Hakan YÜCEL, Suzan TABUR, Sadettin ÖZTÜRK, Mustafa ARAZ, Hale ÇOLAKOĞLU ER, Ertan VURUŞKAN

HASHİMOTO TİROİDİTLİ HASTALARDA ATEROSKLEROZ İLE İLİŞKİLİ PARAMETRELERİN DEĞERLENDİRİLMESİ

Hashimoto tiroiditi otoimmün tiroid hastalığıdır. Aterosklerozda arterlerin subintima tabakasında lipidler, karbonhidratlar, fibröz doku, kalsiyum gibi maddelerin lokal birikimlerinin oluşturduğu patolojik bir durum söz konusudur. Vasküler endotelyal büyüme faktör (VEGF) özellikle hipoksi varlığında seçici olarak endotel hücrelerinde mitojenik etki ile damar gelişimini uyararak yeni damar oluşumunda yaşamsal rol oynar. Biz bu çalışmamızda ötiroid hashimoto hastalarında serum VEGF düzeyi ile akım aracılı dilatasyon (flow-mediated dilation, FMD) ve karotis intima media kalınlığı (KİMK) ölçümü yaparak, otoimmünitenin tiroid hastalarında ateroskleroz ile ilişkisini ortaya koymayı amaçladık.Gaziantep Üniversitesi Tıp Fakültesi Dahiliye Kliniği’nde Hashimoto tiroiditi tanısı almış 40 hasta ile yaş ve cinsiyet uyumlu 40 sağlıklı gönüllü çalışmaya dahil edildi. Serum örneklerinde VEGF düzeyleri ELISA yöntemiyle ölçüldü. Hasta ve kontrol grubunda ultrason eşliğinde KİMK ve FMD değerlendirilerek mevcut sonuçlarla ilişkili olup olmadığı tespit edildi.Hasta ve kontrol grubunun demografik özellikleri benzerdi. Hasta ve kontrol grupları arasında FMD ve KIMK ölçümleri karşılaştırıldığında istatiksel olarak anlamlı fark saptandı (p=0,001; p=0,033). VEGF düzeyinin de hasta grubunda kontrol grubuna göre anlamlı olarak yüksek olduğu tespit edildi (p=0,024).Tüm bu sonuçlar tiroid hormon eksikliği olmadan da otoimmüniteye sekonder ateroskleroz gelişebileceğini ve hashimoto hastalarının erken dönem takiplerindenoninvaziv uygulanabilen FMD, KİMK ölçümlerinin ve VEGF düzeylerinin prediktif değerinin olabileceğini göstermektedir.

THE EVALUATION OF ATHEROSCLEROSIS RELATED PARAMETERS IN PATIENTS WITH HASHIMOTO’S THYROIDITIS

Hashimoto thyroiditis is an autoimmune thyroid disease. Atherosclerosis is a pathological condition characterized by local accumulation of substances such as lipids, carbohydrates, fibrous tissue and calcium in the subintima layer of arteries. In this study, we aimed to reveal the relationship between autoimmunity and atherosclerosis by measuring serum VEGF levels, flow-mediated dilation (FMD) and carotid intima-media thicknes (CIMT) in euthyroid patients with Hashimoto thyroiditis. Forty patients diagnosed with Hashimoto thyroiditis in the Internal Medicine Clinic of Gaziantep University Medical Faculty and 40 healthy volunteers matched for age and gender were included in the study. VEGF levels were measured by ELISA method in serum samples. CIMT and FMD were evaluated with ultrasound guidance in the patient and control groups and it was determined whether there was a association with the present results. The demographic characteristics of the patient and control groups were similar. There was a significant difference between the patients and healthy control group in terms of FMD and CIMC measurements (p =0.001; p = 0.033). It was also found that VEGF levels of patients were higher than those in the control group (p = 0.024). All these results show autoimmunity may lead atherosclerosis even without thyroid hormone deficiency and also noninvasive FMD, CIMT measurements and VEGF levels may have predictive value in the early follow-up of Hashimoto patients.

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