Silikozis Tanılı Seramik İşçilerinde Kan Tiroid Hormon Düzeyinin Değerlendirilmesi

Yıl 2019, Cilt: 16 Sayı: 1, 8 - 12, 22.03.2019

Mevlüt Karataş

Öz

Amaç:Bu çalışmada silikozis tanılı
seramik işçileriyle silika maruziyeti olup silikozis gelişmeyen seramik
işçilerinin,  tiroid hormon düzeylerini
değerlendirmeyi amaçladık.  

Materyal ve metod:Seramik endüstrisinde çalışan
ve muayene için Ankara Meslek Hastalıkları Hastanesine başvuran 134’ü kontrol
260 vaka dahil edildi. Vakalara ait laboratuvar verileri, radyolojik raporlar,  demografik özellikler, sigara öyküsü ve detaylı
iş anamnezi retrospektif olarak hasta dosyalarından taranıp kaydedildi. 

Bulgular:Çalışmaya 126 silikozis ve 134
kontrol vakası dahil edildi.  Silikozisli
grup yaş ortalaması 38.6±6.7, kontrol grubu yaş ortalaması 35.2 (±5.6) olarak
tespit edildi. Silikozisli grubun  çalışma süresi 12 yıl (1-25), kontrol grubunun
çalışma süresi 9 yıl (2-32) olarak tespit edildi. Silikozisli grupta sigara
kullanma süresi 10 yıl (0-30), kontrol grubunda ise 7 yıl (0-30) olarak tespit
edildi. Her iki grupta yaş, çalışma süresi ve sigara kullanma süreleri arasında
anlamlı farlılık tespit edildi, p değeri sırasıyla (p=0.001, p<0.001,
p=0.018). Silikozisli grupta  FEV_1pred,
FVC_pred, ve FEV₁/FVC oranları kontrol grubuna göre düşük
bulundu fakat bu değerler istatistiki anlamlı farklı değildi. Silikozisli
grupta sT₃=2.99±0.33 pg/ml,
sT₄=0.88 (0.67-0.94), TSH=1.28 (0.15-6.24), sT₃/sT₄=3.51±0.51
değerleri kontrol grubundan daha düşük olarak tespit edildi. Silikozisli ve
kontrol grubunda sT₃ ve sT₄ düzeyleri arasında anlamlı
farklılık tespit edildi (p<0.001, p=0.045). 

Sonuç:Bu çalışma silikozisli
vakalarda kontrol grubuna göre, tiroid hormon düzeyi düşüklüğünü gösteren ilk
çalışma olma özelliğini taşımaktadır. Silikozis düşünülen vakaların rutin klinik
tanı süreçlerinde olası tiroid hormon bozukluğu da düşünülmelidir.

Anahtar Kelimeler

Silikozis, Seramik işçisi, Pnömokonyoz, Serbest T3, Serbest T4

Evaluation of Blood Thyroid Hormone Level in Ceramic Workers Diagnosed with Silicosis

Öz

Abstract Background: In this study, it was aimed to evaluate the thyroid hormone levels of ceramic workers with silicosis and ceramic workers without silicosis. Methods: 260 cases (134 controls) who were employed in the ceramic industry and who applied to Ankara Occupational and Enviromental Diseases Hospital to be examined were included in the study. Laboratory data, radiological reports, demographic characteristics, smoking history and detailed work history were retrospectively reviewed and recorded from patient files. Results: The mean age of the silicosis group was 38.6±6.7 years and the mean age of the control group was 35.2±5.6. The working period of silicosis group was 12 years (1-25) and the control group was 9 years (2-32). The duration of smoking in the silicosis group was 10 years (0-30) and in the control group 7 years (0-30). A significant difference was found between age, duration of study and duration of smoking in both groups, and p value was respectively (p=0.001, p <0.00, p=0.018). FEV1pred, FVCpred, and FEV1/FVC ratios were lower in the silicosis group compared to the control group but these values were not statistically different. In the silicosis group sT3=2.99±0.33 pg/ml, sT4=0.88 pg/ml (0.67-0.94), TSH=1.28 mcIU/ml (0.15-6.24), sT3/sT4=3.51±0.51 were found to be lower than the control group. A significant difference was found between sT3 and sT4 levels in silicosis and control groups (p<0.001, p=0.045). Conclusion: In this study, sT3 and sT4 were significantly lower in the patients with silicosis than in the control group. Possible thyroid hormone disorders should be considered in routine clinical diagnosis processes of patients with silicosis.

Anahtar Kelimeler

Silicosis, Pneumoconiosis, Free T3, Free T4

Kaynakça

• Referans1 Cullinan P, Munoz X, Suojalehto H, Agius R, Jindal S, Sigsgaard T, et all. Occupational lung diseases: from old and novel exposures to effective preventive strategies. Lancet Respir Med. 2017;5(5):445-455.
• Referans2 Greenberg MI, Waksman J, Curtis J. Silicosis: a review. Dis Mon. 2007;53(8):394-416.
• Referans3 Standardization of Spirometry, 1994 Update. American Thoracic Society. Am J Respir Crit Care Med. 1995;152(3):1107-1136.
• Referans4 ILO. Guidelines for the use of the ILO International Classification of Radiographs of Pneumoconioses ILO Occupational Safety and Health Series No. 22. Revised edition Geneva2011:1-11.
• Referans5 Oldham JM, Kumar D, Lee C, Patel SB, Takahashi-Manns S, Carley D, et all. Thyroid Disease Is Prevalent and Predicts Survival in Patients With Idiopathic Pulmonary Fibrosis. Chest. 2015 Sep; 148(3): 692–700. Published online 2015 Mar 26. doi: 10.1378/chest.14-2714.
• Referans6 Whitsett JA , Glasser SW . Regulation of surfactant protein gene transcription. Biochim Biophys Acta . 1998 ; 1408 ( 2-3 ): 303 - 311.
• Referans7 Kinder BW , Brown KK , McCormack FX , Ix JH, Kervitsky A, Schwarz MI et all. Serum surfactant protein-A is a strong predictor of early mortality in idiopathic pulmonary fi brosis . C hest . 2009 ; 135 ( 6 ): 1557 – 1563. Referans8 Wert SE , Dey CR , Blair PA , Kimura S , Whitsett JA . Increased expression of thyroid transcription factor-1 (TTF-1) in respiratory epithelial cells inhibits alveolarization and causes pulmonary infl ammation . Dev Biol . 2002 ; 242 ( 2 ): 75 – 87.
• Referans9 Huang H, Li X, Lin L, Shi Y, Lin X, Li L, et all. Upregulation of thyroid transcription factor-1 and human leukocyte antigen class I in Hashimoto’s disease providing a clinical evidence for possible triggering autoimmune reaction . Eur J Endocrinol . 2011 ; 164 ( 5 ): 795-800.
• Referans10 Seyhan EC, Cetinkaya E, Altin S, Gençoğlu A, Simşek N. The incidence of sick euthyroid syndrome in non-small cell lung cancer patient.. Tuberk Toraks. 2008;56(2):163-70.
• Referans11 Mancini A, Corbo GM, Gaballo A, Raimondo S, Di Segni C, Gigliotti P, et all. Relationship between plasma antioxidants and thyroid hormones in chronic obstructive pulmonary disease. Exp Clin Endocrinol Diab 2012;120 623-628.
• Referans12 Chow CC, Mak TW, Chan CH, Cockram CS. Euthyroid sick syndrome in pulmonary tuberculosis before and after treatment. Ann Clin Biochem 1995; 32: 385-91.
• Referans13 Kanmazc D, Yentürk E,Yılmaz B,Alkan N,Tuncay E. The Incidence of Sick Euthyroid Syndrome in Chronic Obstructive Pulmonary Disease. Turkish Thoracic Journal; Ankara Vol. 12, Iss. 1, (Mar 2011): 1-4.
• Referans14 Karadag F, Ozcan H, Karul AB, Yilmaz M, Cildag O. Correlates of non-thyroidal illness syndrome in chronic obstructive pulmonary disease. Respir Med. 2007 Jul;101(7):1439-46. Epub 2007 Mar 7.
• Referans15 Gow SM, Seth J, Beckett GJ, Douglas G: Thyroid function and endocrine abnormalities in elderly patients with severe chronic obstructive pulmonary disease. Thorax 1987, 42:520–525.
• Referans16 Dimopoulou I, Ilias I, Mastorakos G, Mantzos E, Roussos C, Koutras DA: Effects of severity of chronic obstructive pulmonary disease on thyroid function. Metabolism 2001, 50:1397–1401.
• Referans17 Boelen A, Kwakkel I, Schiphorst MP, Mentrun B, Baur A, Kochric J, et all. IL-18, a proinflammatory cytokine, contributes to the pathogenesis of non-thyroidal illness mainly via the central part of the hypothalamus–pituitary–thyroid axis. Eur J Endocrinol 2004;151:497–502.
• Referans18 Rasmussen AK. Cytokine actions on the thyroid gland. Dan Med Bull 2000;47(2):94-114.
• Referans19 Stouthard JML, van der Poll T, Endert E, Bakker PJM, Veenhof CHN, Sauerwein HP, et all. Effects of acute and chronic IL-6 administration on thyroid hormone metabolism in humans. J Clin Endocrinol Metab 1994;79(5):1342–6.