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AS A CARDIOVASCULAR RISK FACTOR IN GRAVES PATIENTS: MPV AND RDW

Yıl 2020, Cilt: 21 Sayı: 3, 251 - 257, 01.07.2020
https://doi.org/10.18229/kocatepetip.632253

Öz

OBJECTIVE: In this study, we aimed to compare mean platelet volume (MPV) and red cell distribution width (RDW) values of graves patients compared to the healthy control group and to determine whether there was a relationship with cardiovascular risk factors.
MATERIAL AND METHODS: Fifty graves patients and 50 healthy control patients were evaluated retrospectively. Patients with diabetes mellitus (DM), iron deficiency anemia, chronic kidney injury, hypertension (HT), previous myocardial infarction, congestive heart failure, chronic inflammatory disease, malignancy and using antihyperlipidemic drugs were not included in the study. MPV and RDW values were recorded at the time of admission in the healthy control group and at the time of diagnosis in the graves group before the treatment was started. At the same time, LDL cholesterol (LDL-C), Hdl cholesterol (HDL-C), triglyceride (TG) values, smoking status, height, weight and body mass index (BMI) of both groups were analyzed retrospectively. The comparison of MPV and RDW values was evaluated by student-t test and the relationship with cardiovascular risk factors was evaluated by pearson correlation test.
RESULTS: There was no significant difference between MPV values of patients with Graves' disease who had not started medication and MPV values of healthy controls (p = 0.291). When the RDW values between two groups were examined, RDW values of the graves were significantly lower than the control group (p<0.05). When MPV and RDW values were compared between female patients with Graves and female patients in the control group; MPV and RDW values of female patients in the control group were significantly higher than female patients with graves (p = 0.047, p = 0.012, respectively). No correlation was found between smoking, advanced age and BMI and MPV, RDW values that are among Graves' cardiovascular risk factors. There was no correlation between LDL-C and RDW in the Graves group whereas there was a negative correlation between LDL-C and MPV (p = 0.016, r = -0.443).
CONCLUSIONS: MPV and RDW values, which are accepted as an indicator of inflammation and cardiovascular disease risk, were not correlated with cardiovascular risk factors in patients with graves.

Kaynakça

  • KAYNAKLAR
  • 1. Tomer Y, Davies TE. Infection, thyroid disease and autoimmunity. Endocr Rev. 1993;14(1):107-120. doi: 10.1210/edrv-14-1-107.
  • 2. Brent GA. Clinical practice: Graves’ disease. N Engl J Med. 2008;358(24):2594-2605. doi: 10.1056/NEJMcp0801880.
  • 3. Prabhakar BS, Bahn RS, Smith TJ. Current perspective on the pathogenesis of Graves’ disease and ophthalmopathy. Endocr Rev. 2003;24(6):802-835. doi: 10.1210/er.2002-0020.
  • 4. Alcelik A, Aktas G, Eroglu M, Tosun M, Savli H, Dikbas O, et al. Platelet function in euthyroid patients under going thyroidectomy in women. Eur Rev Med Pharmacol Sci. 2013;17(17):2350-2353. 5. Erem C, Ersoz HO, Karti SS, Ukinç K, Hacihasanoglu A, Değer O, et al. Blood coagulation and fibrinolysis in patients with hyperthyroidism. J Endocrinol Invest. 2002;25(4):345- 350. doi: 10.1007/BF03344016.
  • 6. Simsek Bagir G, Eksi Haydardedeoglu F, Bakiner O, Bozkirli E, & Ertorer M. E. (2017). Mean platelet volume in Graves’ disease: A sign of hypermetabolism rather than autoimmunity? Pakistan Journal of Medical Sciences, 33(4). doi:10.12669/pjms.334.12659.
  • 7. Gasparyan AY, Sandoo A, Stavropoulos-Kalinoglou A, Kitas GD. Mean platelet volume in patients with rheumatoid arthritis: the effect of anti-TNF-α therapy. Rheumatol Int. 2010;30(8):1125-1129. doi:10.1007/s00296-009-1345-1.
  • 8. Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des. 2011;17(1):47-58.
  • 9. Senaran H, Ileri M, Altinbaş A, et al. Thrombopoietin and mean platelet volume in coronary artery disease. ClinCardiol. 2001 May;24(5):405-8.
  • 10. S. G. Chu, R. C. Becker, P. B. Berger, et al. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis. J ThrombHaemost. 2010 Jan; 8(1): 148–156.
  • 11.Gunebakmaz O, Kaya MG, Duran Met al. Red blood cell distribution width in ‘non-dippers’ versus ‘dippers’ . Cardiology 2012;123:154–159.
  • 12.Nishizaki Y, Yamagami S, Suzuki H et al. Red Blood Cell Distribution Width as an Effective Tool for Detecting Fatal Heart Failure in Superelderly Patients. Internal Med 2012;51:2271–2276
  • 13.Makhoul BF ,Khourieh A ,Kaplan Met al. Relation between changes in red cell distribution width and clinical outcomes in acute decompensated heart failure. Int J Cardiol 2013;167: 1412–1416
  • 14.Karabulut A, Uzunlar B . Correlation Between Red Cell Distribution Width and Coronary Ectasia in the Acute Myocardial Infarction . Clin Appl Thromb-Hem 2012; 8:551 – 552.
  • 15. Marsh WJr ,Bishop J ,Darcy T . Evaluation of red cell volume distribution width (RDW) . Hematologic pathology 1987;1:117.
  • 16. Felker GM, Allen LA, Pocock SJet al. Red cell distribution width as a novel prognostic marker in heart failure – Data from the CHARM program and the Duke Databank. J Am Coll Cardiol 2007;50 : 40 – 47.
  • 17. Tonelli M ,Sacks F ,Arnold Met al. Relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease . Circulation 2008 ; 117 : 163 – 168.
  • 18. Vaya A, Hernandez JL, Zorio Eet al. Association between red blood cell distribution width and the risk of future cardiovascular events . Clin Hemorheol Micro 2012 ; 50 : 221 – 225.
  • 19. Jung DH, Lee HR, Lee YJ, et al. The association between coronary artery calcification and mean platelet volume in the general population. Platelets 2011;22:567–71.
  • 20. Slavka G, Perkmann T, Haslacher H, et al. Mean platelet volume may represent a redictive parameter for overall vascular mortality and ischemic heart disease. Arterioscler Thromb Vasc Biol 2011;31:1215–8.
  • 21. Erikci AA, Karagoz B, Ozturk A, et al. The effect of subclinical hypothyroidism on platelet parameters. Hematology 2009;14:115–7.
  • 22. Coban E, Yazicioglu G, Ozdogan M. Platelet activation in subjects with subclinical hypothyroidism. Med Sci Monit 2007;13:CR21 1– 4.
  • 23. Yilmaz H, Ertugrul O, Ertugrul B, et al. Mean platelet volume in patients with subclinical hypothyroidism. Platelets 2011;22:143–7.
  • 24. Kim JH, Park JH, Kim SY, et al. 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.
  • 25. Carlioglu A, Timur O, Durmaz SA, Ayhan ME. Mean platelet volume in euthyroid patients with Hashimoto’ s thyroiditis. Blood Coagul Fibrinolysis 2015;26:282– 4.
  • 26. Panzer S, Haubenstock A, Minar E. Platelets in hyperthyroidism: studies on platelet counts, mean platelet volume, 111-indium-labeled platelet kinetics, and platelet-associated immunoglobulins G and M. J Clin Endocrinol Metab. 1990;70(2):491-496. doi: 10.1210/jcem-70-2-491.
  • 27.Torun AN, Uzum AK, Aksoy N. Overt and mild subclinical hypothyroidism do not influence mean platelet volume in premenopausal women having low cardiac risk. ClinAppl Thromb Hemost 2012; 18:312–5.
  • 28. Van Dormael JJ, van der Meer, JOosten HR, et al. Hypothyroidism leads to more small-sized platelets in circulat ion. Thromb Haemost. 1987;58:964-5.
  • 29.Artemniak-Wojtowicz,D, Witkowska-Sędek E, Borowiec A, & Pyrżak B. (2019). Peripheral blood picture and aminotransferase activity in children with newly diagnosed Graves’ disease at baseline and after the initiation of antithyroid drug therapy. Central European Journal of Immunology, 44(2), 132–137. doi:10.5114/ceji.2019.87063.
  • 30. Aktas G, Sit M, Dikbas O, Tekce BK, Savli H, Tekce H, & Alcelik A. (2014). Could Red Cell Distribution Width be a Marker in Hashimoto’s Thyroiditis? Experimental and Clinical Endocrinology & Diabetes, 122(10), 572–574. doi:10.1055/s-0034-1383564.

GRAVES HASTALARINDA KARDİYOVASKÜLER RİSK FAKTÖRÜ OLARAK: MPV VE RDW

Yıl 2020, Cilt: 21 Sayı: 3, 251 - 257, 01.07.2020
https://doi.org/10.18229/kocatepetip.632253

Öz

AMAÇ: Bu çalışmada graves hastalarının sağlıklı kontrol grubuna göre ortalama trombosit hacmi (MPV) ve kırmızı kan hücresi dağılım genişliği (RDW) değerlerinin karşılaştırılması ve kardiyovasküler risk faktörleri ile ilişkisinin olup olmadığı amaçlandı.
GEREÇ VE YÖNTEM: 50 graves hastası ve 50 sağlıklı kontrol hasta retrospektif olarak incelendi. Diabetes mellitus (DM), demir eksikliği anemisi, kronik böbrek hasarı, hipertansiyon (HT), daha önce geçirilmiş myokard infarktüsü, konjestif kalp yetmezliği, kronik inflamatuar hastalığı, malignitesi olan ve antihiperlipidemik ilaç kullanan hastalar çalışmaya dahil edilmedi. Sağlıklı kontrol grubunun başvuru anında, graves grubunun ise tanı anında henüz tedavileri başlanmadan tam kan sayımının içinde rutinde bakılan MPV ve RDW değerleri kaydedildi. Aynı zamanda her iki grubun LDL kolesterol (LDL-C), Hdl kolesterol (HDL-C), trigliserid (TG) değerleri, sigara kullanıp kullanmadığı, boy, kilo ve vücut kitle indeksleri (VKİ) dosyalarından retrospektif olarak incelendi. MPV ve RDW değerlerinin karşılaştırılması student-t testi ile, kardiyovasküler risk faktörleri ile olan ilişkisi pearson korelasyon testi ile değerlendirildi.
BULGULAR: Graves hastası olup henüz ilaç tedavisi başlanmamış olan hastaların MPV değerleri ile sağlıklı kontrol grubunun MPV değerleri arasında anlamlı farklılık saptanmadı (p=0.291). İki grup arasında RDW değerlerine bakıldığında; graveslilerin RDW değerleri kontrol grubuna göre anlamlı düşük saptandı (p<0.05). Gravesli kadın hastalar ile kontrol grubundaki kadın hastalar MPV ve RDW değerleri açısından karşılaştırıldığında; kontrol grubundaki kadın hastaların MPV ve RDW değerleri gravesli kadın hastalara göre anlamlı yüksek saptandı (sırasıyla p=0.047, p=0.012). Gravesli hastalarda kardiyovasküler risk faktörlerinden sigara içimi, ileri yaş ve VKİ ile MPV, RDW değerleri arasında korelasyon saptanmadı. Gravesli grupta LDL-C ile RDW arasında korelasyon saptanmazken, LDL-C ile MPV arasında negatif korelasyon saptandı (p=0.016, r=-0.443).
SONUÇ: İnflamasyonun göstergesi ve kardiyovasküler hastalık risk göstergesi olarak kabul gören MPV ve RDW değerlerininin graves hastalarında kardiyovasküler risk faktörleri ile ilişkisi saptanmamıştır.

Kaynakça

  • KAYNAKLAR
  • 1. Tomer Y, Davies TE. Infection, thyroid disease and autoimmunity. Endocr Rev. 1993;14(1):107-120. doi: 10.1210/edrv-14-1-107.
  • 2. Brent GA. Clinical practice: Graves’ disease. N Engl J Med. 2008;358(24):2594-2605. doi: 10.1056/NEJMcp0801880.
  • 3. Prabhakar BS, Bahn RS, Smith TJ. Current perspective on the pathogenesis of Graves’ disease and ophthalmopathy. Endocr Rev. 2003;24(6):802-835. doi: 10.1210/er.2002-0020.
  • 4. Alcelik A, Aktas G, Eroglu M, Tosun M, Savli H, Dikbas O, et al. Platelet function in euthyroid patients under going thyroidectomy in women. Eur Rev Med Pharmacol Sci. 2013;17(17):2350-2353. 5. Erem C, Ersoz HO, Karti SS, Ukinç K, Hacihasanoglu A, Değer O, et al. Blood coagulation and fibrinolysis in patients with hyperthyroidism. J Endocrinol Invest. 2002;25(4):345- 350. doi: 10.1007/BF03344016.
  • 6. Simsek Bagir G, Eksi Haydardedeoglu F, Bakiner O, Bozkirli E, & Ertorer M. E. (2017). Mean platelet volume in Graves’ disease: A sign of hypermetabolism rather than autoimmunity? Pakistan Journal of Medical Sciences, 33(4). doi:10.12669/pjms.334.12659.
  • 7. Gasparyan AY, Sandoo A, Stavropoulos-Kalinoglou A, Kitas GD. Mean platelet volume in patients with rheumatoid arthritis: the effect of anti-TNF-α therapy. Rheumatol Int. 2010;30(8):1125-1129. doi:10.1007/s00296-009-1345-1.
  • 8. Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des. 2011;17(1):47-58.
  • 9. Senaran H, Ileri M, Altinbaş A, et al. Thrombopoietin and mean platelet volume in coronary artery disease. ClinCardiol. 2001 May;24(5):405-8.
  • 10. S. G. Chu, R. C. Becker, P. B. Berger, et al. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis. J ThrombHaemost. 2010 Jan; 8(1): 148–156.
  • 11.Gunebakmaz O, Kaya MG, Duran Met al. Red blood cell distribution width in ‘non-dippers’ versus ‘dippers’ . Cardiology 2012;123:154–159.
  • 12.Nishizaki Y, Yamagami S, Suzuki H et al. Red Blood Cell Distribution Width as an Effective Tool for Detecting Fatal Heart Failure in Superelderly Patients. Internal Med 2012;51:2271–2276
  • 13.Makhoul BF ,Khourieh A ,Kaplan Met al. Relation between changes in red cell distribution width and clinical outcomes in acute decompensated heart failure. Int J Cardiol 2013;167: 1412–1416
  • 14.Karabulut A, Uzunlar B . Correlation Between Red Cell Distribution Width and Coronary Ectasia in the Acute Myocardial Infarction . Clin Appl Thromb-Hem 2012; 8:551 – 552.
  • 15. Marsh WJr ,Bishop J ,Darcy T . Evaluation of red cell volume distribution width (RDW) . Hematologic pathology 1987;1:117.
  • 16. Felker GM, Allen LA, Pocock SJet al. Red cell distribution width as a novel prognostic marker in heart failure – Data from the CHARM program and the Duke Databank. J Am Coll Cardiol 2007;50 : 40 – 47.
  • 17. Tonelli M ,Sacks F ,Arnold Met al. Relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease . Circulation 2008 ; 117 : 163 – 168.
  • 18. Vaya A, Hernandez JL, Zorio Eet al. Association between red blood cell distribution width and the risk of future cardiovascular events . Clin Hemorheol Micro 2012 ; 50 : 221 – 225.
  • 19. Jung DH, Lee HR, Lee YJ, et al. The association between coronary artery calcification and mean platelet volume in the general population. Platelets 2011;22:567–71.
  • 20. Slavka G, Perkmann T, Haslacher H, et al. Mean platelet volume may represent a redictive parameter for overall vascular mortality and ischemic heart disease. Arterioscler Thromb Vasc Biol 2011;31:1215–8.
  • 21. Erikci AA, Karagoz B, Ozturk A, et al. The effect of subclinical hypothyroidism on platelet parameters. Hematology 2009;14:115–7.
  • 22. Coban E, Yazicioglu G, Ozdogan M. Platelet activation in subjects with subclinical hypothyroidism. Med Sci Monit 2007;13:CR21 1– 4.
  • 23. Yilmaz H, Ertugrul O, Ertugrul B, et al. Mean platelet volume in patients with subclinical hypothyroidism. Platelets 2011;22:143–7.
  • 24. Kim JH, Park JH, Kim SY, et al. 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.
  • 25. Carlioglu A, Timur O, Durmaz SA, Ayhan ME. Mean platelet volume in euthyroid patients with Hashimoto’ s thyroiditis. Blood Coagul Fibrinolysis 2015;26:282– 4.
  • 26. Panzer S, Haubenstock A, Minar E. Platelets in hyperthyroidism: studies on platelet counts, mean platelet volume, 111-indium-labeled platelet kinetics, and platelet-associated immunoglobulins G and M. J Clin Endocrinol Metab. 1990;70(2):491-496. doi: 10.1210/jcem-70-2-491.
  • 27.Torun AN, Uzum AK, Aksoy N. Overt and mild subclinical hypothyroidism do not influence mean platelet volume in premenopausal women having low cardiac risk. ClinAppl Thromb Hemost 2012; 18:312–5.
  • 28. Van Dormael JJ, van der Meer, JOosten HR, et al. Hypothyroidism leads to more small-sized platelets in circulat ion. Thromb Haemost. 1987;58:964-5.
  • 29.Artemniak-Wojtowicz,D, Witkowska-Sędek E, Borowiec A, & Pyrżak B. (2019). Peripheral blood picture and aminotransferase activity in children with newly diagnosed Graves’ disease at baseline and after the initiation of antithyroid drug therapy. Central European Journal of Immunology, 44(2), 132–137. doi:10.5114/ceji.2019.87063.
  • 30. Aktas G, Sit M, Dikbas O, Tekce BK, Savli H, Tekce H, & Alcelik A. (2014). Could Red Cell Distribution Width be a Marker in Hashimoto’s Thyroiditis? Experimental and Clinical Endocrinology & Diabetes, 122(10), 572–574. doi:10.1055/s-0034-1383564.
Toplam 30 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri
Bölüm Makaleler-Araştırma Yazıları
Yazarlar

Erhan Bozkurt 0000-0002-1853-7098

Selvihan Beysel 0000-0002-1853-7098

Merve Hafızoğlu 0000-0002-1853-7098

Oğuz Han Koca Bu kişi benim 0000-0002-1853-7098

Ayhan Vurmaz 0000-0002-1853-7098

Serkan Gökaslan 0000-0002-1853-7098

Yayımlanma Tarihi 1 Temmuz 2020
Kabul Tarihi 4 Mart 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 21 Sayı: 3

Kaynak Göster

APA Bozkurt, E., Beysel, S., Hafızoğlu, M., Koca, O. H., vd. (2020). GRAVES HASTALARINDA KARDİYOVASKÜLER RİSK FAKTÖRÜ OLARAK: MPV VE RDW. Kocatepe Tıp Dergisi, 21(3), 251-257. https://doi.org/10.18229/kocatepetip.632253
AMA Bozkurt E, Beysel S, Hafızoğlu M, Koca OH, Vurmaz A, Gökaslan S. GRAVES HASTALARINDA KARDİYOVASKÜLER RİSK FAKTÖRÜ OLARAK: MPV VE RDW. KTD. Temmuz 2020;21(3):251-257. doi:10.18229/kocatepetip.632253
Chicago Bozkurt, Erhan, Selvihan Beysel, Merve Hafızoğlu, Oğuz Han Koca, Ayhan Vurmaz, ve Serkan Gökaslan. “GRAVES HASTALARINDA KARDİYOVASKÜLER RİSK FAKTÖRÜ OLARAK: MPV VE RDW”. Kocatepe Tıp Dergisi 21, sy. 3 (Temmuz 2020): 251-57. https://doi.org/10.18229/kocatepetip.632253.
EndNote Bozkurt E, Beysel S, Hafızoğlu M, Koca OH, Vurmaz A, Gökaslan S (01 Temmuz 2020) GRAVES HASTALARINDA KARDİYOVASKÜLER RİSK FAKTÖRÜ OLARAK: MPV VE RDW. Kocatepe Tıp Dergisi 21 3 251–257.
IEEE E. Bozkurt, S. Beysel, M. Hafızoğlu, O. H. Koca, A. Vurmaz, ve S. Gökaslan, “GRAVES HASTALARINDA KARDİYOVASKÜLER RİSK FAKTÖRÜ OLARAK: MPV VE RDW”, KTD, c. 21, sy. 3, ss. 251–257, 2020, doi: 10.18229/kocatepetip.632253.
ISNAD Bozkurt, Erhan vd. “GRAVES HASTALARINDA KARDİYOVASKÜLER RİSK FAKTÖRÜ OLARAK: MPV VE RDW”. Kocatepe Tıp Dergisi 21/3 (Temmuz 2020), 251-257. https://doi.org/10.18229/kocatepetip.632253.
JAMA Bozkurt E, Beysel S, Hafızoğlu M, Koca OH, Vurmaz A, Gökaslan S. GRAVES HASTALARINDA KARDİYOVASKÜLER RİSK FAKTÖRÜ OLARAK: MPV VE RDW. KTD. 2020;21:251–257.
MLA Bozkurt, Erhan vd. “GRAVES HASTALARINDA KARDİYOVASKÜLER RİSK FAKTÖRÜ OLARAK: MPV VE RDW”. Kocatepe Tıp Dergisi, c. 21, sy. 3, 2020, ss. 251-7, doi:10.18229/kocatepetip.632253.
Vancouver Bozkurt E, Beysel S, Hafızoğlu M, Koca OH, Vurmaz A, Gökaslan S. GRAVES HASTALARINDA KARDİYOVASKÜLER RİSK FAKTÖRÜ OLARAK: MPV VE RDW. KTD. 2020;21(3):251-7.

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