Asymmetric Dimethylarginine, Symmetric Dimethyl Arginine, N-Monomethyl-L-Arginine, Arginine and Citrulline as Early Markers of Cardiovascular Disease in Pubertal Girls with Euthyroid Hashimoto Thyroiditis

Yıl 2023, , 530 - 536, 30.12.2023

Bahri Elmas , Gizem Böke Koçer , Ceylan Bal , Cemil Nural , Gulsen Yilmaz

https://doi.org/10.31832/smj.1386547

Öz

Objective:
Thyroid dysfunction is known to increase the risk of cardiovascular disease (CVD) in patients with Hashimoto's thyroiditis (HT). However, there is insufficient data regarding CVD risk in euthyroid HT patients who have not yet developed thyroid dysfunction. In our study, we investigated whether Asymmetric Dimethylarginine (ADMA), Symmetric Dimethyl Arginine (SDMA), N-Monomethyl-L-Arginine (L-NMMA), Arginine and Citrulline levels can be used as early indicators of this risk.
Materials and Methods:
63 pubertal female patients without thyroid dysfunction and 68 healthy controls, who were diagnosed with HT based on thyroid antibody positivity and ultrasonographic findings, were included in our study. Blood pressure levels, thyroid function test data, thyroid antibody levels, inflammatory parameters and ADMA, SDMA, L-NMMA, Arginine and Citrulline levels were compared between the groups, and the relationships of ADMA, SDMA, L-NMMA, Arginine and Citrulline levels with other CVD markers were determined.
Results:
While TSH, anti-TPO, anti-Tg and ADMA values were found to be high in the patient group; Citrulline, arginine and arginine/ADMA values were found to be low. While a significant positive correlation was observed between ADMA and SDMA, L-NMMA, fT3, total cholesterol, LDL, triglyceride, waist circumference/hip circumference and BMI SSS values in the patient group, a significant negative correlation was detected with arginine/ADMA values.
Conclusion
In our study, patients with euthyroid Hashimoto's thyroiditis; In the early period, an increase in ADMA levels was detected. ADMA can be used as a CVD risk indicator in patients with euthyroid hypertension due to its relationships with anthropometric measurements, metabolic parameters, SDMA and L-NMMA.

Anahtar Kelimeler

ADMA, Arginine, Hashimoto, L-NMMA, SDMA, Citrulline

Ötiroid Hashimoto Tiroiditli Pubertal Kız Hastalarda Kardiyovasküler Risk Belirteçleri Olarak Asimetrik Dimetilarjinin, Simetrik Dimetil Arjinin, N-Monometil-L-Arjinin, Arjinin ve Sitrülin Düzeyleri

Öz

Giriş ve Amaç:
Tiroid fonksiyon bozukluğu, Hashimoto tiroiditi (HT) hastalarında kardiyovasküler hastalık (KVH) riskini artırdığı bilinmektedir. Ancak henüz tiroid fonksiyon bozukluğu gelişmemiş ötiroid HT hastalarında KVH riski ile ilgili veriler yetersizdir. Biz çalışmamızda asimetrik dimetilarjinin (ADMA), simetrik dimetil arjinin (SDMA), N-monometil-L-arjinin (L-NMMA), Arginine and Citrulline düzeylerinin bu riskin erken belirteçleri olarak kullanılıp kullanılamayacağını araştırmayı amaçladık.
Gereç ve Yöntemler:
Tiroid antikor pozitifliği ve ultrasonografik bulgularla HT tanısı alan, tiroid fonksiyon bozukluğu olmayan 65 pubertal kadın hasta ve 70 sağlıklı kontrol çalışmamıza dahil edildi. Gruplar arasında kan basıncı düzeyleri, tiroid fonksiyon testi verileri, tiroid antikor düzeyleri ve inflamatuar parametreler ile ADMA, SDMA, L-NMMA, Arjinin ve Sitrüllin düzeyleri karşılaştırıldı ve ADMA, SDMA, L-NMMA, Arjinin ve Sitrüllin düzeylerinin diğer KVH belirteçleriyle ilişkileri belirlendi.
Bulgular :
Hasta grubunda TSH, anti-TPO, anti-Tg ve ADMA değerleri yüksek saptanırken; sitrülin, arjinin ve arjinin/ADMA değerleri düşük olarak saptandı. Hasta grubunda ADMA ile SDMA, L-NMMA, sT3, total kolesterol, LDL, trigliserit, bel çevresi/kalça çevresi ve VKİ SSS değerleri arasında anlamlı pozitif korelasyon gözlenirken, arjinin/ADMA değerleri ile anlamlı negatif korelasyon saptandı.
Sonuç:
Çalışmamızda ötiroid Hashimoto tiroiditli hastalarda; erken dönemde, ADMA düzeylerinde artış saptandı. ADMA’nın antropometrik ölçümler, metabolik parametreler, SDMA ve L-NMMA ile olan ilişkileri nedeni ile ötiroid HT’li hastalarda KVH risk belirteci olarak kullanılabilir. Ancak daha büyük örneklem büyüklüğüne sahip ileri çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

ADMA, Arjinin, Hashimoto Tiroiditi, L-NMMA, SDMA, Sitrülin

Etik Beyan

Araştırma, Helsinki Bildirgesi ve onun daha sonraki revizyonları veya eşdeğer türdekiler tarafından oluşturulan etik yönergelere uygun olarak yapılmıştır. Çalışmaya T.C. Sakarya Üniversitesi Klinik Araştırmalar Etik Kurulu’ndan onay alınmıştır (Etik kurul tarih:30/07/2018 No: 16214662/050.01.04/62).

Destekleyen Kurum

Yoktur

Teşekkür

Yoktur

Kaynakça

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