Demirhan S, Polat O, Mert M
University of Health Sciences, Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Department of Family Medicine.
University of Health Sciences, Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Department of Endocrinology and Metabolism, Istanbul, Turkey.
Acta Endocrinol (Buchar). 2023 Jul-Sep;19(3):333-338. doi: 10.4183/aeb.2023.333. Epub 2024 Feb 1.
Thyroid hormones have metabolic effects such as relationship between hypothyroidism and atherosclerosis.
Evaluate the effects of hypothyroidism on Non-Alcoholic Fatty Liver Disease and atherosclerosis by using AIP, APRI score, FIB-4 indices.
1370 patients with hypothyroidism who applied to the Endocrinology and Metabolism outpatient clinic between 01.01.2017-30.12.2021 were included the study. Pregnants, patients with a history of thyroid carcinoma, cardiovascular and liver diseases were excluded. TSH, fT4, Anti TPO, Anti TG, thrombocyte, ALT, AST, HDL, Triglyceride values of the cases were analyzed and atherogenic index of plasma (AIP), AST to Platelet Ratio Index (APRI) and Fibrosis-4 (FIB-4) indices were calculated.
1170 (85.4%) of the cases were female.The age of those who had high risk of AIP was found to be higher than those with low and moderate risk (p=0.001; p=0.003; p<0.01). The ages of those who had low-risk FIB-4 Index were found to be lower than those with moderate risk and high risk (p=0.001; p=0.001; p<0.01). A positive relationship was detected between APRI and FIB-4 (r=0.681; p=0.001; p<0.01).AIP increased as TSH increased in hypothyroid patients. No significant correlations were detected between TSH, APRI, and the FIB-4 Index. No significant differences were detected between AIP, APRI, FIB-4, and thyroid autoantibodies.
In hypothyroid patients, the AIP index increased with age and the increase in TSH. A strong relationship was detected between AIP and TSH . For this reason, we think that keeping TSH within the normal range with regular follow-ups and treatment in patients with hypothyroidism will reduce the risk of atherosclerosis.
甲状腺激素具有代谢作用,如甲状腺功能减退与动脉粥样硬化之间的关系。
通过使用动脉粥样硬化指数(AIP)、天冬氨酸氨基转移酶与血小板比值指数(APRI)、纤维化-4(FIB-4)指标,评估甲状腺功能减退对非酒精性脂肪性肝病和动脉粥样硬化的影响。
纳入2017年1月1日至2021年12月31日期间到内分泌与代谢门诊就诊的1370例甲状腺功能减退患者。排除孕妇、有甲状腺癌病史的患者、心血管疾病和肝脏疾病患者。分析病例的促甲状腺激素(TSH)、游离甲状腺素(fT4)、抗甲状腺过氧化物酶抗体(Anti TPO)、抗甲状腺球蛋白抗体(Anti TG)、血小板、谷丙转氨酶(ALT)、谷草转氨酶(AST)、高密度脂蛋白(HDL)、甘油三酯值,并计算血浆动脉粥样硬化指数(AIP)、AST与血小板比值指数(APRI)和纤维化-4(FIB-4)指标。
1170例(85.4%)病例为女性。发现AIP高风险者的年龄高于低风险和中等风险者(p=0.001;p=0.003;p<0.01)。发现FIB-4指数低风险者的年龄低于中等风险和高风险者(p=0.001;p=0.001;p<0.01)。检测到APRI与FIB-4之间存在正相关(r=0.681;p=0.001;p<0.01)。甲状腺功能减退患者中,AIP随TSH升高而升高。未检测到TSH、APRI和FIB-4指数之间存在显著相关性。未检测到AIP、APRI、FIB-4与甲状腺自身抗体之间存在显著差异。
在甲状腺功能减退患者中,AIP指数随年龄和TSH升高而升高。检测到AIP与TSH之间存在密切关系。因此,我们认为对甲状腺功能减退患者进行定期随访和治疗,将TSH维持在正常范围内,可降低动脉粥样硬化风险。