Serum Homosistein Düzeyleri Ve Tiroid Antikorları Arasındaki İlişki

Dilek Tüzün

Serum Homosistein Düzeyleri Ve Tiroid Antikorları Arasındaki İlişki

Abstract

Hipotiroidili ve hipertiroidili vakalarda homosistein düzeyleri ve kardiyovasküler hastalık riski arasındaki ilişki çeşitli çalışmalarda ele alınmışken antitiroid antikor pozitifliği bulunan ötiroid vakalarda bu ilişkinin incelendiği yeterli sayıda çalışma mevcut değildir. Bu nedenle çalışmamızda antitiroid antikor pozitifliği saptanmış ancak tiroid fonksiyon testleri normal aralıkta bulunan vakalarda, serum homosistein düzeyini ve kardiyovasküler hastalıkla ilişkilendirilebilecek risk faktörlerinin ilişkisini incelemeyi hedefledik. Çalışmaya İç Hastalıkları polikliniğine başvuran; yapılan tetkik¬lerinde tiroid otoantikor pozitifliği mevcut 22 olgu (Grup A) ve kont¬rol grubu 20 sağlıklı birey (Grup B) olmak üzere toplam 42 olgu prospektif olarak dahil edildi. Anti-TPO veya Anti-tiroglobulin anti¬kor düzeyleri, tiroid fonksiyon testleri, homosistein düzeyleri, lipid profilleri, HbAlc, yüksek sensitif CRP, vitamin B)2 ve folik asit düzeyleri Ölçüldü. Hastalar 20 dakika dinlendirildikten sonra kan basıncı ölçümleri yapıldı. Hastalar sigara içmiyordu. Ortalama homosistein düzeyleri açısından iki grup karşılaştırıl¬dığında; antikor pozitifliği bulunan grupta ortalama homosistein düzeyi 12.2 ± 4.9 mmol/1 iken, her iki antikorun da negatif saptandığı kontrol grubunda ise 10.3 ±3.0 mmol/1 idi. Gruplar arasında ortalama homosistein düzeyleri açısından anlamlı fark elde edilmedi (p= 0.1). Homosistein ile sistolik kan basıncı değerleri arasında orta derecede (r=+ 0.330, p= 0.03) ilişki tespit edilirken, diğer risk faktörleri arasın¬da ilişki tespit edilmedi. Çalışmamız sonucunda tiroid otoantikor pozitifliği ile homosistein düzeyleri arasında anlamlı ilişki tespit edilmedi. Abstract Despite the fact that the relation between homocystein levels and cardiovascular risks at hypothyroidic and hyperthyroidic patients have been investigated in many studies, there aren’t adequate studies that detects this relation among thyroid autoantibody positive euthyroidic patients. For this reason; we aimed to detect the relation between homo- cystein levels and cardiovascular risk factors in cases who were autoan¬tibody positive but with normal thyroid function tests. We prospectively included in total of 42 patients at our study. 22 patients of these were thyroid autoantibody positive (Group A) and 20 were healthy cases acting as a control group (Group B). Anti-TPO and/or anti- thyroglobulin autoantibodies, thyroid function tests, homosistein levels, lipid profile, HA IC, high sensitive CRP levels, vitamin Bl2 and folic acid levels were determined. Blood pressure of patients were measured after a 20 minute rest. All the patients were nonsmokers According to comparision of mean value of homocysteine lev¬els of two groups; homocysteine level was 12.2 ± 4.9 mmol/1 in autoantibody positive group, 10.3 ± 3.0 mmol/1 was in autoantibody negative group. There was no significant difference in homocysteine levels between groups (p= 0.1). There was moderate relation between homocystein and cystolic blood presure (r=+0.330, p= 0.03) but no relation was determined with the other risk factors. At the end of our study, there was no significant relation be¬tween thyroid autoantibodies and homocysteine levels.

Keywords

References

1. Graham JM, Daly LE, Refsum HM, et al. Plasma homo¬cysteine as a risk factor for vascular disease. The Euro¬pean Concerted Action Project. JAMA 1997;277:1775-81.
2. Stampfer MJ, Malinow MR, Willett WC, et al. A prospec¬tive study of serum total homocysteine and risk of myo¬cardial infarction in US physicians. JAMA 1992;268:877- 81.
3. Nygard O, Nordrehaug JE, Refsum H,Ucland PM, Farstad M, Vollset SE. Plasma homocysteine levels and mortality in patients with coronary artery disease. N Eng J Med 1997;337:230-6.
4. Diekman MJ, Van Der Pt NM, Blom HJ, Tijssen JG, Wiersinga WM. Determinants of changes in plasma ho¬mocysteine in hyperthyroidism and hypothyroidism. Clin Endocrinol 2001;54:197-204.
5. Nedrebo BG, Ericson UB, Nygard O, et al. Plasma total homocysteine levels in hyperthyroid and hypothyroid patients. Metabolism 1998;47:89-93.
6. Ueland PM, Refsum H, Stabler SP, et al. Total homocysteine in plasma or serum:methods and clinical application.Clin Chern 1993;39:1764-79.
7. Eikelboom JW, Lonn L, Genest J Jr, Hankey G, Yusuf S. Homocysteine and Cardiovascular Disease: A Critical Review of The Epidemiologic Evidence. Ann Intern Med 1999;131:363-75.
8. Harker LA, Ross R, Slichter SI, Scott CR. Homocysteine - induced arteriosclerosis:the role of endothelial cell injury and platelet respofise in its genesis. J Clin Invest 1976;58:731-41.

9. James TN. The spectrum of diseases of small coronary arteries and their physiologic consequences. J Am Coll Cardiol 1990;15:763-74.
10. Harker LA, Slichter SJ, Scott CR, Ross R. Homocysteinemia:vascular injury and arterial thrombosis. N Engl J Med 1974;291:537-43.
11. Celermajer DS, Sürensen K, Ryalls M, et al. Impaired endothelial function occurs in the systemic arteries of children with homozygous homocystinuria but not in the inheterozygous parents. J Am Coll Cardiol 1993;22:854-8.
12. Van DEN Berg M, Boers GH, et al. Hyperhomocysteinaemia and endothelial dysfunction in young patients with peripheral arterial occlusive disease. EurJClin Invest 1995;25:176-81.
13. Misra HP. Generation of superoxide free radical during the autooxidation of thiols. J Biol Chern 1974;249:2151-5.
14. Miura S, Iitaka M, Suzuki S, et al. Decrease in Serum Levels of Thyroid Hormone in Patients with Coronary Heart Disease. Endocr J 1996;43:657-63.
15. Elisabeth AH, Huibert APP, Theo JV, et al. Subclinical Hypothyroidism is an independent Risk Factor for Athero-sclerosis and Myocardial Infarction in Elderly Women: The Rotterdam Study. Ann Intern Med 2000; 132: 270-8.
16. Hussein WI, Gren R, Jacobsen DW, Faiman C. Normali¬zation of hyperhomocysteinemia with L-thyroxin in hypo-thyroidism. Ann Intern Med 1999;131:348-51.
17. Lien EA, Nedrebo BG, Varhaug JE, Nygard O, Askvaag A, Ueland PM. Plasma total homocysteine levels during short term iatrogenic hypothyroidism. J Clin Endocrinol Metab 2000;85:1049-53.
18. Morris MS, Bostom AG, Jacques PF,Selhub J, Rosenberg IH. Hyperhomocysteinemia associated with hypothyroid¬ism in the third US National Health and Nutrition Exami¬nation Survey. Atherosclerosis 2001;155:195-200.
19. Christ-Crain M. Meier Christian, Guglielmetti M. Ele¬vated C-reactive protein and homocysteine values: cardio¬vascular risk factors in hypothyroidism ? Across-sectional and a double-blind,placebo-controlled trial. Atherosclero¬sis 2003;166:379-86.
20. Bicikova M, Tallova J, Hill M, Vanuga A, Putz Z, To- mandi J. Effect of treatment of hypothyroidism on the plasma concentrations of neuroactive steroids and homo¬cysteine. Clin Chern Lab Med 2001;39:753-7.
21. Vierhapper H, Nardi A, Grosser P, et al. Low-density lipoprotein cholesterol in subclinical hypothyroidism. Thyroid 2000;10:981-4.
22. Luboshitzky R, Aviv A, Herer P, Lavie L. Risk factors for cardiovascular disease in women with subclinical hypothyroidism. Thyroid 2002;12:421-5.
23. Massoudi MS, Meilahn EN, Orchard TJ, et al. Prevalance of thyroid antibodies among healthy middle-aged women. Findings from the thyroid in healthy women. Annals of Epidemiology 1995;229-33.
24. Hak AE, Pols HA, Visser TJ, Drexhage HA, Hofman A, Witteman JC. Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam Study. Ann Intern Med 2000;132:270-8.
25. Wells BJ, Hueston WJ. Are thyroid peroxidase antibodies associated with cardiovascular disease risk in patients with subclinical hypothyroidism? Clinical Endocrinology 2005;62:580-4.

Details

Primary Language

Turkish

Subjects

Clinical Sciences (Other)

Journal Section

Clinical Research

Authors

Dilek Tüzün This is me
Türkiye

Publication Date

March 20, 2007

Submission Date

March 1, 2007

Acceptance Date

March 1, 2007

Published in Issue

Year 2007 Volume: 1 Number: 1

IZ

https://izlik.org/JA76CK83WR

Cite

RIS / Bibtex

APA

Tüzün, D. (2007). Serum Homosistein Düzeyleri Ve Tiroid Antikorları Arasındaki İlişki. Turkish Medical Journal, 1(1), 19-23. https://izlik.org/JA76CK83WR

AMA

1.Tüzün D. Serum Homosistein Düzeyleri Ve Tiroid Antikorları Arasındaki İlişki. TMJ. 2007;1(1):19-23. https://izlik.org/JA76CK83WR

Chicago

Tüzün, Dilek. 2007. “Serum Homosistein Düzeyleri Ve Tiroid Antikorları Arasındaki İlişki”. Turkish Medical Journal 1 (1): 19-23. https://izlik.org/JA76CK83WR.

EndNote

Tüzün D (March 1, 2007) Serum Homosistein Düzeyleri Ve Tiroid Antikorları Arasındaki İlişki. Turkish Medical Journal 1 1 19–23.

IEEE

[1]D. Tüzün, “Serum Homosistein Düzeyleri Ve Tiroid Antikorları Arasındaki İlişki”, TMJ, vol. 1, no. 1, pp. 19–23, Mar. 2007, [Online]. Available: https://izlik.org/JA76CK83WR

ISNAD

Tüzün, Dilek. “Serum Homosistein Düzeyleri Ve Tiroid Antikorları Arasındaki İlişki”. Turkish Medical Journal 1/1 (March 1, 2007): 19-23. https://izlik.org/JA76CK83WR.

JAMA

1.Tüzün D. Serum Homosistein Düzeyleri Ve Tiroid Antikorları Arasındaki İlişki. TMJ. 2007;1:19–23.

MLA

Tüzün, Dilek. “Serum Homosistein Düzeyleri Ve Tiroid Antikorları Arasındaki İlişki”. Turkish Medical Journal, vol. 1, no. 1, Mar. 2007, pp. 19-23, https://izlik.org/JA76CK83WR.

Vancouver

1.Dilek Tüzün. Serum Homosistein Düzeyleri Ve Tiroid Antikorları Arasındaki İlişki. TMJ [Internet]. 2007 Mar. 1;1(1):19-23. Available from: https://izlik.org/JA76CK83WR