THE EFFECTS OF THYROID-STIMULATING HORMONE, FREE THYROXINE LEVELS, AND THYROID ANTIBODIES ON MEAN PLATELET VOLUME: ORIGINAL RESEARCH

Abstract

Background: Coagulation abnormalities has been reported in patients with impaired metabolism of thyroid hormones. Platelets play an important role in coagulation and Mean Platelet Volume has been considered as an inflammatory biomarker in multiple diseases. Objectives: The aim of this study was to investigate whether any relationship exists between the values of thyroid-stimulating hormone, free thyroxine, anti-thyroid peroxidase, anti-thyroglobulin and those of the MPV. Methods: Patients who were admitted to the Endocrinology outpatient clinic between October 2013 and July 2019 with a pre-diagnosis of thyroid disease were included in the study. The data were analyzed with IBM SPSS V23. Compatibility with normal distribution was examined with the Shapiro Wilk test. The relation between the variables was evaluated with Spearman rank correlation. Results: Records of 1098 patients were examined. There is a very weak positive relationship between TSH and MPV (r: 0,075), there is no significant relationship between ST4, Anti TPO, Anti TG and MPV. Conclusion: Patients have high TSH values display a increased MPV should hence be acknowledged in risk prediction of thrombotic events.

Keywords

• Thyroid hormones
• Mean platelet volume
• THYROID DISEASE

TİROİD UYARICI HORMON, SERBEST TİROKSİN SEVİYELERİ VE TİROİD ANTİKORLARININ ORTALAMA TROMBOSİT HACMİ ÜZERİNDEKİ ETKİLERİ: ORİJİNAL ARAŞTIRMA

Abstract

Giriş: Tiroid hormonlarının metabolizması bozulmuş hastalarda pıhtılaşma anormallikleri bildirilmiştir. Trombositler pıhtılaşmada önemli bir rol oynar ve Ortalama Trombosit Hacmi (MPV), birçok hastalıkta inflamatuar bir biyobelirteç olarak kabul edilir. Amaç: Bu çalışmanın amacı, tiroid uyarıcı hormon, serbest tiroksin, anti-tiroid peroksidaz ve anti-tiroglobulin değerleri ile MPV değerleri arasında herhangi bir ilişki olup olmadığını araştırmaktı. Yöntemler: Endokrinoloji polikliniğine Ekim 2013 - Temmuz 2019 tarihleri ​​arasında tiroid hastalığı ön tanısıyla başvuran hastalar dahil edildi. Veriler IBM SPSS V23 ile analiz edildi. Normal dağılıma uyumluluk Shapiro Wilk testi ile incelendi. Değişkenler arasındaki ilişki Spearman sıra korelasyonu ile değerlendirildi. Bulgular: 1098 hastanın kayıtları incelendi. TSH ile MPV arasında çok zayıf bir pozitif ilişki vardı (r: 0,075), ST4, Anti TPO, Anti TG ve MPV arasında anlamlı bir ilişki yoktu. Sonuç: Yüksek TSH değerlerine sahip hastalarda yüksek MPV değerleri görülmekte olup trombotik olayların risk tahmini yapılabilir.

Keywords

• Tiroid hormonları
• Ortalama trombosit hacmi
• Tiroid hastalığı

References

1. 1. Lippi G, Franchini M, Targher G. Arterial thrombus formation in cardiovascular disease. Nat Rev Cardiol 2011;8:502–12. [Crossref], [PubMed], [Web of Science ®], [Google Scholar]
2. 2. Wisler JW, Becker RC. Emerging paradigms in arterial thrombosis. J Thromb Thrombolysis 2014;37:4–11. [Crossref], [PubMed], [Web of Science ®], [Google Scholar]
3. 3. Kamath S, Blann AD, Lip GY. Platelet activation: assessment and quantification. Eur Heart J 2011;22:1561–71. [Crossref], [Web of Science ®], [Google Scholar]
4. 4. Park Y, Schoene N, Harris W. Mean platelet volume as an indicator of platelet activation: methodological issues. Platelets 2002;13:301–6 .[Taylor & Francis Online], [Web of Science ®], [Google Scholar]
5. 5. https://labtestsonline.org/tests/complete-blood-count-cbc.accessed at:24.03.2020.
6. 6. Lippi G, Franchini M, Targher G, et al. Hyperthyroidism is associated with shortened APTT and increased fibrinogen values in a general population of unselected outpatients. J Thromb Thrombolysis 2009;28:362–5. [Crossref], [PubMed], [Web of Science ®], [Google Scholar]
7. 7. Franchini M, Lippi G, Manzato F, Vescovi PP. Thyroid-associated autoimmune coagulation disorders. J Thromb Thrombolysis 2010;29:87-91. [Crossref], [PubMed], [Web of Science ®], [Google Scholar]
8. 8. Stuijver DJ, van Zaane B, Romualdi E, et al. The effect of hyperthyroidism on procoagulant, anticoagulant and fibrinolytic factors: a systematic review and meta-analysis. Thromb Haemost 2010;108:1077–88. [Crossref], [Web of Science ®], [Google Scholar]

9. 9. Vescovi PP, Favaloro EJ, Lippi G, et al. The spectrum of coagulation abnormalities in thyroid disorders. Semin Thromb Hemost 2011;37:7–10. [Crossref], [PubMed], [Web of Science ®], [Google Scholar]
10. 10. Erem C. Thyroid disorders and hypercoagulability. Semin Thromb Hemost 2011;37:17-26.
11. 11. Franchini M. Hemostatic changes in thyroid diseases: haemostasis and thrombosis. Hematology 2006;11:203-8.
12. 12. Korniluk A, Koper-Lenkiewicz OM, Kamińska J, Kemona H, Dymicka-Piekarska V. Mean Platelet Volume (MPV): New Perspectives for an Old Marker in the Course and Prognosis of Inflammatory Conditions. Mediators Inflamm. 2019 Apr 17;2019:9213074. doi: 10.1155/2019/9213074. eCollection 2019.
13. 13. Ma Y, Zong D, Zhan Z, Li H, Dai Z, Cui Y, Luo L, Zeng Z, He C, Chen Y. Feasibility of mean platelet volume as a biomarker for chronic obstructive pulmonary disease: A systematic review and meta-analysis. J Int Med Res. 2019 Nov 27:300060519887886. doi: 10.1177/0300060519887886).
14. 14. Kurt M, Onal IK, Sayilir AY, Beyazit Y, Oztas E, Kekilli M et al. The role of mean platelet volume in the diagnosis of hepatocellular carcinoma in patients with chronic liver disease. Hepatogastroenterology 2012;59(117):1580–82. [Google Scholar]
15. 15. Osada J, Rusak M, Kamocki Z, Dabrowska MI, Kedra B. Platelet activation inpatients with advanced gastric cancer. Neoplasma 2010;57(2):145–50. [Crossref] [Google Scholar]
16. 16. Tuncel T, Ozgun A, Emirzeoglu L, Celik S, Bilgi O, Karagoz B. Mean platelet volume as a prognostic marker in metastatic colorectal cancer patients treated with bevacizumab-combined chemotherapy. Asian Pac J Cancer Prev 2014;15(15):6421–23. [Crossref] [Google Scholar]
17. 17. Bayhan Z, Zeren S, Ozbay I, Kahraman C, Yaylak F, Tiryaki C, Ekici MF. Mean Platelet Volume as a Biomarker for Thyroid Carcinoma. Int Surg: Jan.-Feb. 2016; 101(1-2): 50-53. https://doi.org/10.9738/INTSURG-D-15-00123.1
18. 18. Colkesen Y, Muderrisoglu H. The role of mean platelet volume in predicting thrombotic events. Clin Chem Lab Med 2012;50:631–4 [Crossref], [PubMed], [Web of Science ®], [Google Scholar]
19. 19. Korkmaz S. Mean platelet volume and platelet distribution width levels in patients with mild psoriasis vulgaris with metabolic syndrome. Postepy Dermatol Alergol. 2018 Aug;35(4):367-71. doi: 10.5114/ada.2017.71285. Epub 2018 Aug 21.
20. 20. Lippi G, Danese E, Montagnana M, Nouvenne A, Meschi T, Loris Borghi L. Mean platelet volume is significantly associated with serum levels of thyroid-stimulating hormone in a cohort of older euthyroid subjects, Endocrine Research, 2015; 40:4, 227-30, DOI: 10.3109/07435800.2015.1037392
21. 21. Erikci AA, Karagoz B, Ozturk A, et al. The effect of subclinical hypothyroidism on platelet parameters. Hematology 2009;14:115–7 [Taylor & Francis Online], [Web of Science ®], [Google Scholar])
22. 22. Carlioglu A, Timur O, Durmaz SA, Ayhan ME. Mean platelet volume in euthyroid patients with Hashimoto's thyroiditis. Blood Coagul Fibrinolysis 2015;26(3):282–4. [Crossref] [Google Scholar])
23. 23. Kim JH, Park JH, Kim SY, Bae HY.The mean platelet volume is positively correlated with serum thyrotropin concentrations in a population of healthy subjects and subjects with unsuspected subclinical hypothyroidism. Thyroid. 2013 Jan;23(1):31-7. doi: 10.1089/thy.2012.0033. Epub 2012 Nov 15.
24. 24. Panzer S, Haubenstock A, Minar E. Platelets in hyperthyroidism: studies on platelet counts, mean platelet volume, 111-indium-labeled platelet kinetics, and platelet-associated immunoglobulins G and M. J Clin Endocrinol Metab, 1990;70: 491–6.
25. 25. Bagir GS, Haydardedeoglu FE, Bakiner OS, Bozkirli E, Ertorer ME. Mean platelet volume in Graves’ disease: A sign of hypermetabolism rather than autoimmunity? Pak J Med Sci. 2017;33(4): 871-5.
26. 26. Erem C, Ersoz HO, Karti SS, et al. Blood coagulation and fibrinolysis in patients with hyperthyroidism. J Endocrinol Invest 2002;25:345–50 [Crossref], [PubMed], [Web of Science ®], [Google Scholar])
27. 27. Thompson CB, Jakubowski JA, Quinn PG, et al. Platelet size as a determinant of platelet function. J Lab Clin Med 1983;101:205–13 [PubMed], [Web of Science ®], [Google Scholar]
28. 28. Kristensen SD, Martin JF. Platelet heterogeneity and coronary artery thrombosis. Platelets 1991;2:11–7 [Taylor & Francis Online], [Google Scholar]
29. 29. Guthikonda S, Alviar CL, Vaduganathan M, et al. Role of reticulated platelets and platelet size heterogeneity on platelet activity after dual antiplatelet therapy with aspirin and clopidogrel in patients with stable coronary artery disease. J Am Coll Cardiol 2008;52:743–9. [Crossref], [PubMed], [Web of Science ®], [Google Scholar]).