Mean platelet volume (MPV) levels in subclinical hypothyroidism and its relation to serum lipid levels

Abstract

Background: Subclinical hypothyroidism (SCH) is a term to define a mild and early thyroid deficiency. Some reports claim SCH has an association with increased cardiovascular disease (CVD), especially in individuals <70 years old. Mean platelet volume (MPV) is thought to be an independent marker for CVD. Dyslipidemia is also a common entity in thyroid related disorders and a tradational biomarker of increased risk of CVD. This study aims to reveal the MPV levels in SCH and to discuss its relation to lipid profile. Material and Method: This retrospective single-center study was conducted between 2009 March and August. 94 newly diagnosed patients with SCH and 79 controller were enrolled in the study. Patients with normal serum levels of free T3 and T4 and >4 mIU/L TSH levels were labelled for SCH group. Both groups were evaluated for MPV, lipid profiles and epidemiological features. Results: SCH group had higher levels of MPV, total cholesterol (TC) and LDL cholesterol (LDL-C) levels (P<0.05, for each parameter). MPV had a positive correlation to TC and LDL-C (r=0,175 ve p=0,025; r=0,154 and p=0,043). However, a multivariate analysis that rendered the impact of age and gender revealed that SCH had no impact on MPV after adjustment for those parameters gender revealed that SCH had no impact on MPV after adjustment for those parameters (B=0,304; 95% CI: -0,021 – 0,628; p=0,066). Conclusion: SCH patients may have higher levels of MPV. However, age and gender had an impact on MPV levels and we think increased CVD risk in SCH patients is associated with factors other than MPV levels.

Keywords

• MPV
• lipids
• subclinical hypothyroidism

Project Number

Yok

References

1. Fatourechi V. Subclinical hypothyroidism: an update for primary care physicians. Mayo Clin Proc 2009; 84: 65-71.
2. Biondi B, Cappola AR, Cooper DS. Subclinical Hypothyroidism: A Review. JAMA 2019; 322: 153-60.
3. Suh S, Kim DK. Subclinical Hypothyroidism and Cardiovascular Disease. Endocrinol Metab (Seoul) 2015; 30: 246-51.
4. Liu D, Jiang F, Shan Z, et al. A cross-sectional survey of relationship between serum TSH level and blood pressure. J Hum Hypertens 2010; 24: 134-8.
5. Ye Y, Xie H, Zeng Y, Zhao X, Tian Z, Zhang S. Association between subclinical hypothyroidism and blood pressure-a meta-analysis of observational studies. Endocr Pract 2014; 20:150-8.
6. Razvi S, Ingoe L, Keeka G, Oates C, McMillan C, Weaver JU. The beneficial effect of L-thyroxine on cardiovascular risk factors, endothelial function, and quality of life in subclinical hypothyroidism: randomized, crossover trial. J Clin Endocrinol Metab 2007; 92: 1715-23.
7. Pearce EN. Update in lipid alterations in subclinical hypothyroidism. J Clin Endocrinol Metab 2012; 97: 326-33.
8. Yılmaz H, Ertuğrul Ö, Ertuğrul B, Ertuğrul D. Mean platelet volume in patients with subclinical hypothyroidism. Platelets 2011; 22: 143-7.

9. 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; 23: 31-7.
10. Kutluturk F, Gul SS, Sahin S, Tasliyurt T. Comparison of mean platelet volume, platelet count, neutrophil/ lymphocyte ratio and platelet/lymphocyte ratio in the euthyroid, overt hypothyroid and subclinical hyperthyroid phases of papillary thyroid carcinoma. Endocr Metab Immune Disord Drug Targets 2019; 19: 859-65.
11. Torun AN, Uzum AK, Aksoy N. Overt and mild subclinical hypothyroidism do not influence mean platelet volume in premenopausal women having low cardiac risk. Clin Appl Thromb Hemost 2012; 18: 312-5.
12. Ren X, Meng Z, Liu M, et al. No associations exist between mean platelet volume or platelet distribution width and thyroid function in Chinese. Medicine (Baltimore) 2016; 95:e4573.
13. Gao F, Wang G, Xu J. Alteration of hemostatic parameters in patients with different levels of subclinical hypothyroidism and the effect of l-thyroxine treatment. Ann Clin Lab Sci 2017; 47: 29-35.
14. Coban E, Kucuktag S, Basyigit S. Platelet activation in subjects with impaired glucose tolerance. Platelets 2007; 18: 591-4.
15. Park Y, Schoene N, Harris W. Mean platelet volume as an indicator of platelet activation: methodological issues. Platelets 2002; 13: 301-6.
16. Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des 2011; 17: 47-58.
17. Jabbar A, Pingitore A, Pearce SH, Zaman A, Iervasi G, Razvi S. Thyroid hormones and cardiovascular disease. Nat Rev Cardiol 2017 Jan;14: 39-55.
18. Cappola AR, Desai AS, Medici M, et al. Thyroid and cardiovascular disease: research agenda for enhancing knowledge, prevention, and treatment. Thyroid 2019; 29: 760-77.
19. Grymuła K, Paczkowska E, Dziedziejko V, et al. The influence of 3,3’,5-triiodo-L-thyronine on human haematopoiesis. Cell Prolif 2007; 40: 302-15.
20. Chute JP, Ross JR, McDonnell DP. Minireview: Nuclear receptors, hematopoiesis, and stem cells. Mol Endocrinol 2010; 24: 1-10.
21. Josefsson EC, White MJ, Dowling MR, Kile BT. Platelet life span and apoptosis. Methods Mol Biol 2012; 788: 59-71.