Papers by Neslihan Tutuncu
Turkish Journal of Endocrinology and Metabolism, Jun 23, 2016
Cardiovascular effects of hypothyroidism are well known. Osteopontin (OPN) is a new inflammatory ... more Cardiovascular effects of hypothyroidism are well known. Osteopontin (OPN) is a new inflammatory marker which was first isolated from the bone. Flow-mediated dilatation (FMD), a noninvasive technique to measure this endothelium-dependent function, has been used in several clinical studies to show cardiovascular risks. The aim of our study was to assess FMD value in hypothyroidism patients and to investigate whether plasma OPN level is a parameter which can predict cardiovascular risks in this group of patients. Material and Method: This study included 39 patients who had high levels of thyroid-stimulating hormone (TSH) and 11 healthy euthyroid controls. Plasma TSH, free thyroxine, fibrinogen, high-sensitive C-reactive protein (hsCRP), fasting plasma glucose, total cholesterol (T-chol), low density lipoprotein (LDL), triglyceride and OPN levels were measured at the time hypothyroidism was first detected and after euthyroid state was achieved with levothyroxine treatment. In parallel with these assessments, brachial FMD measurements were also performed. Results: In hypothyroid patients cardiovascular risk factors such as T-chol, LDL and triglyceride levels were higher than in control group but fibrinogen and hsCRP levels were not different between the groups. OPN levels were similar in patient and control groups, but basal FMD levels were lower in patients with hypothyroidism. After euthyroidism was achieved, OPN levels significantly decreased and FMD levels significantly increased, but a correlation was not detected between these two parameters. Discussion: Our study did not show a significant correlation between OPN and cardiovascular risk parameters. Further studies are needed to use OPN as a cardiovascular risk marker in hypothyroid patients.
Turkish Journal of Endocrinology and Metabolism, Jun 5, 2015
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women in reproductiv... more Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women in reproductive age. Conflicting results are reported in the studies examining insulin resistance in lean PCOS subjects. We aimed to observe the controversial presence of insulin resistance in lean PCOS subjects with the gold standard method and assess the impacts of family history of type 2 diabetes mellitus (T2DM) on insulin resistance in these patients. Material and Method: Nineteen patients with PCOS and nine age-BMI matched control subjects were recruited into the study. Patients with PCOS were divided into two groups according to their FH of T2DM among their first degree relatives (FHneg vs FHpos). Insulin resistance was evaluated with homeostasis model assessment of insulin resistance (HOMA-IR) and hyperinsulinemic euglycemic clamp technique for all participants. Results: Mean M values were significantly higher in the control group when compared with PCOS patients (p=0.003). There was no statistically significant difference for HOMA-IR and M values when FHneg and FHpos patients were compared. Although HOMA-IR values were similar between all groups, M values were lower in FHneg and FHpos groups compared to the controls (p=0.02 and 0.004 respectively). Discussion: Lean PCOS patients have evident insulin resistance when compared to healthy subjects, and FH of T2DM seems to not affect insulin resistance. Even non-obese PCOS patients should be encouraged for healthy eating style and exercise to prevent the potential risks associated with insulin resistance. Furthermore these patients can see benefits from medical therapies which improve insulin sensitivity.
AdrH Pozitif Reklam ve İletişim Merkezi, 2019
Acta Endocrinologica (Bucharest), 2018
Context. Previous studies have associated overt/ subclinical hypothyroidism and obesity but have ... more Context. Previous studies have associated overt/ subclinical hypothyroidism and obesity but have failed to confirm a causative relationship between them. Confusion is even more for subjects with Hashimoto's Thyroiditis (HT). Objective. In this study, we aimed to evaluate the fat distribution and metabolic profile of subjects with euthyroid HT as well as to establish an appropriate cutoff level of TSH for the development of metabolic syndrome (Mets) in both groups. Patients and Methods. All subjects were euthyroid whether under levothyroxine replacement or not. We recruited 301 volunteers (99 with HT and 202 without thyroid autoimmunity). Together with some metabolic variables, we measured the waist circumference, hip circumference, neck circumference manually; the total body fat with a body composition analyzer; and the visceral fat/ trunk fat percentage via abdominal bioelectrical impedance analysis. Results. A significant positive correlation was established between TSH levels and insulin, fasting plasma glucose, HOMA-IR and body mass index (r=0.28; p<0.001; r=0.27; p<0.05: r=0.32; p<0.001: r=0.13; p<0.05 respectively). The prevalence of Metabolic Syndrome (Mets) was comparable in HT and control groups (27.3% vs. 30.7%; p>0.05). The prevalence of Mets was similar when HT subjects using levothyroxine or HT subjects with accompanying thyroid nodules were taken into consideration. Similarly, anthropometric and metabolic parameters were similar in both the HT group and the control group. We were unable to establish the TSH cutoff level by ROC analysis with desired sensitivity and specificity (AUC: 0.563 with 95% C.I. p=0.35; standard error 0.76). Conclusions. Although weight gain is frequently encountered in subjects with HT, such subjects with thyroid function tests in the euthyroid range have a similar prevalence of Mets and similar metabolic and anthropometric measurements compared to subjects without autoimmunity.
Endocrine Practice, Oct 1, 2001
Objective: To document a case of thyroid cancer metastatic from the breast. Methods: We present t... more Objective: To document a case of thyroid cancer metastatic from the breast. Methods: We present the clinical, laboratory, radiologic, and biopsy findings in our patient and review the related literature. Results: A 47-year-old female patient was referred to our clinic because of dyspnea and generalized bone pain. Physical examination revealed a diffusely enlarged nodular goiter, and fine-needle aspiration biopsy demonstrated intrathyroidal anaplastic cells. Total thyroidectomy was done, and the histopathologic diagnosis was anaplastic carcinoma. Unexpected rapid progression of the disease with cervical and intrathoracic lymphadenopathies and osteoblastic metastatic lesions without radioiodine uptake prompted us to attempt to rule out a primary nonthyroidal malignant lesion metastatic to the thyroid gland. The plasma level of CA 15-3 was profoundly increased (388 U/mL). Detailed reassessment of the patient disclosed a small mass in the right mammary gland with histopathologic features similar to those of the thyroidectomy material. Reevaluation of the thyroid specimens resulted in a final diagnosis of primary breast carcinoma in conjunction with metastatic carcinoma of the thyroid. Conclusion: Thorough systemic clinical assessment of a patient with a thyroid nodule and careful study of biopsy specimens should be done to ascertain whether the nodule is a primary or a metastatic lesion.
Journal of Endocrinological Investigation, Jul 14, 2009
To evaluate the risk of developing endocrine hyperactivity and carcinoma during a period of up to... more To evaluate the risk of developing endocrine hyperactivity and carcinoma during a period of up to 5 yr in patients with apparently benign and non-functioning adrenal incidentalomas. Thirty-two patients (mean age: 57.0+/-8.3 yr) were investigated in a prospective follow-up study for a median time of 24 months. Twenty-eight patients had unilateral and 4 had bilateral masses. Initial average mass diameter was 17.47+/-6.60 mm. All patients were followed up yearly by physical examination, metabolic parameters, hormonal evaluation [morning cortisol after 3-mg dexamethasone suppression, urinary metanephrines, and upright aldosterone/ plasma renin activity (PRA)]. Among the clinical characteristics, 48% of patients were obese, 20% were hypertensive, 13 had Type 2 diabetes and impaired glucose tolerance. During follow-up period no significant change in the functional status was observed and nomalignant transformation occurred. Only 1 patient developed subclinical Cushing&#39;s syndrome at the end of the 1st year and referred to surgery. Change in mass size was correlated with homeostasis model assessment of insulin resistance (p=0.002), upright aldosterone/ PRA (p=0.041), cortisol after dexamethasone suppression (p=0.048) and 24-h urinary normetanephrine (p=0.005) levels. Gender, body mass index, glucose metabolism, and blood pressure were not found to be correlated with change in mass size and functional status. Due to the extremely low risk of developing malignancy during up to 5 yr of follow-up, conservative approach for the management of adrenal incidentalomas is thought to be appropriate. However, possibility of evolution to hormonal hypersecretion makes long-term follow-up of 2-to-5 yr seems to be obligatory.
Endocrine Pathology, 2006
We evaluated the usefulness of ultrasound-guided fine-needle-aspiration biopsy (US-FNAB) for infr... more We evaluated the usefulness of ultrasound-guided fine-needle-aspiration biopsy (US-FNAB) for infracentimetric nodules. In addition, we used sonography to assess the risk of malignancy of thyroid nodules, and we evaluated the extent of disease in infracentimetric cancers. The cytopathological results of 472 US-FNABs from 207 nodular goiter patients (170 women, 37 men; mean age, 51.5±13.1 yr) seen between 1999 and 2004
10th European Congress of Endocrinology, May 1, 2008
Background: The prevalence rate of thyroid cancers in patients with renal failure is variable in ... more Background: The prevalence rate of thyroid cancers in patients with renal failure is variable in different studies. Our aim was to determine the prevalence and clinicopathological characteristics of thyroid cancers in the dialysis population and to evaluate the potential risk factors. Methods: We performed a retrospective analysis on end-stage renal disease (ESRD) patients on dialysis and thyroidectomized patients without ESRD (2000-2006). Then we compared the data of thyroid cancer patients on dialysis (n ¼ 9) with the data of patients who had histopathologically verified benign thyroid disease on dialysis (n ¼ 23) and with the histopathological data of thyroid cancer patients without ESRD. Results: Papillary thyroid cancer (PTC) was the only histotype that was found in 9 of 420 (2.1%) ESRD patients on dialysis. Multifocal PTC was found in eight of nine patients; of them, four had follicular variant of PTC (FVPTC). Two patients had lymphatic metastasis at diagnosis. Eight PTCs were classified as tumor-nodemetastasis (TNM) stage I and one as stage II. Among the analyzed factors, age (r ¼ 0.374, p ¼ 0.01) and duration of dialysis (r ¼ 0.436, p ¼ 0.007) showed a significant positive correlation with the occurrence of thyroid cancer. Conclusions: We conclude that the prevalence of thyroid cancer in patients undergoing dialysis was not higher than that in the background population. Age and duration of dialysis showed a significant positive correlation with the occurrence of thyroid cancer in patients on dialysis. Among the histotypes, there may be higher percentage of PTC, FVPTC, and multifocality in dialysis patients. The effect of these characteristics on prognosis of thyroid cancer in dialysis patients is needed to be further evaluated.
International Journal of Oral and Maxillofacial Surgery, Oct 1, 2013
Background: Psoriatic arthritis (PsA) is a chronic inflammatory arthropathy associated with psori... more Background: Psoriatic arthritis (PsA) is a chronic inflammatory arthropathy associated with psoriasis. PsA is classified among the seronegative spondyloarthropathies, characterized by joint destruction, extra-articular involvement (i.e. eye, gut, bowel, ureter), and a negative rheumatoid factor. The clinical features of TMJ involvement are actually much complex. Temporomandibular disorders (TMD) are a heterogeneous group of pathologies affecting the temporo-mandibular joint (TMJ), the jaw muscles, or both. There are few data in literature for the association of Psoriasis or PsA and TMD although we know that a possible trait d'union between these three entities could be represented by the inflammatory pathway. Methods: From November 2011 to December 2012 a total number of 157 patients have been screened at the outpatient service of the "Clinica Dermatologica, Policlinico Umberto I, Sapienza Università di Roma". A group of 80 healthy people (no diagnosis of PsO, PsA or TMDs) served as control. Considered the similarity of pathogenethic mechanisms for joint involvement in PsA and TMDs the authors wanted to investigate the comorbidity of the two pathologies. TMJ involvement might be considered the first sign of arthropatic involvement of PsA. Results: If we consider the whole number of TMJ positive patients and the radiological results we found and impressive series of bone erosion and remodelling of the mandibular condyle. Conclusions: Comparing the TMJ damage to the PsA the systemic treatment for TMDs should be taken into account not only to limit the local progress of the pathology but as the prevention of PsA typical progression.
Brazilian Dental Science, 2020
Objective:Bisphosphonate related osteonecrosis of the jaws (BRONJ) is a challenging complication ... more Objective:Bisphosphonate related osteonecrosis of the jaws (BRONJ) is a challenging complication of chronic bisphosphonate (BP) uptake. Relaxin is able to induce the multistep differentiation process of human osteoclastogenesis and exhibits anti-fibrotic and anti-inflammatory actions, and promotes vasodilatation, wound healing, and angiogenesis. The present study aimed to evaluate the effect of relaxin hormone on prevention and management of BRONJ. Materials and Methods:Thirty six male Sprague-Dawley rats were used in this study. The rats were randomly divided into four groups. In the first group Relaxin and Bisphosphonate were applied together in the same time for 12 weeks, in the second group Relaxin was applied for 12 weeks following Bisphosphonate, in the third group only bisphosphonate was alone and the fourth group saline (control) alone were applied to four groups of rats.Results:Necrosis, inflammation and the intensity of the osteoblast cells in the mandibles and BRONJ wer...
Journal of Oral and Maxillofacial Surgery, 2012
stratified by race, gender and anatomic sub-site. Outcomes were measured by number of occurrences... more stratified by race, gender and anatomic sub-site. Outcomes were measured by number of occurrences per 100,000 people. Results: The overall incidence of OOC was stable over time. Males had higher incidence of OOC with a marked difference between Black males and females (11.72 and 3.82 respectively). In a collective analysis there was a decreased incidence (18.39 to 9.21) among Blacks 40-64. There was increased incidence of tongue cancer among Whites in particular age groups; 3.84 to 5.65 in the 40-64 and 8.45 to 10.6 in the 65ϩ. Blacks had an interval decrease of tongue cancer; 6.63 to 4.06 in the 40-64 age cohort. There was a significant decrease in the incidence of FOM cancer in all races (1.49 to 0.65). The incidence of gingival cancer was stable over time, however it was significantly decreased in Blacks 40-64 (6.02 to 2.31). White females Ͼ65 had a higher incidence of gingival cancer than Black females of the same age; 7.54 versus 5.32. Oropharyngeal cancer had the lowest incidence among the measured sub-sites; however, Blacks demonstrated an increased trend in both the 40-64 and 65 ϩ cohorts. The overall 3 and 5-year observed survival (OS) rates for all sub-sites improved over time. Older age groups demonstrated a 34% mean improvement in survival. Blacks demonstrated the poorest OS irrespective of age, gender and sub-site. The mean difference in survival between Blacks and Whites ranged 10-30%. The disease specific mortality has decreased over time in tongue, gingival and FOM cancer. Whites and Blacks had proportionate decreases in mortality in ages 40-64. Whites aged 65 ϩ had a greater decrease in mortality compared to Blacks; 30% reduction versus 21%. Increased mortality was noted for oropharyngeal cancer; Blacks 65 ϩ had a 110% increase compared to 40% in Whites of the same age. Conclusions: This study was designed to raise awareness among practitioners of OOC trends. The data confirms known trends with respect to gender and age and will serve as a framework to develop early diagnostics and focus therapeutics in high-risk demographic subsites such as Black males, White males with tongue cancer and females with gingival cancer. Overall disease specific survival has improved in both Blacks and Whites, but less so for Blacks. Mortality for oropharyngeal cancers increased twofold. These points re-emphasize the importance of potential etiologic factors other than smoking and alcohol abuse, such as HPV. Further investigations will focus on factors that contribute to these differences in an effort to improve outcomes.
American Journal of Medical Genetics, Apr 15, 2006
Fewer than 10 families have been reported with dilated cardiomyopathy and hypergonadotrophic hypo... more Fewer than 10 families have been reported with dilated cardiomyopathy and hypergonadotrophic hypogonadism (DCM-HH), which has been described as the ''congestive cardiomyopathy-hyper
Clinical Endocrinology, Oct 1, 2006
Objective Controversy surrounds the evaluation of nodules with indeterminate cytology results. Ma... more Objective Controversy surrounds the evaluation of nodules with indeterminate cytology results. Malignancy rates in these nodules are not low. We examined the malignancy rates in nodules that showed follicular neoplasm or atypical cells on cytology and attempted to predict malignancy based on ultrasonographic features.Design and patients We retrospectively analysed 5 years’ cytopathology results of fine‐needle aspiration biopsy (FNAB) specimens of indeterminate follicular thyroid lesions prior to thyroidectomy. The prevalence of malignancy on final histology was determined. The sonographic features of the thyroid nodules with respect to size, echogenicity, echo structure, border shape and presence of calcification were analysed.Results A total of 86 patients (15 men, 61 women; mean age 52·1 ± 12·5 years) with indeterminate cytology underwent thyroidectomy and had histopathological diagnoses. The average nodule was 18·9 ± 12·3 mm. The prevalence of malignancy in patients with atypical cell cytology was 51·7% (30 of 59), and the prevalence of malignancy in patients with follicular neoplasm cytology was 15% (4 of 27). Malignancy prevalence was higher in patients who had follicular neoplasm cytology with atypical cells than in those without atypical cells (2 of 7 and 2 of 20, respectively).We found no significant correlations between sonographic or clinical features and malignancy in this patient group. Sonographic features and nodule size are not useful predictors of malignancy.Conclusion Until better molecular markers for malignancy are developed, surgical consultation remains necessary after examination of cytologically indeterminate FNAB specimens in patients with follicular thyroid lesions. But in follicular lesions without atypical cells the malignancy rate is low and reassessment later on could be an alternative approach.
15th International & 14th European Congress of Endocrinology, May 1, 2012
Clinical Endocrinology, May 1, 2007
Pain is one of the few drawbacks of fine-needle aspiration biopsy (FNAB) in patients with nodular... more Pain is one of the few drawbacks of fine-needle aspiration biopsy (FNAB) in patients with nodular thyroid disease (NTD). Lidocaine/prilocaine cream, a eutectic mixture of local anaesthetics (EMLA), is a frequently used topical anaesthetic. Despite its well-documented efficacy for the relief of pain associated with other cutaneous procedures that involve needle insertion, the analgesic role of EMLA has not been previously reported in patients with NTD who are undergoing FNAB. The aim of this study was to determine the analgesic efficacy of EMLA for FNAB-associated pain in patients with NTD. Design: Double-blind, placebo-controlled clinical trial. Patients: The study was conducted at a thyroid outpatient clinic. We studied 99 patients with NTD. Measurements: Patients with NTD were allocated to receive either 2.5 g of EMLA (n = 50) or placebo (n = 49) 60 min before ultrasonographically guided FNAB. A series of four biopsies of each nodule was performed. Patients rated pain associated with the procedure according to a 100-mm visual analogue scale (VAS), an 11-point numeric rating scale (NRS), and 4-category verbal rating scale (VRS). Results: When the EMLA group was compared with the placebo group, there were no significant differences with respect to age, sex, thyroid volume, nodule size or nodule site. Significant differences were noted in the pain ratings of the two groups according to all three pain scales. When the effectiveness of EMLA was compared with that of placebo, the mean VAS score was 25.0 ± 22.3 mm vs. 40.0 ± 30.5 mm (P = 0.006) and the mean NRS score was 2.9 ± 2.3 points vs. 4.0 ± 2.6 points (P = 0.02). The absolute numbers according to VRS score in each group was also significantly different (P = 0.01). Although our sample size was small, the data suggest that FNABassociated pain was sex-related and that women were significantly more sensitive than were men (P = 0.003 for VAS score and P = 0.001 for NRS score). No adverse effects from the use of EMLA were reported. Conclusions: To our knowledge, this is the first study demonstrating that a topical anaesthetic,
Endocrine, Jun 1, 2008
Thyroid hemiagenesis is a rare form of thyroid dysgenesis, in which one thyroid lobe fails to dev... more Thyroid hemiagenesis is a rare form of thyroid dysgenesis, in which one thyroid lobe fails to develop. The true prevalence of this rare abnormality is about 0.05-0.2% in normal population. We aimed to determine prevalence of thyroid hemiagenesis in patients with various thyroid disorders and a normal population in a mild to moderate iodine-deficient area. The clinical and thyroid ultrasonography records of 4,833 patients who presented with various thyroid disorders were reviewed. In addition, ultrasonographic data of two large surveys carried out for the community screening of iodine status of children (n = 4,772) and thyroid disorders of adult subjects (n = 2,935) were analyzed. In patients with thyroid disorders, we found 12 cases with thyroid hemiagenesis (0.25%). Thyroid hemiagenesis was due to the agenesis of the left lobe in all cases. The underlying thyroid diseases were Hashimoto&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s thyroiditis (n = 4), euthyroid multinodular goiter (n = 4), and toxic adenoma (n = 1). Three subjects have no underlying thyroid disease. In ultrasonography screening of normal population, altogether, the absence of the left lobe was detected in only two cases, indicating a true prevalence of thyroid hemiagenesis of 0.025%. None of the reviewed patients had thyroid dysfunction. Our community-based data is in accordance with previous studies in terms of prevalence and male-to-female ratio.
Thyroid, 2008
Background: The prevalence rate of thyroid cancers in patients with renal failure is variable in ... more Background: The prevalence rate of thyroid cancers in patients with renal failure is variable in different studies. Our aim was to determine the prevalence and clinicopathological characteristics of thyroid cancers in the dialysis population and to evaluate the potential risk factors. Methods: We performed a retrospective analysis on end-stage renal disease (ESRD) patients on dialysis and thyroidectomized patients without ESRD (2000-2006). Then we compared the data of thyroid cancer patients on dialysis (n ¼ 9) with the data of patients who had histopathologically verified benign thyroid disease on dialysis (n ¼ 23) and with the histopathological data of thyroid cancer patients without ESRD. Results: Papillary thyroid cancer (PTC) was the only histotype that was found in 9 of 420 (2.1%) ESRD patients on dialysis. Multifocal PTC was found in eight of nine patients; of them, four had follicular variant of PTC (FVPTC). Two patients had lymphatic metastasis at diagnosis. Eight PTCs were classified as tumor-nodemetastasis (TNM) stage I and one as stage II. Among the analyzed factors, age (r ¼ 0.374, p ¼ 0.01) and duration of dialysis (r ¼ 0.436, p ¼ 0.007) showed a significant positive correlation with the occurrence of thyroid cancer. Conclusions: We conclude that the prevalence of thyroid cancer in patients undergoing dialysis was not higher than that in the background population. Age and duration of dialysis showed a significant positive correlation with the occurrence of thyroid cancer in patients on dialysis. Among the histotypes, there may be higher percentage of PTC, FVPTC, and multifocality in dialysis patients. The effect of these characteristics on prognosis of thyroid cancer in dialysis patients is needed to be further evaluated.
9th European Congress of Endocrinology, Apr 28, 2007
OBJECTIVE-To evaluate the safety and efficacy of treatment with insulin alone, insulin plus metfo... more OBJECTIVE-To evaluate the safety and efficacy of treatment with insulin alone, insulin plus metformin, or insulin plus troglitazone in individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS-A total of 88 type 2 diabetic subjects using insulin monotherapy (baseline HbA lc 8.7%) were randomly assigned to insulin alone (n ϭ 31), insulin plus metformin (n ϭ 27), or insulin plus troglitazone (n ϭ 30) for 4 months. The insulin dose was increased only in the insulin group. Metformin was titrated to a maximum dose of 2,000 mg and troglitazone to 600 mg. RESULTS-HbA lc levels decreased in all groups, the lowest level occurring in the insulin plus troglitazone group (insulin alone to 7.0%, insulin plus metformin to 7.1%, and insulin plus troglitazone to 6.4%, P Ͻ 0.0001). The dose of insulin increased by 55 units/day in the insulin alone group (P Ͻ 0.0001) and decreased by 1.4 units/day in the insulin plus metformin group and 12.8 units/day in the insulin plus troglitazone group (insulin plus metformin versus insulin plus troglitazone, P ϭ 0.004). Body weight increased by 0.5 kg in the insulin plus metformin group, whereas the other two groups gained 4.4 kg (P Ͻ 0.0001 vs. baseline). Triglyceride and VLDL triglyceride levels significantly improved only in the insulin plus troglitazone group. Subjects taking metformin experienced significantly more gastrointestinal side effects and less hypoglycemia. CONCLUSIONS-Aggressive insulin therapy significantly improved glycemic control in type 2 diabetic subjects to levels comparable with those achieved by adding metformin to insulin therapy. Troglitazone was the most effective in lowering HbA lc , total daily insulin dose, and triglyceride levels. However, treatment with insulin plus metformin was advantageous in avoiding weight gain and hypoglycemia.
Journal of Endocrinological Investigation, Apr 1, 2009
The aim of this study was to investigate systolic pulmonary artery pressure (SPAP) and echocardio... more The aim of this study was to investigate systolic pulmonary artery pressure (SPAP) and echocardiographic findings in patients with euthyroid Hashimoto&#39;s thyroiditis (HT). Thirty (8 male, 22 female, mean age 47.4+/-10.5 yr) consecutive patients with euthyroid HT and 30 (9 male, 21 female, mean age 46.4+/-10.7 yr) healthy controls were included in the study. Transthoracic echocardiography was performed for all patients and levels of thyroid hormones, thyroid autoantibodies, glucose, insulin, urea, and creatinine were compared. There were no significant differences in sex, age, body mass index, serum free T4, serum TSH, lipid profiles between patients and controls. Mean SPAP in patients with euthyroid HT were significantly higher than in controls (31.6+/-5.0 vs 25.6+/-4.5 mmHg, p=0.005). Late diastolic transmitral velocity and isovolumic relaxation time were also significantly higher in patients in comparison to controls. In addition, euthyroid HT patients with tricuspid or mitral regurgitation had a higher grade. Correlation between SPAP and antithyroid antibodies and TSH, however, was not significant in this population. Pulmonary arterial pressure is higher in patients with euthyroid HT. There may be a relationship between elevated pulmonary arterial pressure and autoimmune thyroid disease independent from thyroid function status. However, further investigations are needed to determine the exact mechanism of association between autoimmune thyroid diseases and pulmonary hypertension.
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Papers by Neslihan Tutuncu