Relationship between subclinical hypothyroidism and serum homocysteine concentration in premenopausal women

Yıl 2013, Cilt: 4 Sayı: 3, 293 - 297, 01.09.2013

Ayfer Çolak Ramazan Avcı Serkan Yener Yusuf Kurtulmuş Mustafa Osman Zengin Ümit Bozkurt Füsun Üstüner

https://doi.org/10.5799/ahinjs.01.2013.03.0287

Öz

Objective: In our study we aimed to examine serum homocysteine levels of patients without thyroid dysfunctions who have high serum anti thyroid peroxidase (anti-TPO) levels and patients with subclinical hypothyroidism who have high serum thyroid stimulating hormone (TSH) and anti-TPO levels. Methods: One hundred and seven premenopause female outpatients who referred to endocrine clinic of our hospital were included in our study. We generated 3 groups. First group (Control) consists of 53 (50%) patients between the ages of 30-40 years. Second group (Euthyroid) consists of 31 (29%) patients between the ages of 26-49. Third group (Subclinical Hypothyroidism) consists of 23 (21%) patients between the ages of 33-53 years. Serum total cholesterol, triglycerides, high density lipoprotein (HDL) levels were measured by Olympus 2700 autoanalyzer. Serum TSH, free T4, anti-TPO and homocysteine levels were measured by Siemens Immulite 2000 autoanalyzer. Results: In our study, total cholesterol, triglycerides, low density lipoprotein (LDL) and very low density lipoprotein (VLDL) levels were not statistically significantly different among the groups. Although serum homocysteine levels of the third group were higher than the other groups it was not statistically significantly different among the groups. Conclusion: Serum homocysteine and lipid levels of patients with euthyroidism and subclinical hypothyroidism who have positive anti-TPO levels may be inadequate in assessing the risk of cardiovascular diseases. J Clin Exp Invest 2013; 4 (3): 293-297

Anahtar Kelimeler

Hypothyroidsm, homocysteine, premenopause

Premenopozlu kadınlarda subklinik hipotiroidi ve homosistein düzeyleri ilişkisi

Öz

Amaç: Çalışmamızda serum anti-tiroid peroksidaz antikor (anti-TPO) seviyesi yüksek, tiroid disfonksiyonu olmayan olgular ile serum tiroid stimulan hormon (TSH) ve anti-TPO seviyeleri yüksek subklinik hipotiroidili olgularda serum homosistein düzeylerini incelemeyi amaçladık. Yöntemler: Çalışmamıza hastanemiz endokrin polikliniğine başvuran premenopozlu 107 kadın olgu alındı. Birinci grup; 30-40 yaşları arasında 53 (%50) kişi kontrol grubu, ikinci grup; 26-49 yaşları arasında 31 (%29) kişi ötiroid grubu, üçüncü grup; 33-53 yaşları arasında 23 (%21) kişi subklinik hipotiroidi grubu olarak belirlendi. Serum total kolesterol, trigliserid, yüksek dansiteli lipoprotein(HDL) düzeyi Olympus 2700 otoanalizöründe, tiroid stimülan hormon (TSH), serbest tiroksin (FT4), anti-TPO ve homosistein düzeyleri Immulite-2000 cihazında ölçüldü. Bulgular: Çalışmamızda gruplar arasında total kolesterol, trigliserid, düşük dansiteli lipoprotein (LDL) ve çok düşük dansiteli lipoprotein (VLDL) düzeyleri farklılık göstermedi. Subklinik hipotiroidi grubunda homosistein düzeyleri diğer gruplara göre daha yüksek olmasına rağmen gruplar arasında anlamlı bir fark saptanmadı. Sonuç: Anti tiroid peroksidaz pozitif, ötiroid ve subklinik hipotiroidili olan olgularda serum lipid ve homosistein düzeyleri kardiyovasküler hastalık riskini değerlendirmede yetersiz kalabilir.

Anahtar Kelimeler

Hipotiroidi, homosistein, premenapoz

Kaynakça

• Miner SE, Evrovski J, Cole DE. Clinical chemistry and molecular biology of homocysteine metabolism: an update. Clin Biochem 1997;30:189-201.
• Erşan İ, Öztürk BT, Kamış Ü, Özkağnıcı A, Kemal G. Comparison of plasma homocysteine levels in pa- tients with type 2 diabetes mellitus with normal sub- jects. Journal of Clinical and Experimental Investiga- tions 2012;3:235-239.
• Turhan S, Sezer S, Erden G, et al. Plasma homocys- teine concentrations and serum lipid profile as ath- erosclerotic risk factors in subclinical hypothyroidism. Ann Saudi Med 2008;28:96-101.
• Sütken E, Akalın A, Özdemir F, Çolak Ö. Lipid profile and levels of homocysteine, leptin, fibrinogen and C- reactive protein in hyperthyroid patients before and after treatment. Dicle Med J 2009;37:1-7.
• Graham IM, Daly LE, Refsum HM, et al. Plasma ho- mocysteine as a risk factor for vascular disease. The European Concerted Action Project. JAMA 1997;277:1775-1781.
• Stampfer MJ, Malinow MR, Willett WC, et al. A pro- spective study of plasma homocyst(e)ine and risk of myocardial infarction in US physicians. JAMA 1992;268:877-881.
• Vignini A, Nanetti L, Bacchetti, et al. Modification in- duced by homocysteine and low-density lipoprotein on human aortic endothelial cells: an in vitro study. J Clin Endocrinol Metab 2004;89:4558-4561.
• Perna AF, Ingrosso O, Lombardi, et al. Possible mech- anisms of homocysteine toxicity. Kidney Int Suppl 2003:S137-140.
• Chao CL, Kuo TL, Lee YT. Effects of methionine-in- duced hyperhomocysteinemia on endothelium-de- pendent vasodilation and oxidative status in healthy adults. Circulation 2000; 101:485-490.
• Homocysteine and risk of ischemic heart disease and stroke: a meta-analysis. JAMA 2002;288:2015-2022.
• Nedrebo BG, Ericsson UB, Nygard O, et al. Plasma total homocysteine levels in hyperthyroid and hypo- thyroid patients. Metabolism 1998;47:89-93.
• Barış N, Demir M, Ataytay A, ve ark. Hipotiroidizm ve Hipertiroidizmde Kardiyovasküler Risk Faktörleri. Yeni Tıp Dergisi 2011;28:30-33.
• Brent GA, Larsen PR, Davies TF: Hypothyroidism and Myxedema Coma. In:Melmed S, Polonsky KS, Larsen PR (Eds). Williams Textbook of Endocrinology 2008; 11: 377
• Wiersinga WM. Hypothyroidism and myxedema coma. In: Jameson JL and De Groot LJ, (Eds). Endo- crinology Adult and Pediatric 2010; 6:1607
• Kıskaç M, Helvacı A, Zorlu M, ve ark. Subklinik hipo- tiroidili hastalardaki QT dispersiyonunun ötiroid has- talarla karşılaştırılması. Dicle Medical J 2010;37:129- 133
• Weetman AP, Jameson JL. Chapter 320: ‘Disorder of thyroid gland’. Harrison’s Principles of Internal Medi- cine 16.2004:2104-2127.
• Chu JW, Crapo LM. The treatment of subclinical hy- pothyroidism is seldom necessary. J Clin Endocrinol Metab 2001;86:4591-4599.
• Stanger O, Herrmann W, Pietrzik K, et al. DACH- LIGA homocystein (german, austrian and swiss ho- mocysteine society): consensus paper on the rational clinical use of homocysteine, folic acid and B-vitamins in cardiovascular and thrombotic diseases: guide- lines and recommendations. Clin Chem Lab Med 2003;41:1392-1403.
• Luboshitzky R, Herer P. Cardiovascular risk factors in middle-aged women with subclinical hypothyroidism. Neuro Endocrinol Lett 2004;25:262-266.
• Ertugrul O, Ahmet U, Asim E, et al. Prevalence of Subclinical Hypothyroidism among Patients with Acute Myocardial Infarction. ISRN Endocrinol 2011;2011:810251 , doi=10.5402/2011/810251.
• Park YJ, Lee YJ, Choi SI, et al. Impact of subclini- cal hypothyroidism on the coronary artery disease in apparently healthy subjects. Eur J Endocrinol 2011;165:115-121.
• Hak AE, Pols HA, Visser TJ, et al. Subclinical hypo- thyroidism is an independent risk factor for atheroscle- rosis and myocardial infarction in elderly women: the Rotterdam Study. Ann Intern Med 2000;132:270-278.
• Wang CY, Chang TC, Chen MF. Associations between subclinical thyroid disease and metabolic syndrome. Endocr J 2012;59:911-917.