Hashimoto Tiroiditi Hastalarında Metabolik Sendrom, Obezite ve Menopoz İlişkisi

Abstract

Amaç Bu çalışmanın amacı Hashimoto tiroiditi olan hastalarda metabolik sendrom, obezite ve menopoz ilişkisinin araştırılmasıdır. Materyal ve Metot: Bu kesitsel çalışmaya Hashimoto tiroiditi tanısı olan 119 erişkin ötiroid kadın hasta alındı. Hastalar premenopozal ve postmenopozal şeklinde iki grup olarak incelendi. Grupların metabolik sendrom ve obezite sıklığı değerlendirildi. Premenopozal ve postmenopozal grupların metabolik sendrom, metabolik sendrom bileşenleri, vücut kitle indeksleri karşılaştırıldı. Bulgular: Hastaların yaş ortalaması 44,6±13 yıl idi. Hastaların 66’sı premenopozal (yaş ortalaması 35,3±7,8 yıl) ve 53’ü postmenopozal (yaş ortalaması 56,2±7,9 yıl) idi. Hastalardaki metabolik sendrom sıklığı %36,1 ve obezite sıklığı %52,1 bulundu. Metabolik sendrom postmenopozal hastalarda premenopozal olanlardan daha yüksek bulundu (p=0,001). Postmenopozal grupta premenopozal gruba göre metabolik sendrom bileşenlerinden abdominal obezite, trigliserid yüksekliği, kan basıncı yüksekliği ve açlık serum glukoz yüksekliği daha fazla saptandı (sırasıyla p=0,019, p<0,001, p<0,001, p<0,001). Premenopozal grupta normal kilolu hasta sayısı fazla bulunurken (p=0,001), postmenopozal grupta morbid obez hasta sayısı fazla bulundu (p=0,010). Sonuç: Çalışma sonuçlarımıza göre, Hashimoto tiroiditi hastalarında metabolik sendrom ve abdominal obezite sıklığı postmenopozal olanlarda premenopozal olanlardan daha yüksektir..  ( Sakarya Tıp Dergisi 2016, 6(1):1-6 ) Anahtar Kelimeler: Dislipidemi, hipertansiyon, hiperglisemi, otoimmün tiroidi

Keywords

• Dislipidemi, hipertansiyon, hiperglisemi, otoimmün tiroidit

References

1. Balkau B, Valensi P, Eschwe`ge E, Slamad G. A review of the metabolic syndrome. Diabetes Metab 2007;33:405–413.
2. Lakka HM, Laaksonen DE, Lakka TA, Niskanen LK, Kumpusalo E, Tuomilehto J, et al. The metabolic syndrome and total cardiovascular disease mortality in middle age men. JAMA 2002;288:2709–2716.
3. Isomaa B, Almgren P, Tuomi T, Torsen B, Lahti K, Nissen M, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001;24:683– 689.
4. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA 2001;285:2486–2497.
5. National Cholesterol Education Program (NCEP) Expert Panel on Detection. Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002;106:3143–3121.
6. Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the Third
7. National Health and Nutrition Examination Survey. JAMA 2002;287:356–359.
8. Gupta A, Gupta R, Sarna M, Rastogi S, Grupta VP, Kothari K. Prevalence of diabetes, impaired fasting glucose and insulin resistance syndrome in an urban Indian population. Diabetes Res Clin Pract 2003;61:69–76.

9. Balkau B, Vernay M, Mhamdi L, Novak M, Arondel D, Vol S, et al. The D.E.S.I.R. study group. The incidence and persistence of the NCEP (National Cholesterol Education Program) metabolic syndrome. The French D.E.S.I.R. study. Diabetes Metab 2003;29:526–532.
10. Erem C, Hacıhasanoglu A, Deger O, Topbasm M, Hosver I, Onder Ersoz H, et al. Prevalence of metabolic syndrome and associated risk factors among Turkish adults: Trabzon MetS study. Endocrinology 2008;33:9–20.
11. Ozsahin AK, Gokcel A, Sezgin N, Akbaba M, Guvener N, Ozisik L, et al. Prevalence of the metabolic syndrome in a Turkish adult population. Diabetes Nutr Metab 2004;17:230–234.
12. Cameron AJ, Shaw JE, Zimmet PZ. The metabolic syndrome: prevalence in worldwide populations. Endocrinol Metab Clin 2004;3:351–375.
13. Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, et al. Prevalence of obesity, diabetes, and obesityrelated health risk factors, 2001. JAMA 2003;289:76–79.
14. Steinbaum SR. The metabolic syndrome: an emerging health epidemic in women. Prog Cardiovasc Dis 2004;46:321–336.
15. Bruckert E. Abdominal obesity: A health threat. Presse Med. 2008;37(10):1407-1414.
16. Vanderpump MP, Tunbridge WM, French JM, et al. The incidence of thyroid disorders in the community: a twentyyear follow-up of the Whickham Survey. Clin Endocrinol (Oxf) 1995;43:55.
17. Singer PA. Thyroiditis. Lavin N (ed). Manual of Endocrinology and Metabolism. Lippincott Williams & Wilkins, Philadelphia 2002;390–392.
18. Cappola AR, Ladenson PW. Hypothyroidism and atherosclerosis. J Clin Endocrinol Metab 2003;88: 24382444.
19. Wick G, Schett G, Amberger A, Kleindienst R, Xu Q. Is atherosclerosis an immunologically mediated disease? Immunol Today 1995;16: 27–33.
20. Bastenie PA, Vanhaelst L, Golstein J, Smets P. Asymptomatic autoimmune thyroiditis and coronary heart disease. Crosssectional and prospective studies. Lancet 1977;2: 155–158.
21. Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005;112:2735.
22. World Health Organization. Prevention and management of the global epidemic of obesity. Report of the WHO Consultation on Obesity. Geneva: WHO; 1998 (Technical Report Series, No. 894).
23. Han TS, Lean MEJ. Obezite Antropetrik Gostergeleri ve Yağ Depolarının Bolgesel Dağılımı. Bjorntorp P (ed). International Text Book of Obesity. And Danışmanlık, Eğitim, Yayıncılık ve Organizasyon Ltd. Şti., Istanbul,2002; 60–65.
24. Koh KK, Han SH, Quon MJ. Inflammatory markers and the metabolic syndrome: insights from therapeutic interventions. J Am Coll Cardiol 2005;46:1978-1985.
25. Hu FB, Meigs JB, Li TY, Rifai N, Manson JE. Inflammatory markers and risk of developing type 2 diabetes in women. Diabetes 2004; 53:693-700.
26. Bastenie PA, Vanhaelst L, Bonnyns M, Neve P, Staquet M. Preclinical hypothyroidism: a risk factor for coronary heart disease. Lancet 1971;1: 203–204.
27. Vanderpump MP, Tunbridge WM, French JM, et. The devel¬opment of ischemic heart disease in relation to autoimmune thyroid dis¬ease in a 20-year follow-up study of an English community. Thyroid 1996; 6:155-160.
28. Cappola AR, Fried LP, Arnold AM, et al. Thyroid status, cardiovascular risk, and mor-tality in older adults. JAMA 2006; 295: 1033-1041.
29. Mc Dermott MT, Ridgway EC. Subclinical hypothyroidism is mild thyroid failure and should be treated. J Clin Endocrinol Metab 2001; 86:4585–4590.
30. Vierhapper H, Nardi A, Grosser P, Raber W, Gessl
31. A. Low-density lipoprotein cholesterol in subclinical hypothyroidism. Thyroid 2000;10:981–984.
32. Vanderpump MP, Tunbridge WM, French JM et al. The development of ischemic heart disease in relation to autoimmune thyroid disease in a 20 year follow-up study of an English community. Thyroid 1996; 6:155–160.
33. Türk Kardiyoloji Derneği. METSAR “Türkiye Metabolik Sendrom Araştırması”. 21. Ulusal Kardiyoloji Kongresi; 1620 Kasım 2005: Antalya, Türkiye.
34. Kozan O, Oguz A, Abaci A, Erol C, Ongen Z, Temizhan A, Celik S. Prevalence of the metabolic syndrome among Turkish adults. Eur J Clin Nutr. 2007 Apr;61(4):548-553.
35. Uzunlulu M, Yorulmaz E, Oguz A. Prevalence of subclinical hypothyroidism in patients with metabolic syndrome. Endocrine J 2007;54:71–76.
36. Onat A, Sansoy V. Halkımızda koroner hastalığın baş suçlusu metabolik sendrom: sıklığı, unsurları, koroner risk ile ilişkisi ve yüksek risk kriterleri. Türk Kardiyol Dern Arş 2002;30:8-15.
37. Carr MC. The emergence of the metabolic syndrome with menopause. J Clin Endocr Metab 2003;88:2404–2411.
38. Kannel WB, Wilson PW. Risk factors that attenuate the female coronary disease advantage. Arch Intern Med 1995;155:57–61.
39. Tamer G, Mert m, Tamer I, Mesci B, Kılıc D, Arık S. Effects of thyroid autoimmunity on abdominal obesity and hyperlipidaemia. Pol J Endocrinol 201;62: 421–428.
40. Park YW, Zhu S, Palaniappan L, et al. The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994. Arch Intern Med 2003;163:427-436.
41. Palaniappan L, Carnethon MR, Wang Y, Hanley AJ, Fortmann SP, Haffner SM, et al. Predictors of the incident metabolic syndrome in adults: the Insulin Resistance Atherosclerosis Study. Diabetes Care 2004; 27:788-793.
42. Gohlke-Barwolf C. Coronary artery disease: is menopause a risk factor? Basic Res Cardiol 2000;95:177-1783.
43. Aydın Y, Celbek G, Kutlucan A, Önder E, Güngör A, Alemdar R, et al. Batı Karadeniz Bölgesinde Obezite Prevelansı: Melen Calışması. Turk Jem 2012;16:52-57