HAKİM ÇELİK, Seyhan TAŞKIN, Adnan KİRMİT, Mehmet Ali EREN

Graves Olgularında Kardiyovasküler Hastalık Risk Değerlendirmesi: Trombosit İndekslerinin Rolü

Amaç: Gelişmiş ülkelerde en sık görülen hipertiroidi nedeni olarak belirtilen Graves hastalığı, tirotoksikoz, diffüz guatr ve oftalmopati ile karakterize otoimmün bir hastalıktır. Tiroid hormonunun, kardiyovasküler hemodinamiği değiştirebilecek etkilere sahip olması, hipertroidili hastaların kardiyovasküler komplikasyonlara yakalanma riskini arttırmaktadır. Tam kan sayımında rutin olarak rapor edilen; ortalama trombosit hacmi başta olmak üzere, trombosit indeksleri kardiyovasküler hastalıkların gelişimi ve takibinde önemli biyobelirteçler olarak kabul edilmektedir. Bu nedenle çalışmamızda Graves hastalığının kardiyovasküler hastalıklar ile ilişkisini değerlendirebilmek amacıyla trombosit indekslerinin rolü araştırıldı. Yöntemler: Çalışmaya 33 Graves hipertiroidili hasta ile cinsiyet, yaş ve vücut kitle indeksi benzer 37 sağlıklı kontrol dahil edildi. Çalışmada rutin olarak ölçülmüş olan trombosit indeksleri ve tiroid fonksiyon parametreleri incelendi. Bulgular: Graves hastaları ile kontrol grupları arasında trombosit sayısı ve trombosit yüzdesi bakımından anlamlı herhangi bir fark bulunmazken (sırasıyla; p= 0,202; p= 0,289), ortalama trombosit hacmi ve trombosit dağılım genişliği Graves hastalarında kontrol grubuna göre anlamlı ölçüde yüksek bulundu (sırasıyla; p< 0,001; p= 0,015). Ayrıca Graves hastalarında ortalama trombosit hacmi ve trombosit dağılım genişliği ile serbest triiyodotironin arasında anlamlı pozitif ilişki saptanmıştır (sırasıyla; r= 0,505; p= 0,003 ve r= 0,366; p= 0,036). Yapılan alıcı işletim karakteristiği (ROC) analizine göre Graves hastalarında, ortalama trombosit hacmi ve trombosit dağılım genişliği düzeylerinin kardiyovasküler hastalıkların risk değerlendirilmesi için kabul edilebilir bir prediktif değere sahip olduğu gösterilmiştir. Sonuç: Sonuç olarak, Graves hastalarında kardiyovasküler hastalıkları öngörebilecek önemli biyobelirteçler olduğu düşünülen ortalama trombosit hacmi ve trombosit dağılım genişliği yüksek bulunmuştur. Bu durum Graves hastalarının kardiyovasküler hastalıklara yakalanma riskinin yüksek olabileceğini düşündürmektedir.

Cardiovascular Disease Risk Assessment in Graves' Cases: The Role of Platelet Indices

Objective: Graves' disease, which is the most common cause of hyperthyroidism in developed countries, is an autoimmune disease characterized by thyrotoxicosis, diffuse goiter and ophthalmopathy. The fact that thyroid hormone has effects that can change cardiovascular hemodynamics increases the risk of cardiovascular complications in patients with hyperthyroidism. Platelet indices, especially mean platelet volume routinely reported in whole blood count are considered as important biomarkers for the development and follow-up of cardiovascular diseases. Therefore, in this study, we investigated the role of platelet indices in order to evaluate the relationship between Graves' disease and cardiovascular diseases. Methods: Thirty-three patients with Graves' hyperthyroidism and 37 healthy controls with similar sex, age and body mass index were included in the study. In this study, platelet indices and thyroid function parameters routinely measured were evaluated. Results: There was no significant difference in platelet count and platelet percentage between Graves patients and control groups (p= 0.202; p= 0.289, respectively), whereas mean platelet volume and platelet distribution width were significantly higher in Graves patients compared to control group (p< 0.001; p= 0.015, respectively). In addition, a significant positive correlation was found between mean platelet volume and platelet distribution width and free triiodothyronine in Graves' patients (r= 0.505; p= 0.003 and r= 0.366; p= 0.036, respectively). According to Receiver operating characteristic (ROC) analysis, mean platelet volume and platelet distribution width levels have an acceptable predictive value for cardiovascular diseases risk assessment in Graves' patients. Conclusion: Our results showed that mean platelet volume and platelet distribution width are important biomarkers that may predicting cardiovascular diseases in Graves 'disease. Therefore, in this study platelet indices suggest that Graves' patients may have a high risk of developing cardiovascular diseases.

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