Hipotiroidi ile koroner arter hastalığı arasındaki ilişki: Koroner BT anjiografi ile değerlendirme
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Date
2013
Authors
Eritmen, Ülkü
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Hipotiroidizm tiroid bezinin az hormon salgılaması nedeniyle oluşan bir hastalıktır. Klinik hipotiroidizmin, genellikle eşlik eden hiperkolesterolemi ileberaber ateroskleroz ve bunu izleyen kardiyovasküler hastalık için bir riskfaktörü olduğu belirtilmektedir. Subklinik hipotirodizmin (SKH) kardiyovasküler hastalıklarla ilişkisi tartışmalıdır. SKH'in kan lipid düzeylerineolumsuz etkisi ve direk endotel üzerindeki hasarı ile ateroskleroza yol açtığı gösterilmiştir. Bu çalışmanın amacı; SKH ile koroner arter hastalığı (KAH) arasındaki ilişkinin multidedektör bilgisayarlı tomografi (MDBT) koroner anjiografi ile araştırılmasıdır. Prospektif olarak planlanan bu çalışmaya; Uludağ Üniversitesi Tıp Fakültesi Endokrin ve Genel Dahiliye polikliniklerine Eylül 2011- Mayıs 2012tarihleri arasında başvuran, 18-65 yaş arası 85 hasta dahil edildi. 47`si hastagrubu, 38'i ise kontrol grubunu oluşturdu. Hastaların demografik özellikleri, vital bulguları, boy, kiloları ile laboratuvar bilgileri kaydedildi. MDBT'de koroner kalsiyum skorları (KKS) ve koroner anjiyografi ile KAH varlığı belirlendi. KKS>0 olanlar da KKS: 0-10, 11-100, 101-400 ve >400 olarak gruplandırıldı. Koroner anjiyografi ile KAH (-) ve KAH (+) olanlar belirlendi. Gruplar arasında yaş, kilo, boy ve vücut kitle indeksi (VKİ) bakımındananlamlı fark saptanmadı (p>0.05). İki grup karşılaştırıldığında total kolesterol, LDL ve trigliserid düzeyi yüksek olanların sayısı hasta grubunda anlamlı olarak fazla idi (p<0.05). Hasta grubunda sağ koroner arterde 3, sol koroner arterde 2, sirkumfleks arterde 3, kontrol grubunda ise sağ koroner arterde 2, sol koroner arterde 7, sirkumfleks arterde 2 hastada stenoza yol açan plaklar saptandı. Bu sonuçlar iki grup arasında karşılaştırıldığında anlamlı farklılık bulunmadı (p>0.05). Sonuç olarak; çalışmamızda SKH'nin lipid profili üzerine olumsuz etkileri olmakla beraber, KAH varlığı ile direk ilişkisi saptanmamıştır.
Hypothroidism is a disease caused by low hormone secretion ofthyroid gland. Clinically apparent hypothyroidism has been represented as arisk factor for atherosclerosis and accompanying hypercholesterolemiaresulting in cardiovascular disease. Relationship between subclinical hypothyroidism (SCH) and cardiovascular diseases is controversial. Subclinical hypothyroidism has been shown to cause atherosclerosis by its advers effects on blood lipid levels and direct endothelial injury. The aim ofthis study is to investigate the relationship between subclinical hypothyroidism and coronary artery disease (CAD) by multidedector computed tomography (MDCT) coronary angiography.In this prospective study, 85 patients aging 18 to 65 years old whoapproached to Uludag University Faculty of Medicine out-patients clinics between September 2011 and May 2012 were included. 47 of them hadhypothyroidism while 38 constituted control group. Demographic data, vital signs, height, weight and laboratory findings of patients were recorded. Coronary calcium scores (CCS) were determined by MDCT and presence of coronary artery disease (CAD) was determined by coronary angiography. Patients with CCS>0 were divided into 0-10, 11-100, 101-400 and >400groups. CAD (-) ve CAD (+) patients were determined by coronary angiography. There were no significant difference between age, weight, height andbody mass index properties of groups (p>0.05). When two grups arecompared, number of subjects with high blood total cholesterol, LDL andtriglyceride levels was significantly higher in the patient group (p<0.05). In thepatient group there were stenotic plaques in 3 patients right coronary artery, 2 patients left anterior descending, 3 patients circumflex artery, while in theivcontrol group these numbers were 2 for right coronary artery, 7 for left anterior descending and 2 for circumflex artery. There was no significantly differance between two groups (p>0.05).In conclusion, while subclinical hypothyroidism was found to negativeeffects on lipid profiles, no relationship with CAD was found.
Hypothroidism is a disease caused by low hormone secretion ofthyroid gland. Clinically apparent hypothyroidism has been represented as arisk factor for atherosclerosis and accompanying hypercholesterolemiaresulting in cardiovascular disease. Relationship between subclinical hypothyroidism (SCH) and cardiovascular diseases is controversial. Subclinical hypothyroidism has been shown to cause atherosclerosis by its advers effects on blood lipid levels and direct endothelial injury. The aim ofthis study is to investigate the relationship between subclinical hypothyroidism and coronary artery disease (CAD) by multidedector computed tomography (MDCT) coronary angiography.In this prospective study, 85 patients aging 18 to 65 years old whoapproached to Uludag University Faculty of Medicine out-patients clinics between September 2011 and May 2012 were included. 47 of them hadhypothyroidism while 38 constituted control group. Demographic data, vital signs, height, weight and laboratory findings of patients were recorded. Coronary calcium scores (CCS) were determined by MDCT and presence of coronary artery disease (CAD) was determined by coronary angiography. Patients with CCS>0 were divided into 0-10, 11-100, 101-400 and >400groups. CAD (-) ve CAD (+) patients were determined by coronary angiography. There were no significant difference between age, weight, height andbody mass index properties of groups (p>0.05). When two grups arecompared, number of subjects with high blood total cholesterol, LDL andtriglyceride levels was significantly higher in the patient group (p<0.05). In thepatient group there were stenotic plaques in 3 patients right coronary artery, 2 patients left anterior descending, 3 patients circumflex artery, while in theivcontrol group these numbers were 2 for right coronary artery, 7 for left anterior descending and 2 for circumflex artery. There was no significantly differance between two groups (p>0.05).In conclusion, while subclinical hypothyroidism was found to negativeeffects on lipid profiles, no relationship with CAD was found.
Description
Keywords
Hipotiroidi, MDBT, Koroner anjiyografi, Lipid, KAH, Hypothyroidism, MDCT, Coronary angiography, CAD
Citation
Eritmen, Ü. (2013). Hipotiroidi ile koroner arter hastalığı arasındaki ilişki: Koroner BT anjiografi ile değerlendirme. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.