Subklinik Hipotiroidili Hastalarda Tiroksin Tedavisinin Kardiyovasküler Risk Faktörleri Üzerine Etkisi

Öz

Amaç: Subklinik hipotiroidizm (SH) kardiyovasküler risk faktörleri (KVR) üzerinde zararlı bir etkiye sahiptir; ancak tedavi edilip edilmemesi halen tartışmalıdır. Çalışmanın amacı, SH hastaların KVR’ini belirlemek ve kısa süreli tiroksin tedavisinin bunlara etkisini araştırmaktır. Gereç ve Yöntemler: Bu retrospektif çalışmaya SH grubu(n=30) ve yaş-cinsiyet eşleştirilmiş kontrol grubu (n=40) dahil edildi. SH hastalarına 3 ay boyunca 50 μg/gün tiroksin tedavisi verildi. Tedaviden önceki KVR, tedaviden sonraki KVR ile karşılaştırıldı. Bulgular: Kontrol (kadın %66,7; yaş 45,76±14,55 yıl) ve SH (kadın %77,3; yaş 45,23±12,02 yıl) grubu arasında, cinsiyet dağılımı ve yaş ortalaması benzerdi (p>0,05). Vücut kitle indeksi (VKİ) SH grubunda (32,66±5,57 kg/m2), kontrol grubundan (25,13±3,20 kg/m2) daha yüksekti. Başlangıçta, SH grubunda serum glukoz (83,76±9,51 vs 91,73± 9,96 mg/dl), toplam kolesterol (162,36±13,41 vs 184,21±51,91 mg/dl), düşük-yoğunluklu lipoprotein-kolesterol (LDL-C; 91,73±22,04 vs 104,61±11,36 mg/dl), C-reaktif protein (hs-CRP; 1,53±0,66 vs 2,63±0,93 mg/L) düzeyi, kontrol grubuna göre daha yüksekti (p<0,05). Tedaviden sonra, SH grubunda VKI değerinde (31,35±5,54 kg/m2) azalma ile birlikte serum LDL-C (97,30±9,63 mg/dl) ve hs-CRP (1,96±0,42 mg/L) düzeyi azaldı (p<0,05). Tiroid stimulan hormon, bağımsız olarak LDL-C ile ilişkiliydi (OR=2,17,%95 CI [1,26-2,54], p=0,005). Sonuç: Bu çalışmada, SH’li hastalarda kardiyometabolik bozuklukların tiroksin tedavisi ile kısmen düzeldiği gösterildi. Tiroksin tedavisi, subklinik hipotiroidide artmış kardiyovasküler riskin azaltılmasına katkıda bulunabilir.

Anahtar Kelimeler

• subklinik hipotiroidi
• tiroksin tedavisi
• kardiyovasküler risk faktörü

The Effect of Thyroxine Therapy on Cardiovascular Risk Factors in Patients with Subclinical Hypothyroidism

Öz

Aim: Subclinical hypothyroidism (SH) has a deleterious effect on cardiovascular risk factors (CVR); however it should be treated or not is stil controversial. The aim of our study is to determine CVR in patients with SH, and to investigate the short term effect of thyroxine treatment on CVR. Material and Methods: Patients with SH (n=30), and age- and sex-matched control group (n=40) were included in this retrospective study. SH patients were treated by 50μg/day thyroxine for 3 months. Pre-treatment CVR was compared with post-treatment CVR. Results: Sex distribution and mean age were similar between control (female 66.7%; age 45.76±14.55 years) and SH (female 77.3%; age 45.23±12.02 years) groups (p>0.05). Body mass index (BMI) was high in SH group (32.66±5.57 kg/m2) than in control group (25.13±3.20 kg/m2, p<0.05). At baseline, serum glucose (83.76±9.51 vs 91.73±9.96 mg/dl), total cholesterol (162.36±13.41 vs 184.21±51.91 mg/dl), low-density lipoprotein-cholesterol (LDL-C; 91.73±22.04 vs 104.61±11.36 mg/dl), and C-reactive protein (hs-CRP; 1.53±0.66 vs 2.63±0.93 mg/L) levels were higher in SH group than in the control group (p<0.05). After treatment, BMI value decreased (31.35±5.54 kg/m2) along with decreasing serum LDL-C (97.30±9.63 mg/dl) and hs-CRP (1.96±0.42 mg/L) levels in SH group (p<0.05). Thyroid stimulating hormone was independently associated with LDL-C (OR=2.17,%95CI [1.26-2.54], p=0.005). Conclusion: In this study, it was determined that cardiometabolic disorders in patients with subclinical hypothyroidism partiel improved with thyroxine treatment. Thyroxine treatment may contribute to the reduction of increased cardiovascular risk in subclinical hypothyroidism.

Anahtar Kelimeler

• subclinical hypothyroidism
• thyroxine therapy
• cardiovascular risk factor

Kaynakça

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