Naslov (srp)

Karakteristike metaboličkog sindroma X u bolesnika sa subkliničkom hipotireozom : doktorska disertacija / Mersudin Mulić.

Autor

Mulić, Mersudin, 1962-

Doprinosi

Đukić, Aleksandar, 1967-
Živančević-Simonović, Snežana, 1960-
Zamlakar, Miroslava
Micić, Dragan, 1950-
Lalić, Nebojša, 1958-

Opis (eng)

Increased cardiovascular risk in the thyroid dysfunction is related to disorders of lipid and lipoprotein metabolism, endothelial dysfunction, metabolic, hormonal and hemodynamic changes, and coagulation disorders. Subclinical hypothyroidism (SH) is characterized by supranormal levels of TSH with normal thyroid hormone levels. The association of SH with increased cardiovascular risk is still not fully understood. Objective of the study was to identify parameters in patients with SH that can indicate increased cardiometabolic risk as well as the assessment of the significance of the extension and distribution of body fat mass, leptin levels and insulin resistance levels in the identification of metabolic syndrome X (MSX). Method. The research will involve 140 patients aged 18-65 years; of these, 105 patients with SH and a control group of 35 healthy, well-nourished subjects without SH. In all subjects a research program will be conducted involving the following: a detailed anamnesis and physical examination, anthropometric measurements (estimation of body mass, body height, waist circumference, body fat mass estimation by bioelectric impedance analysis (BIA), calculation of body mass index (BMI), laboratory examinations (total blood count, fibrinogen, CRP, uric acid, fasting glucose, insulinemia, leptin, lipids and lipoprotein levels, fT3, fT4, TSH), while the evaluation of insulin resistance levels will be determined by the application of HOMA-IR (HOMA- IR = fasting glucose (mmol/L x fasting insulinemia (μU/ml)/22.5). Results. Of 105 patients with SH, of mean age 44.15±11.23 years, 77 (73.3%) had metabolic syndrome X (MSX). In the control group of 35 subjects with mean age 33.80±10.60 years, only 3 (8.6%) had MSH. The mean value of body fat mass (% BFM) (Т tеst=8.594, p<0.0001) was statistically significantly higher in the subjects with SH (Х±SD:37.26) in relation to mean values % BFM in the control group (Х±SD:24.56). The mean leptin levels in the group with SH was 22.88±17.76 mmol/L (МD=17.30 mmol/L), and in the control group subjects without SH it was 6.82±4.09 mmol/L (МD=5.40 mmol/L); the testing showed a statistically significant difference between the groups (T test=434.50, p<0.0001), and a considerably higher leptin levels in the group with SH. The mean value of Homeostasis Model Assessment for insulin resistance (HOMA-IR) in the SH group was considerably higher compared to the control group (2.86±2.22; MD=2.01 vs. 1.42±0.63; MD=1.33, Т tеst=5.698, p<0.0001).

Opis (srp)

Povećan kardiovaskularni rizik u disfunkciji štitaste žlezde u vezi je sa poremećajima metabolizma lipida i lipoproteina, endotelijalnom disfunkcijom, metaboličkim, hormonskim, hemodinamskim promenama i poremećajima koagulacije. Subklinički hipotireoidizam (SH), karakteriše se supranormalnim nivom TSH uz normalne vrednosti tireoidnih hormona. Udrženost subkliničkog hipotireoidizma sa povećanim kardiovaskularnim rizikom još uvek nije u potpunosti razjašnjen. Cilj ispitivanja predstavlja identifikaciju parametara kod bolesnika sa SH koji mogu ukazati na povećan kardiometabolički rizik, kao i procena značaja veličine i distribucije masne mase, nivoa leptina i stepena insulinske rezistencije u identifikaciji Metaboličkog sindroma H (MSH ). Metod. Istraživanjem će biti obuhvaćeno 140 bolesnika uzrasta 18-65 godina i to 105 bolesnika sa SH i kontrolna grupa od 35 zdrava, normalno uhranjena ispitanika bez SH. Kod svih ispitanika biće sproveden program istraživanja koji uključuje: detaljnu anamnezu i fizikalni pregled, antropometriska merenja (merenje telesne mase, telesne visine, obima struka, merenje masne mase tela postupkom bioelektrične impedane analize (BIA), izračunavanje indeksa telesne mase (ITM), laboratoriska ispitivanja (kompletna krvna slika, fibrinogen, CRP, acidum urikum, glikemija našte, insulinemija, leptin, lipidni i lipoproteinski status, fT3, fT4, TSH), a procena stepena insulinske rezistencije sprovešće se primenom HOMA-IR (HOMA-IR = glikemija našte (mmol/l) h insulinemija našte (μU/ml) / 22.5). Rezultati. Od 105 bolesnika sa SH, prosečne starosti 44,15±11,23 godina, 77 bolesnika (73,3%) ima MSH. U kontrolnoj grupi od 35 ispitanika, prosečne starosti 33,80±10,60 godina, samo 3 ispitanika (8,6%) ima MSH. Procenat prosečne veličine masne mase tela (%BFT) (T test=8,594, p<0,0001) je bio statistički značajno viši kod ispitanika sa SH (H±SD: 37,26) u odnosu na prosečne vrednosti %BFT u kontrolnoj grupi (H±SD: 24,56). Prosečna vrednost leptina u grupi sa SH bila je 22,88±17,76 mmol/L (Md=17,30 mmol/L), a kod ispitanika, kontrolne grupe, bez SH bila je 6,82±4,09mmol/L (Md=5,40mmol/L), te je testiranjem dokazana statistički značajna razlika među grupama (T test=434,50 , p<0,0001), pri čemu je vrednost leptina značajno viša u grupi sa SH. Prosečna vrednost HOMA-IR u grupi sa SH bila je značajno viša u odnosu na kontrolnu grupu (2,86±2,22 (Md=2,01) vs 1,42±0,63 (Md=1,33), T test =5,698, p<0,0001).

Opis (srp)

Umnoženo za odbranu. Univerzitet u Kragujevcu, Fakultet medicinskih nauka, 2014, dr medicinskih nauka, Endokrinologija. Bibliografija : listovi 135-154. Izvod ; Abstract.

Jezik

srpski

Datum

2014

Licenca

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Creative Commons CC BY-NC 2.0 AT - Creative Commons Autorstvo - Nekomercijalno 2.0 Austria License.

CC BY-NC 2.0 AT

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