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Evaluation of Respiratory Functions in Subclinical and Clinical Hypothyroidism

Year 2013, Volume: 20 Issue: 1, 8 - 11, 01.02.2013
https://doi.org/10.7247/jtomc.20.1.3

Abstract

Aim: Subclinical hypothyroidism reflects the earliest stage of thyroid dysfunction with subjects having normal or decreased fT4, normal fT3 and decreased thyroid stimulating hormone levels. Thyroid hormones have effects on the respiratory system functions. It is well known that thyroid hormones have effects on the respiratory system functions however there are few studies concerning the effect of subclinical hypothyroidism on the respiratory system. We aimed to investigate the respiratory functions in patients diagnosed with subclinical and clinical hypothyroidism. Material and Methods: A total of 61 patients with clinical (n=31) or subclinical (n=30) hypothyroidism and 27 healthy subjects as a control group were included in the present study. Respiratory functions were evaluated by simple spirometry. All respiratory parameters including FVC, FVC%, FEV1, FEV1%, FEV1/FVC, FEF25-75, FEF25-75%, PEF, PEF% were assessed. Additionally, free triiodothyronine (FT3), free thyroxin (FT4) and thyroid stimulating hormone (TSH) levels were measured in all subjects. Results: Patients in the clinical hypothyrodism, subclinical hypothyroidism and control groups were homogenous in terms of age and gender distribution. Body mass index (kg/m2) was determined to be significantly higher in patients with clinical hypothyroidism when compared to control subjects (p<0.05). Spirometric evaluation of the respiratory function revealed significantly lower values for FVC (L; p<0.05), FVC (%; p<0.05), FEV1 (L; p<0.05) and FEV1 (%; p<0.05) in all hypothyroid patients regardless of the clinical type when compared to control subjects. Conclusions: Respiratory function tests seem to be beneficial in the evaluation of respiratory functional state in hypothyroidism. We think that community screening with simple spirometry may be helpful for patients with risk of subclinical hypothyroidism. Key words: Subclinical Hypothyroidism; Clinical Hypothyroidism; Respiratory Functions.

References

  • Surks MI, Ortiz E, Daniels GH, Sawin CT, Col NF, Cobin RH et al. Subclinical thyroid disease: scientific review and guidelines for diagnosis and management. JAMA 2004;291:228-38.
  • Col NF, Surks MI, Daniels GH. Subclinical thyroid disease:clinical applications. JAMA 2004;291:239-43.
  • Siafakas NM, Salesiotou V, Filaditaki V. Respiratory
  • muscle strength in hypothyroidism. Chest 1992;102:189-94.
  • Harrison RN, Tattersfield AE. Airway response to inhaled salbutamol in hyperthyroid and hypothyroid patients before and after treatment. Thorax 1984;39:34-9.
  • Ciftci F, Tozkoparan E, Deniz O, Bozkanat E, Okutan O, Ilvan A. Measurement of ventilatory responsiveness in hypothyroidism. Tuberc Thorax 2001;49:4591-9.
  • Chu JW, Crapo LM. The treatment of subclinical hypothyroidism is seldom necessary. J Clin Endocrinol Metab 2001;86:4591-9.
  • Zulewski H, Muller B, Exer P, Miserez AR, Staub JJ. Estimation of tissue hypothyroidism by a new clinical score: evaluation of patients with various grades of hypothyroidism and controls. J Clin Endocrinol Metab 1997;82:771-6.
  • Laroche CM, Cairns T, Moxham J, Green M. Hypothyroidism presenting with respiratory muscle weakness. Am Rev Respir Dis 1988;138:472-4.
  • Weiner M, Chausow A, Szidon P. Reversible respiratory muscle weakness in hypothyroidism. Br J Dis Chest 1986; 80:391-5.
  • Kek PC, Ho SC, Khoo DH. Subclinical thyroid disease. Singapore Med J 2003;44:595-600.
  • Cooper DS. Clinical practice. Subclinical hypothyroidism. N Engl J Med 2001;345:260-5.
  • Fatourechi V. Subclinical thyroid disease. Mayo Clin Proc 2001;76:413-6.
  • Beyer IW, Karmali R, Demeester-Mirkine N, Cogan E, Fuss hypothyroidism. J Clin Endocrinol Metab 1998;83:1823.
  • Cakmak G, Saler T, Saglam ZA, Yenigun M, Demir T. dysfunction in subclinical Spirometry in patients with clinical and subclinical hypothyroidism. Tuberk Toraks 2007;55:266-70.
  • Martinez FJ, Bermudez-Gomez M, Celli BR. Hypothyroidism. A reversible cause of diaphragmatic dysfunction. Chest 1989; 96:1059-63.

Klinik Ve Subklinik Hipotiroidizimde Solunum Fonksiyonlarının Değerlendirilmesi

Year 2013, Volume: 20 Issue: 1, 8 - 11, 01.02.2013
https://doi.org/10.7247/jtomc.20.1.3

Abstract

Amaç: Subklinik hipotiroidizm tiroid disfonksiyonlarının erken evresidir ve hastaların ft4 düzeyleri normal veya düşük, ft3 düzeyleri normal ve tiroid stimulan hormonu düzeyleri azalmıştır. Tiroid hormonlarının solunum sistemi fonksiyonları üzerinde etkileri vardır. Titoid hormonlarının solunum sistemi fonksiyonları üzerine olan etkisi iyi bilinirken, Subklinik hipotiroidinin solunum sistemin üzerindeki etkilerini araştıran çok az çalışma vardır. Biz klinik ve subklinik hipotiroidi tanısı almış hastalarda solunum fonksiyonlarını araştırmayı amaçladık. Gereç ve Yöntemler: Çalışmamıza, 31 klinik ve 30 subklinik hipotiroidili olmak üzere toplam 61 hasta ve 27 sağlıklı birey kontrol grubu olarak alındı. Solunum fonksiyonları basit spirometrik testler ile ile değerlendirildi. Tüm solunum parametreleri, FVC, FVC%, FEV1, FEV1%, FEV1/FVC, FEF25-75, FEF25-75%, PEF, PEF% değerlendirildi. Ayrıca, serbest triiodotironin (ST3) ve serbest tiroksin( ST4) ve tiroid stimule edici hormon (TSH) tüm bireylerde ölçüldü. Bulgular: Klinik hipotroidili, subklinik hipotiroidili hastalar ve kontrol grubu yaş ve cinsiyet dağılımı açısından homojendi. BMI (kg/m2) klinik hipotiroidili hastalarda kontrol grubu ile kıyaslandığında önemli düzeyde yüksekti (p<0.05). Solunum fonksiyonlarının değerlendirilmesinde FVC (L; p<0.05), FVC (%; p<0.05), FEV1 (L; p<0.05) and FEV1 (%; p<0.05) değerleri kontrol grubu ile karşılaştırıldığında, tüm hipotiroidili hastalarda klinik tipten bağımsız olarak önemli düzeyde düşüktü. Sonuç: Solunum fonksiyon testleri, hipotiroidizmli hastaların solunum fonksiyon durumunun değerlendirilmesinde faydalıdır. Basit spirometre ile toplum taramasının subklinik hipotroidi riski taşıyan hastaların tespiti açısından faydalı olacağını düşünüyoruz. Anahtar kelimeler: Hipotiroidizm; Klinik Hipotiroidizm; Solunum Fonksiyonları.

References

  • Surks MI, Ortiz E, Daniels GH, Sawin CT, Col NF, Cobin RH et al. Subclinical thyroid disease: scientific review and guidelines for diagnosis and management. JAMA 2004;291:228-38.
  • Col NF, Surks MI, Daniels GH. Subclinical thyroid disease:clinical applications. JAMA 2004;291:239-43.
  • Siafakas NM, Salesiotou V, Filaditaki V. Respiratory
  • muscle strength in hypothyroidism. Chest 1992;102:189-94.
  • Harrison RN, Tattersfield AE. Airway response to inhaled salbutamol in hyperthyroid and hypothyroid patients before and after treatment. Thorax 1984;39:34-9.
  • Ciftci F, Tozkoparan E, Deniz O, Bozkanat E, Okutan O, Ilvan A. Measurement of ventilatory responsiveness in hypothyroidism. Tuberc Thorax 2001;49:4591-9.
  • Chu JW, Crapo LM. The treatment of subclinical hypothyroidism is seldom necessary. J Clin Endocrinol Metab 2001;86:4591-9.
  • Zulewski H, Muller B, Exer P, Miserez AR, Staub JJ. Estimation of tissue hypothyroidism by a new clinical score: evaluation of patients with various grades of hypothyroidism and controls. J Clin Endocrinol Metab 1997;82:771-6.
  • Laroche CM, Cairns T, Moxham J, Green M. Hypothyroidism presenting with respiratory muscle weakness. Am Rev Respir Dis 1988;138:472-4.
  • Weiner M, Chausow A, Szidon P. Reversible respiratory muscle weakness in hypothyroidism. Br J Dis Chest 1986; 80:391-5.
  • Kek PC, Ho SC, Khoo DH. Subclinical thyroid disease. Singapore Med J 2003;44:595-600.
  • Cooper DS. Clinical practice. Subclinical hypothyroidism. N Engl J Med 2001;345:260-5.
  • Fatourechi V. Subclinical thyroid disease. Mayo Clin Proc 2001;76:413-6.
  • Beyer IW, Karmali R, Demeester-Mirkine N, Cogan E, Fuss hypothyroidism. J Clin Endocrinol Metab 1998;83:1823.
  • Cakmak G, Saler T, Saglam ZA, Yenigun M, Demir T. dysfunction in subclinical Spirometry in patients with clinical and subclinical hypothyroidism. Tuberk Toraks 2007;55:266-70.
  • Martinez FJ, Bermudez-Gomez M, Celli BR. Hypothyroidism. A reversible cause of diaphragmatic dysfunction. Chest 1989; 96:1059-63.
There are 16 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Gulay Yilmaz This is me

Mine Adas This is me

Aysen Helvaci This is me

Nejat Altintas This is me

Meral Günaldi This is me

Publication Date February 1, 2013
Published in Issue Year 2013 Volume: 20 Issue: 1

Cite

APA Yilmaz, G., Adas, M., Helvaci, A., Altintas, N., et al. (2013). Klinik Ve Subklinik Hipotiroidizimde Solunum Fonksiyonlarının Değerlendirilmesi. Journal of Turgut Ozal Medical Center, 20(1), 8-11. https://doi.org/10.7247/jtomc.20.1.3
AMA Yilmaz G, Adas M, Helvaci A, Altintas N, Günaldi M. Klinik Ve Subklinik Hipotiroidizimde Solunum Fonksiyonlarının Değerlendirilmesi. J Turgut Ozal Med Cent. February 2013;20(1):8-11. doi:10.7247/jtomc.20.1.3
Chicago Yilmaz, Gulay, Mine Adas, Aysen Helvaci, Nejat Altintas, and Meral Günaldi. “Klinik Ve Subklinik Hipotiroidizimde Solunum Fonksiyonlarının Değerlendirilmesi”. Journal of Turgut Ozal Medical Center 20, no. 1 (February 2013): 8-11. https://doi.org/10.7247/jtomc.20.1.3.
EndNote Yilmaz G, Adas M, Helvaci A, Altintas N, Günaldi M (February 1, 2013) Klinik Ve Subklinik Hipotiroidizimde Solunum Fonksiyonlarının Değerlendirilmesi. Journal of Turgut Ozal Medical Center 20 1 8–11.
IEEE G. Yilmaz, M. Adas, A. Helvaci, N. Altintas, and M. Günaldi, “Klinik Ve Subklinik Hipotiroidizimde Solunum Fonksiyonlarının Değerlendirilmesi”, J Turgut Ozal Med Cent, vol. 20, no. 1, pp. 8–11, 2013, doi: 10.7247/jtomc.20.1.3.
ISNAD Yilmaz, Gulay et al. “Klinik Ve Subklinik Hipotiroidizimde Solunum Fonksiyonlarının Değerlendirilmesi”. Journal of Turgut Ozal Medical Center 20/1 (February 2013), 8-11. https://doi.org/10.7247/jtomc.20.1.3.
JAMA Yilmaz G, Adas M, Helvaci A, Altintas N, Günaldi M. Klinik Ve Subklinik Hipotiroidizimde Solunum Fonksiyonlarının Değerlendirilmesi. J Turgut Ozal Med Cent. 2013;20:8–11.
MLA Yilmaz, Gulay et al. “Klinik Ve Subklinik Hipotiroidizimde Solunum Fonksiyonlarının Değerlendirilmesi”. Journal of Turgut Ozal Medical Center, vol. 20, no. 1, 2013, pp. 8-11, doi:10.7247/jtomc.20.1.3.
Vancouver Yilmaz G, Adas M, Helvaci A, Altintas N, Günaldi M. Klinik Ve Subklinik Hipotiroidizimde Solunum Fonksiyonlarının Değerlendirilmesi. J Turgut Ozal Med Cent. 2013;20(1):8-11.