الفهرس 
Thyroid – Heart InterrelationOnly 14 pages are availabe for public view
 |  | from | 149 |  |  |
| | | from | 149 | | |
Abstract
Hypothyroidism is associated with an increased risk for coronary artery atherosclerosis and coronary heart disease, while this atherosclerotic process is believed to be diminished in hyperthyroidism. The increased cardiovascular morbidity in hypothyroid patients has been attributed to elevated LDL-C levels. However, not all patients with hypothyroidism have lipid abnormalities or hypertension; other mechanisms may be involved. The aim of the present work is to assess the level of some endothelial and vascular markers in patient with subclinical and overt hypothyroidism. To achieve this target, a total of 40 patients were included in this study, 11 males and 29 females with ratio of 1: 2.63. They were selected randomly from Endocrinology Out Patient Clinic In Specialized Medical Centre, Mansoura University Hospitals. They were divided into 2 groups, group I overt hypothyroidism which includes 30 patients, 8 males (26.7%) and 22 females (73.3%), groups II subclinical hypothyroidism which includes 10 patients, 3 males (30%) and 7 females (70%). In addition to, group III which includes 10 healthy subjects were chosen as a control group, 4 males (40%) and 6 females (60%). There was non-significant statistical difference as regard the age between all studied groups. BMI was significantly increased in subclinical and overt hypothyroidism when compared to controls. There was significant elevation in serum cholesterol and LDL-C in subclinical and overt hypothyroid patients compared to control while comparison of overt and subclinical hypothyroid patients showed significant elevation in cholesterol and no changes in LDL-C. Non significant changes in serum TG as well as HDL-C values in patients groups compared to control and in overt versus subclinical hypothyroid group were detected. There was significant elevation in Lp(a) in overt hypothyroidism compared to controls. Whereas non significant elevation in Lp(a) in subclinical hypothyroidism compared to controls and overt hypothyroidism. There significant elevation of serum TSH and serum Lp(a) in hypothyroid patients with ischemic ECG changes compared to those without ischemic ECG change. And also significant elevation of serum TSH, TG and Lp(a) in patients with chest pain compared to those without chest pain. In addition, significant positive correlation between TSH and cholesterol, LDL-C and Lp(a). Serum leptin levels were significantly elevated in studied groups as well as in both subclinical and overt hypothyroidism as compared to controls. While, there was non-significant elevation in subclinical and overt hypothyroidism and significant positive correlation between serum leptin and TSH. There was significant elevation of plasma concentration of homocysteine in both clinical and overt hypothyroidism compared to control. but there was non-significant elevation in overt compared to subclinical hypothyroidism. There was non significant changes in homocysteine levels in patients with ischemic ECG changes compared to those without ischemic ECG changes. Also, there was non significant changes in homocysteine in patients with chest pain compared to those without chest pain. Conclusions: ” Hypothyroidism is associated with an increased risk for coronary atherosclerosis and coronary heart disease. ” Plasma levels of Lp(a), homocysteine and leptin (atherogenic risk factors) were elevated in hypothyroid patients both overt and subclinical. So, subclinical hypothyroidism must be treated with L-thyronine therapy to avoid coronary atherosclerosis. ” Lp(a) can be used as an early marker of atherosclerosis in hypothyroid patient and also used for follow up during treatment. Recommendation: ” Follow up study of hypothyroid patient is recommended for early prediction of coronary atherosclerosis.