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Vol. 41 Br. 3 (2022)
Vol. 41 Br. 3 (2022)

Specifičan uticaj kardiovaskularnih faktora rizika na koronarnu mikrocirkulaciju u pacijenata sa subkliničkom hipotireozom: Coronary in subclinical hypothyroidism

DOI: 10.5937/jomb0-34545
Mirjana Stojković
Clinic of endocrinology, diabetes and metabolic disease, University Clinical Center of Serbia
Biljana Nedeljković-Beleslin
1. Faculty of Medicine, University od Belgrade 2. Clinic of Endocrinology, Diabetes and Metabolic diseases, Clinical Center of Serbia
Milorad Tesic
Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, Serbia 3. Clinic for Cardiology Clinical Center of Serbia
Zoran Bukumiric
1. Faculty of Medicine, University od Belgrade 4. Institute of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade
Jasmina Ciric
1. Faculty of Medicine, University od Belgrade 2. Clinic of Endocrinology, Diabetes and Metabolic diseases, Clinical Center of Serbia
Milos Stojanovic Stojanovic
1. Faculty of Medicine, University od Belgrade 2. Clinic of Endocrinology, Diabetes and Metabolic diseases, Clinical Center of Serbia
Marija Miletic
1. Faculty of Medicine, University od Belgrade 2. Clinic of Endocrinology, Diabetes and Metabolic diseases, Clinical Center of Serbia
Ana Djordjevic-Dikic
Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, Serbia 3. Clinic for Cardiology Clinical Center of Serbia
Vojislav Giga
Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, Serbia 3. Clinic for Cardiology Clinical Center of Serbia0
Branko Beleslin
Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, Serbia 3. Clinic for Cardiology Clinical Center of Serbia
Milos Zarkovic
1. Faculty of Medicine, University od Belgrade 2. Clinic of Endocrinology, Diabetes and Metabolic diseases, Clinical Center of Serbia
PDF (engleski)

Objavljeno

2021-12-03

Sekcija

Original paper

Sažetak

Uvod: Poznato je da tiroidni hormoni imaju značajan efekat na kardiovaskularni system, ali i dalje ostaje da se utvrdi uticaj suptilnih promena na nivou tiroidne osovine kao što je subklinička hipotireoza (SHT). Ispitivali smo koronarnu rezervu protoka (KRP) kod pacijenata sa subkliničkom hipotireozom.

Metode: Trideset dva ispitanika sa subkliničkom hipotireozom i osamnaest kontrolnih ispitanika sa urednim tiroidnim hormonskim statusom su bili uključeni u studiju. Mereni su TSH, fT4, fT3, glukoza, insulin, HbA1c, holesterol, trigliceridi i CRP. Koronarne dijastolne brzine protoka u levoj prednjoj silaznoj koronarnoj arteriji merene su na početku i nakon infuzije adenozina. Koronarna rezerva protoka je izračunata kao odnos hiperemijske i osnovne dijastolne brzine protoka.

Rezultati: Vrednosti koronarne reserve protoka se nisu značajno razlikovale između dve grupe (SHT 2,76 ± 0,35 u odnosu na kontrole 2,76 ± 0,42). Postojala je značajna korelacija KRP sa odnosom struka i kukova, hipertenzijom, navikama pušenja, markerima glikoregulacije (nivo glukoze, HbA1c, nivo insulina, HOMA IR), holesterolom, LDL-holesterolom i nivoom triglicerida u SHT grupi, dok je samo nivo holesterola pokazao značajnu korelaciju sa KRP u kontrolnoj grupi. Nije bilo korelacije između KRP i hormona štitaste žlezde.

Zaključak: Zaključili smo da postoji drugačiji uticaj kardiovaskularnih faktora rizika na koronarnu rezervu protoka kod pacijenata sa subkliničkom hipotireozom u poređenju sa zdravom kontrolom i da se ove dve grupe ponašaju različito u istim okolnostima, pod istim faktorima rizika. Osnova za ovu razliku mogla bi biti  da promenjen “set point” tiroidne osovine menja osetljivost mikrovaskulature kod pacijenata sa SHT na poznate faktore rizika.

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DOI: 10.5937/jomb0-34545

Reference

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