Kutluturk Faruk, Gul Serdar S, Sahin Safak, Tasliyurt Turker
Department of Endocrinology and Metabolism, Gaziosmanpasa University Faculty of Medicine, Tokat, Turkey.
Department of Nuclear Medicine, Gaziosmanpasa University Faculty of Medicine, Tokat, Turkey.
Endocr Metab Immune Disord Drug Targets. 2019;19(6):859-865. doi: 10.2174/1871530319666190206125545.
Thyroid hormones are essential for the normal development, differentiation, metabolic balance and physiological function of all tissues. Mean platelet volume (MPV) indicates mean platelet size and reflects platelet production rate and stimulation. Increased platelet size has been observed in association with known cardiovascular risk factors. The neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) are known markers of the systemic inflammatory response. This study aimed to investigate the effect of thyroid hormone changes by comparing platelet count, MPV values, NLR and PLR in thyroid papillary carcinoma.
Forty-nine females and nine males comprising a total of 58 patients were included in the study. Clinical and laboratory parameters of patients were recorded in the following three phases of the disease: euthyroid phase (before thyroid surgery), overt hypothyroid (OH) phase (before radioactive iodine [RAI] treatment) and subclinical hyperthyroid (SCH) phase (six months after RAI treatment).
The mean thyroid-stimulating hormone (TSH) values of the patients in the euthyroid, OH and SCH phases were 1.62±1.17, 76.4±37.5 and 0.09±0.07 µIU/mL, respectively. The mean MPV values of the patients in the euthyroid, OH and SCH phases were 9.45±1.33, 9.81±1.35 and 9.96±1.21 fL, respectively. MPV was significantly higher in the SCH phase than in the euthyroid phase (p=0.013). Platelet count, NLR and PLR were not statistically different between the euthyroid, OH and SCH phases.
The results of this study demonstrated that the levels of MPV increased significantly in the SCH phase in patients with papillary thyroid carcinoma (PTC), and increased MPV values contributed to increased risk of cardiovascular complications. These findings suggest that MPV can be a valuable, practical parameter for monitoring the haemostatic condition in thyroid disorders. No significant difference was observed in platelet count, NLR and PLR in all stages of PTC.
甲状腺激素对于所有组织的正常发育、分化、代谢平衡及生理功能至关重要。平均血小板体积（MPV）表明平均血小板大小，并反映血小板生成率和刺激情况。已观察到血小板大小增加与已知心血管危险因素相关。中性粒细胞/淋巴细胞比值（NLR）和血小板/淋巴细胞比值（PLR）是全身炎症反应的已知标志物。本研究旨在通过比较甲状腺乳头状癌患者的血小板计数、MPV值、NLR和PLR来探究甲状腺激素变化的影响。
本研究共纳入58例患者，其中49例女性和9例男性。记录患者在疾病的以下三个阶段的临床和实验室参数：甲状腺功能正常阶段（甲状腺手术前）、显性甲状腺功能减退（OH）阶段（放射性碘[RAI]治疗前）和亚临床甲状腺功能亢进（SCH）阶段（RAI治疗后6个月）。
甲状腺功能正常、OH和SCH阶段患者的平均促甲状腺激素（TSH）值分别为1.62±1.17、76.4±37.5和0.09±0.07 μIU/mL。甲状腺功能正常、OH和SCH阶段患者的平均MPV值分别为9.45±1.33、9.81±1.35和9.96±1.21 fL。SCH阶段的MPV显著高于甲状腺功能正常阶段（p = 0.013）。甲状腺功能正常、OH和SCH阶段之间的血小板计数、NLR和PLR无统计学差异。
本研究结果表明，甲状腺乳头状癌（PTC）患者在SCH阶段MPV水平显著升高，且MPV值升高会增加心血管并发症风险。这些发现表明，MPV可作为监测甲状腺疾病止血状况的一个有价值的实用参数。PTC各阶段的血小板计数、NLR和PLR均未观察到显著差异。
