Uticaj subkliničke hipotireoze na funkciju endotela, koronarnu mikrocirkulaciju i pojavu ranih aterosklerotskih promena na karotidnim arterijama
Influence of subclinical hypothyroidism on endothel function, coronary microcirculation and the appearance of early atherosclerotic changes in the carotid arteries
Author
Stojković, MirjanaMentor
Žarković, MilošCommittee members
Beleslin, BrankoĆirić, Jasmina
Giga, Vojislav
Hajduković, Zoran
Metadata
Show full item recordAbstract
Uvod: Iako je poznato da tiroidni hormoni imaju značajan efekat na kardiovaskularni sistem,
uticaj blage tiroidne disfunkcije u pravcu subkliničke hipotireoze na funkcionalne
kardiovaskularne promene i dalje je otvoreno pitanje. Ispitivali smo povezanost promene u
tiroidnoj funkciji u pravcu subkliničke hipotireoze sa mikrovaskularnom disfunkcijom i ranim
aterosklerotskim promenama na krvnim sudovima.
Metodologija: istraživanje je uključilo je 78 ispitanika sa subkliničkom hipotireozom i 55
ispitanika sa urednom tiroidnom funkcijom. Određeni su tiroidni hormonski status,
antropometrijski i metabolički parametri. Merene su i izračunate protokom posredovana
dilatacija (PPD), debljina intima-medija kompleksa (IMK) i koronarna rezerva protoka (KRP).
Rezultati: vrednosti PPD, debljina IMK i KRP se nisu značajno razlikovale među grupama i
nije bilo povezanosti PPD, debljine IMK i KRP sa tiroidnim hormonskim statusom. Kod osoba
sa subkliničkom hipotireozom, ali ne i kod eutiroidnih osoba nađe...na je značajna povezanost
debljine IMK sa indeksom telesne mase, vrednostima glikemije, HOMA IR i fT4 i značajna
povezanost KRP sa sa odnosom struka i kukova, hipertenzijom, pušenjem, markerima
glikoregulacije, holesterolom, LDL-holesterolom i trigliceridima.
Zaključak: Zaključili smo da postoji različit uticaj klasičnih kardiovaskularnih faktora rizika
na debljinu IMK i KRP kod osoba sa subkliničkom hipotireozom u poređenju sa eutiroidnim
osobama i da se ove dve grupe različito ponašaju u istim okolnostima, pod istim faktorima
rizika. Osnova za ovu razliku bi mogla biti izmenjen „set point“ hipotalamo-hipofizno-tiroidne
osovine koji menja osetljivost mikrovaskulature kod osoba sa subkliničkom hipotireozom na
poznate faktore rizika u pravcu koji je proaterogen i čini ih podložnijim za hroničnu inflamaciju
niskog stepena.
Background: Although thyroid hormones have significant effect on cardiovascular system,
the impact of subtle thyroid dysfunction such as subclinical hypothyroidism remains to be
determined. We investigated possible association of microvascular dysfunction and early
atherosclerotic changes with subclinical hypothyroidism.
Methods: 78 subjects with subclinical hypothyroidism and 55 control subjects with normal
serum thyroid hormonal status were included in the study. TSH, free thyroxine, free
triiodothyronine, glucose, insulin, HbA1c, cholesterol, triglyceride and C-reactive protein were
measured. Flow mediated dilatation (FMD), intima-media thickness (IMT) and coronary flow
reserve were measured and calculated.
Results: FMD, IMT and CFR were not significantly different between the two groups. and
there was no association of FMD, IMT and CFR with thyroid hormonal status. In subjects with
subclinical hypothyroidism, but not in euthyroid subjects, a significant association between
IMT and ...body mass index, glycemia, HOMA IR and fT4 and a significant association between
CFR and waist-hip ratio, hypertension, smoking, markers of glycoregulation, cholesterol,
LDL-cholesterol and triglycerides was found.
Conclusion: We concluded that there is a different impact of cardiovascular risk factors on
IMT and CFR in subjects with subclinical hypothyroidism compared with euthyroid subjects
and that these two groups behave differently in the same circumstances, under the same risk
factors. The basis for this difference could be a modified "set point" of the hypothalamicpituitary-
thyroid axis, which changes the sensitivity of the microvasculature in people with
subclinical hypothyroidism to known risk factors in the direction that is proaterogenic and
makes them more susceptible to low-grade chronic inflammation