Subklinik Tiroid Hastalarında Metabolik Sendrom Sıklığı

Yıl 2025, Cilt: 20 Sayı: 1, 35 - 44

Özge Kösemehmetoğlu , Erdal Eskioğlu

https://doi.org/10.17517/ksutfd.1466604

Öz

Amaç: Kardiyovasküler hastalıklar açısından metabolik sendrom ve subklinik tiroid hastalıkları risk oluşturmaktadır. Çalışmamızda subklinik tiroid hastalıkları ile metabolik sendrom parametreleri arasındaki ilişkileri ve bu hastalarda metabolik sendrom sıklığını incelemeyi amaçladık.
Gereç ve Yöntemler: 23 ile 82 yaşları arasında, 59 kadın ve 38 erkek, toplam 97 hastayı çalışmamıza aldık. Hastaları tiroid fonksiyon testlerine göre subklinik hipotiroidi (n=29), subklinik hipertiroidi (n=37) ve ötiroid (n=31) olmak üzere 3 gruba ayırdık ve her grubu National Cholesterol Education Program (NCEP) Adult Tratment Panel III (ATP III) kriterlerine göre metabolik sendrom parametreleri ve varlığı açısından inceledik. Ayrıca insülin düzeyleri, insülin direnci (Homeostatic model assesment-HOMA), sedimentasyon hızı ve C-reaktif protein (CRP) düzeyleri de karşılaştırıldı.
Bulgular: Metabolik sendrom bulguları subklinik hipotiroidi, subklinik hipertiroidi ve ötiroid hasta gruplarında benzer olmakla beraber, çalışmaya dahil edilen hastaların tümünde metabolik sendrom sıklığını %57 olarak bulduk. Metabolik sendrom parametrelerinden yalnızca high density lipoprotein (HDL) düşüklüğü subklinik tiroid hastalarında kontrol grubuna göre daha fazla idi (38 mg/dL ye karşın 44 mg/dL, p=0.044). Metabolik sendrom kadınlarda ve ileri yaşta daha sık olma eğiliminde idi. Subklinik hipotiroidili hastalarda abdominal obezite ve HDL düşüklüğü, subklinik hipertiroidili hastalarda HDL düşüklüğü, ötiroid kontrol grubunda ise abdominal obezite en sık rastlanan metabolik sendrom parametreleriydi.
Sonuç: Subklinik tiroid hastalarında metabolik sendrom sıklığında artış tespit etmedik; ancak hem metabolik sendrom hem de subklinik tiroid hastalıkları kardiyovasküler hastalıklar açısından risk oluşturduğundan, subklinik tiroid hastalığı olan hastalarda kardiyovasküler hastalıkların tedavisinin gerekliliğine karar verebilmek için tiroid stimülan hormon (TSH) düzeyleri ve metabolik sendrom parametreleri açısından tarama yapılması gerektiğini düşünüyoruz.

Anahtar Kelimeler

Hipotiroidi, hipertiroidi, serum kolesterol seviyesi, insülin direnci, bel çevresi

Frequency of Metabolic Syndrome in Patients with Subclinical Thyroid Disease

Öz

Objective: Metabolic syndrome and subclinical thyroid diseases pose risks for cardiovascular diseases. In our study, we aimed to examine the relationships between subclinical thyroid diseases, metabolic syndrome and the frequency of metabolic syndrome in these patients.

Material and Methods: Our cohort included 97 patients, 59 women and 38 men, aged between 23 and 82. We divided the patients into 3 groups: subclinical hypothyroidism (n=29), subclinical hyperthyroidism (n=37), and euthyroidism (n=31) according to thyroid function tests, and examined each group in terms of metabolic syndrome parameters and presence according to National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria. In addition, insulin levels, insulin resistance (Homeostatic model assessment), sedimentation rate, and C-reactive protein (CRP) levels were also compared.

Results: The frequency of metabolic syndrome was 57% in our cohort, although metabolic syndrome findings were similar in subclinical hypothyroidism, subclinical hyperthyroidism, and euthyroid patient groups. Only high-density lipoprotein (HDL) levels were lower in subclinical thyroid patients than in the control group (38 mg/dL vs 44 mg/dL, p=0,044). Metabolic syndrome tended to be more common in women and at older ages. Abdominal obesity and low HDL in patients with subclinical hypothyroidism, low HDL in patients with subclinical hyperthyroidism, and abdominal obesity in the euthyroid control group were the most common metabolic syndrome parameters.

Conclusion: We did not detect an increased frequency of metabolic syndrome in subclinical thyroid patients; however, since both metabolic syndrome and subclinical thyroid diseases pose a risk of cardiovascular disease, we believe that patients with subclinical thyroid disease should be screened for thyroid stimulating hormone (TSH) levels and metabolic syndrome parameters to decide whether treatment is necessary.

Anahtar Kelimeler

Hypothyroidism, hyperthyroidism, serum cholesterol level, insulin resistance, waist circumference

Kaynakça

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