Lipid profile and levels of homocysteine, leptin, fibrinogen and C-reactive protein in hyperthyroid patients before and after treatment

Objectives: The present study was carried out to determine whether thyroid hormones affect lipid profile and levels of erithrocyte sedimentation rate (ESR), serum total homocysteine (t-hcy), leptin, fibrinogen, C-reactive protein (CRP in patients with hyperthyroidism.Materials and methods: This study was carried out on 23 hyperthroid subjects (3 men / 20 women, mean age 41.8 ± 2.4 years). Serum levels of homocysteine, leptin, fibrinogen, CRP, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and ESR were measured and body mass index (BMI) were calculated before and after treatment of hyperthyroidism.Results: Pretreatment t-hcy, TC, LDL-C, HDL-C levels and BMI of patients were significantly lower than those of the post-treatment (p<0.001, for each variable). However, fibrinogen and ESR decreased after the treatment (p<0.001 and p<0.05, respectively). There were no differences in leptin and CRP levels between pre- and post-treatment periods. Pre and post treatment TC and LDL-C levels were negatively correlated with free triiodothyronine (fT3) levels (r=-0.588, p<0.01; r=-0.534, p<0.01; r=-0.543, p<0.01 and r =-0.653, p<0.01, respectively). Pre-treatment HDL-C was inversely correlated with TSH (r=-0.423, p<0.05). Pre-post- treatment LDL-C was negatively correlated with free thyroxine (fT4) levels (r=-0.536, p<0.001 and r=- 0.422, p<0.05 respectively). Pre-treatment TC was inversely correlated with fT4 (r=-0.590, p<0.01).Conclusion: Hyperthyroidism is associated with high plasma fibrinogen and ESR levels. Elevated plasma fibrinogen and ESR levels may be a possible explanation for the high cardiovascular morbidity among hyperthyroidic subjects. These changes may reflect low-grade inflammation or disturbances in coagulation in hyperthyroidism

Endothelial functions of the patients with hyperparathyroidism

Introduction: Primary hyperparathyroidism (PHPT) is associated with increased risk of mortality from cardiovascular disease and this appears to decrease with time after parathyroidectomy. However, data on hyperparathyroid patients are conflicting and there is no data regarding secondary hyperparathyroid patients. Our aim in this study was to determine the association between flow-mediated dilatation (endothelium dependent, FMD), nitroglycerine-induced dilatation (endothelium independent, NID) and carotid artery intima media thickness (IMT) in primary hyperparathyroidism (PHPT), secondary hyperparathyroidism (SHPT) and the control group.Material and methods: Twenty patients with primary hyperparathyroidism, twenty with secondary hyperparathyroidism and 12 healthy subjects were included in the study. Both groups were matched with respect to age. Serum calcium level, parathormone(PTH) and daily urinary calcium excretion (UCE) were calculated and FMD, NID and IMT were also evaluated for all subjects.Results: Serum Ca levels were significantly higher in patients with primary hyperparathyroid patients compared to both patients with secondary hyperparathyroidism and the control group (P&lt;0.001 and&nbsp;P&lt;0.001 respectively). As expected, urinary calcium excretion levels of the patients with primary hyperparathyroidism were higher than both the control group and the patients with secondary hyperparathyroidism (P&lt;0.001,&nbsp;P&lt;0.001 respectively). Serum PTH levels were also significantly higher in patients with primary and secondary hyperparathyroidism than the control group (P&lt;0.05 and&nbsp;P&lt;0.05 respectively). FMD, NID and IMT levels were not significantly different between the groups. But there was a negative correlation between serum calcium levels and FMD (r:−0.41&nbsp;P&lt;0.01).Conclusion: This finding suggests that the cause of the cardiovascular diseases seen in hyperparathyroid patients is the increased calcium levels rather than the hyperparathyroidism itself.</p