期刊论文详细信息
BMC Endocrine Disorders
Serum homocysteine levels are decreased in levothyroxine-treated women with autoimmune thyroiditis
Marek Ruchała2  Wojciech Kozubski3  Jakub Fischbach2  Michał Michalak1  Michał K Owecki3  Anna Oczkowska3  Nadia Sawicka-Gutaj2  Jolanta Dorszewska3  Maciej Owecki2 
[1] Department of Informatics and Statistics, Poznan University of Medical Sciences, Dąbrowskiego St. 79, 60-529 Poznań, Poland;Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Przybyszewskiego St. 49, 60-355 Poznań, Poland;Department of Neurology, Poznan University of Medical Sciences, Przybyszewskiego St. 49, 60-355 Poznań, Poland
关键词: Hashimoto disease;    Autoimmunity;    Thyroid;    Homocysteine;   
Others  :  864956
DOI  :  10.1186/1472-6823-14-18
 received in 2013-11-25, accepted in 2014-02-25,  发布年份 2014
PDF
【 摘 要 】

Background

Hyperhomocysteinemia is a well-known cardiovascular risk factor and its elevation is established in overt hypothyroidism. Since some authors suggest that chronic autoimmune thyroiditis per se may be considered as a novel risk factor of atherosclerosis independent of thyroid function, the analysis of classical cardiovascular risk factors might be helpful in evaluation the causative relationship. Data concerning the impact of thyroid autoimmunity in euthyroid state on homocysteine (Hcy) level is lacking. The aim of this study was to evaluate Hcy level in context of anti-thyroperoxidase antibodies (TPOAbs) in euthyroidism.

Methods

It is a case–control study. 31 euthyroid women treated with levothyroxine (L-T4) due to Hashimoto thyroiditis (HT) and 26 females in euthyroidism without L-T4 replacement therapy were enrolled in the study. All women with HT had positive TPOAbs. Forty healthy females negative for TPOAbs comparable for age and body mass index (BMI) participated in the study as controls. Exclusion criteria were a history of any acute or chronic disease, use of any medications (including oral contraceptives and vitamin supplements), smoking, alcoholism.

Results

TPOAbs titers were higher in both groups of HT patients versus the healthy controls. Hcy levels were found to be significantly lower in treated HT patients (Me 11 μmol; IQR 4.2 μmol) as compared with healthy controls (Me 13.35 μmol; IQR 6.34 μmol; p = 0.0179). In contrast, no significant difference was found between non treated HT and control group in Hcy level. The study groups and the controls did not differ in age and BMI. Furthermore, levels of TSH, FT4, TC, LDL, HDL and TAG did not differ between the study group and the control group.

Conclusion

The main finding of the study is a decrease in Hcy level in treated HT as compared with healthy controls. Based on our observations one can also assume that correct L-T4 replacement was associated here with a decrease of Hcy. Furthermore, it seems that non treated HT in euthyroidism is not associated with Hcy increase, in contrast to overt hypothyroidism. This may be just another argument against the concepts about the role of “euthyroid HT” in the development of atherosclerosis.

【 授权许可】

   
2014 Owecki et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20140726022230933.pdf 261KB PDF download
28KB Image download
27KB Image download
【 图 表 】

【 参考文献 】
  • [1]Selhub J: Homocysteine metabolism. Annu Rev Nutr 1999, 19:217-246.
  • [2]McCully KS: Vascular pathology of homocysteinemia: implications for the pathogenesis of arteriosclerosis. Am J Pathol 1969, 56:111-128.
  • [3]Homocysteine Studies Collaboration: Homocysteine and risk of ischemic heart disease and stroke: a meta-analysis. JAMA 2002, 288:2015-2022.
  • [4]Klerk M, Verhoef P, Clarke R, Blom HJ, Kok FJ, Schouten EG: MTHFR Studies Collaboration Group MTHFR 677C → T polymorphism and risk of coronary heart disease: a meta-analysis. JAMA 2002, 288:2023-2032.
  • [5]Thampi P, Stewart BW, Joseph L, Melnyk SB, Hennings LJ, Nagarajan S: Dietary homocysteine promotes atherosclerosis in apoE-deficient mice by inducing scavenger receptors expression. Atherosclerosis 2008, 197:620-629.
  • [6]Clarke R, Halsey J, Bennett D, Lewington S: Homocysteine and vascular disease: review of published results of the homocysteine-lowering trials. J Inherit Metab Dis 2011, 34:83-91.
  • [7]Nedrebø BG, Ericsson UB, Nygård O, Refsum H, Ueland PM, Aakvaag A, Aanderud S, Lien EA: Plasma total homocysteine levels in hyperthyroid and hypothyroid patients. Metabolism 1998, 47:89-93.
  • [8]Morris MS, Bostom AG, Jacques PF, Selhub J, Rosenberg IH: Hyperhomocysteinemia and hypercholesterolemia associated with hypothyroidism in the third US National Health and Nutrition Examination Survey. Atherosclerosis 2001, 155:195-200.
  • [9]Gunduz M, Gunduz E, Kircelli F, Okur N, Ozkaya M: Role of surrogate markers of atherosclerosis in clinical and subclinical thyroidism. Int J Endocrinol 2012. doi:10.1155/2012/109797
  • [10]Lien EA, Nedrebø BG, Varhaugh JE, Nygard O, Aakvaag A, Ueland PM: Plasma total homocysteine levels during short-term iatrogenic hypothyroidism. J Clin Endocrinol Metab 2000, 85:1049-1053.
  • [11]Nedrebø BG, Nygård O, Ueland PM, Lien EA: Plasma total homocysteine in hyper- and hypothyroid patients before and during 12 months of treatment. Clin Chem 2001, 47:1738-1741.
  • [12]Diekman MJ, van der Put NM, Blom HJ, Tijssen JG, Wiersinga WM: Determinants of changes in plasma homocysteine in hyperthyroidism and hypothyroidism. Clin Endocrinol (Oxf) 2001, 54:197-204.
  • [13]Lien EA, Nedrebø BG, Varhaug JE, Nygård O, Aakvaag A, Ueland PM: Plasma tHcy levels during short-term iatrogenic hypothyroidism. J Clin Endocrinol Metab 2000, 85:1049-1053.
  • [14]Nedrebø BG, Nygård O, Ueland PM, Lien EA: Plasma tHcy in hyper- and hypothyroid patients before and during 12 months of treatment. Clin Chem 2001, 47:1738-1741.
  • [15]Chan MM, Stokstad EL: Metabolic responses of folic acid and related compounds to thyroxine in rats. Biochimica Biophysica Acta 1980, 632:244-253.
  • [16]Nair CP, Viswanathan G, Noronha JM: Folate-mediated incorporation of ring-2-carbon of histidine into nucleic acids: influence of thyroid hormone. Metabolism 1994, 43:1575-1578.
  • [17]Ayav A, Alberto JM, Barbe F, Brunaud L, Gerard P, Merten M, Gueant JL: Defective remethylation of homocysteine is related to decreased synthesis of coenzymes B2 in thyroidectomized rats. Amino Acids 2005, 28:37-43.
  • [18]Luboshitzky R, Aviv A, Herer P, Lavie L: Risk factors for cardiovascular disease in women with subclinical hypothyroidism. Thyroid 2002, 12:421-425.
  • [19]Atabek ME, Pirgon O, Erkul I: Plasma homocysteine concentration in adolescents with subclinical hypothyroidism. J Pediatr Endocrinol Metab 2003, 16:1245-1248.
  • [20]Sengul E, Cetinarslan B, Tarkun I, Canturk Z, Turemen E: Homocysteine concentrations in subclinical hypothyroidism. Endocr Res 2004, 30:351-359.
  • [21]Bastenie PA, Vanhaelst L, Golstein J, Smets P: Asymptomatic autoimmune thyroiditis and coronary heart disease.Cross-sectional and prospective studies. Lancet 1977, 2:155-158.
  • [22]Hak AE, Pols HA, Visser TJ, Drexhage HA, Hofman A, Witteman JC: Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam study. Ann Intern Med 2000, 132:270-278.
  • [23]Nyirenda MJ, Clark DN, Finlayson AR, Read J, Elders A, Bain M, Fox KA, Toft AD: Thyroid disease and increased cardiovascular risk. Thyroid 2005, 15:718-724.
  • [24]Zoller B, Li X, Sundquist J, Sundquist K: Risk of subsequent ischemic and hemorrhagic stroke in patients hospitalized for immune-mediated diseases: a nationwide follow-up study from Sweden. BMC Neurol 2012, 12:41. BioMed Central Full Text
  • [25]Tamer G, Mert M, Tamer I, Mesci B, Kilic D, Arik S: Effects of thyroid autoimmunity on abdominal obesity and hyperlipideamia. Endokrynol Pol 2011, 62:421-428.
  • [26]Topaloglu O, Gokay F, Kucukler K, Burnik FS, Mete T, Yavuz HC, Berker D, Guler S: Is autoimmune thyroiditis a risk factor for early atherosclerosis in premenopausal women even if in euthyroid status? Endocrine 2013, 44:145-151.
  • [27]Ciccone MM, De Pergola G, Porcelli MT, Scicchitano P, Caldarola P, Lacoviello M, Pietro G, Giorgino F, Favale S: Increased carotid IMT in overweight and obese women affected by Hashimoto’s thyroiditis: an adiposity and autoimmune linkage? BMC Cardiovasc Disord 2010, 10:22. BioMed Central Full Text
  • [28]Wang YP, Lin HP, Chen HM, Kuo YS, Lang MJ, Sun A: Hemoglobin, iron, and vitamin B12 deficiencies and high blood homocysteine levels in patients with anti-thyroid autoantibodies. J Formos Med Assoc 2012. doi:10.1016/j.jfma.2012.04.003
  • [29]Orzechowska-Pawilojc A, Sworczak K, Lewczuk A, Babinska A: Homocysteine, folate and cobalamin levels in hypothyroid women before and after treatment. Endocr J 2007, 54:471-476.
  • [30]Colucci P, Seng Yue C, Ducharme M, Benvenga S: A review of the pharmacokinetics of levothyroxine for the treatment of hypothyroidism. Eur Endocrinol 2013, 9:40-47.
  • [31]Ain KB, Pucino F, Shiver TM, Banks SM: Thyroid hormone levels affected by time of blood sampling in thyroxine-treated patients. Thyroid 1993, 3:81-85.
  文献评价指标  
  下载次数:16次 浏览次数:9次