism, 88, 2438–2444.
  • 10. Ochs N, Auer R, Bauer DC, et al. Meta-analysis: subclinical thyroid dysfunctionand the risk for coronary heart disease and mortality. Ann Intern Med 2008; 148:832-45
  • 11. Monzani F, Caraccio N, Kozakowa M, et al. Effect of levothyroxine replacement on lipid profile and intima media thickness in hypothyroidism: a double blind, placebo controlled study. J Clin Endocrinol Metab. 2004 May; 89(5):2099-1063.
  • 12. Iacobellis G, Corradi D, Sharma AM. Epicardial adipose tissue: anatomic, biomolecular and clinical relationships with the heart. Nat Clin Pract Cardiovasc Med 2005;2: 536-43. 13. Jeong JW, Jeong MH, Yun KH, Oh SK, Park EM, Kim YK, et al. Echocardiographic epicardial fat thickness and coronary artery disease. Circ J 2007; 71: 536-9.
  • 14. 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
  • 15. Korkmaz L, Sahin S, Akyuz AR, Ziyrek M, Anaforoglu I, Kose M, Erkan H, Ağaç MT, Acar Z. Epicardial adipose tissue increased in patients with newly diagnosed subclinical hypothyroidism. Med Princ Pract. 2013;22(1):42-6
  • 16. Santos OC, Silva NA, Vaisman M, Turano MD, Dytz MG, Huber GA, Braulio VB, Teixeira PF. Evaluation of epicardial fat tissue thickness as a marker of cardiovascular risk in patients with subclinicalhypothyroidism. J Endocrinol Invest. 2015 Apr;38(4):421-7
  • 17. Mamiya S, Hagiwara M, Inoue S, Hidaka H: Thyroid hormones inhibit platelet function and myosin light chain kinase. J Biol Chem 1989; 264: 8575–8579.
  • 18. Nagasaki T, Inaba M, Henmi Y, et al. Decrease in ca¬rotid intima-media thickness in hypothyroidism patients after normalization of thyroid function. Clinical Endocrinology 2003; 59: 607-612
  • 19. Taddei S, Caraccio N, Virdis A, Dardano A, Versari D, Ghiadoni L, Ferrannini E, Salvetti A, Monzani F (2006) Low-grade systemic inflammation causes endothelial dysfunction in patients with Hashimoto’ s thyroiditis. J Clin Endocrinol Metab 91: 5076-5082
  • 20. Kvetny J, Heldgaard PE, Bladbjerg EM, Gram J (2004) Subclinical hypothyroidism is associated with a lowgrade inflammation, increased triglyceride levels and predicts cardiovascular disease in males below 50 years. Clin Endocrinol (Oxf) 61: 232-238
  • 21. Ciccone, M.M., De Pergola, G., Porcelli, M.T., et al. (2010) Increased carotid IMT in overweight and obese women affected 22. Cakir, E., Dogan, M., Topaloglu, O., et al. (2013) Subclinical atherosclerosis and hyperandrogenemia are independent risk factors for increased epicardial fat thickness in patients with PCOS and idiopathic hirsutism. Atherosclerosis, 226, 291–295
  • 23. Sengul, C., Cevik, C., Ozveren, O., et al. (2011) Echocardiographic epicardial fat thickness is associated with carotid intima-media thickness in patients with metabolic syndrome. Echocardiography, 28, 853–858
There are 21 citations in total.

Details

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

Abdullah Doğan 0000-0001-7721-3707

Aziz Karabulut

Faruk Kılınç

Zafer Pekkolay

Alparslan Kemal Tuzcu

Publication Date June 30, 2019
Acceptance Date June 12, 2019
Published in Issue Year 2019

Cite

AMA Doğan A, Karabulut A, Kılınç F, Pekkolay Z, Tuzcu AK. The Evaluation of Epicardial Fat Thickness and Carotid Intima-Media Thickness in the Patients with Subclinical and Overt Hypothyroidism. J Contemp Med. June 2019;9(2):145-150. doi:10.16899/jcm.577187