Investigation of thyroid function tests and lipid levels in cerebrovascular patients

Year 2024, Volume: 7 Issue: 1, 32 - 37, 03.06.2024

Zafer Çambay , Taner Adsiz Serhat Keser , Füsun Mayda Domaç

https://doi.org/10.54565/jphcfum.1459969

Abstract

Worldwide, cerebrovascular diseases rank third as the cause of death after heart diseases and cancer, and ranks first as the cause of handicap and disability. It is a disease that needs to be well known and recognized, especially due to the high risk of mortality in the acute period and the severe loss of function in the majority of surviving patients, requiring long-term care and assistance. In this study, it is aimed to contribute to the literature and to examine the relationship between thyroid dysfunction and cerebrovascular diseases in patients with hyperlipidemia. When the patient and control groups were evaluated in terms of blood lipid levels, HDL levels were found to be significantly lower in the patient group compared to the control group. VLDL, TG and cholesterol levels were found to be significantly higher in the patient group compared to the control group. The T3 value was found to be statistically significantly lower in the patient group. In some cases such as hyperthyroidism, hypothyroidism and hyperlipidemia, it may not show serious clinical symptoms, which increases the importance of these investigations. We believe that the detected thyroid dysfunction and dyslipidemia treatments will decrease the acute stroke prevalence and improve the prognosis.

Keywords

Cerebrovascular, Cholesterol, Lipid, Thyroid, Triglyceride

References

• P. Thorvaldsen, K. Asplund, K. Kuulasma, A.M. Rajakangas, M. Schroll, “Stroke incidence, case fatality and mortality in the WHO MONICA Project. World Health Organization monitoring trends and determinants in cardiovascular disease” Stroke, 26, 361-367, 1995.
• N. Ünivar, S. Mollahaliloğlu, N. Yardım, “Türkiye Hastalık Yükü Çalışması (In Turkish)”, Ankara, 2004.
• K.S. Yew, E. Cheng, “Acute stroke diagnosis” American Academy of Family Physicians, 80, 33-40, 2009.
• B. Ovbiagele, L.B. Goldstein, R.T. Higashida, V.J. Howard, S.C. Johnston, O.A. Khavjou, D.T. Lackland, J.H. Lichtman, S. Mohl, R.L. Sacco, J.L. Saver, J.G. Trogdon, “Forecasting the future of stroke in the United States: a policy statement from the American Heart Association and American Stroke Association” Stroke, 44, 361-2375, 2013.
• C.K. Glass, J.M. Holloway, “Regulation of gene expression by the thyroid hormone receptor” Biochimica et Biophysica Acta, 1032, 157-176, 1990.
• G.A. Brent, D.D. Moore, P.R.Larsen, “Thyroid hormone regulation of gene expression” Annual Review of Physiology, 53, 17-35, 1991.
• G.S. Levey, I. Klein, “Disorders of the thyroid and Stein’s textbook of medicine” 2nd edition, Brown, 1994.
• P.A. Masters, R.J. Simons, “Clinical use of sensitive assays for thyroid–stimulating hormone” Journal of General Internal Medicine, 11, 115-127, 1996.
• R. Bonita, “Epidemiology of stroke” The Lancet, 339, 342-344, 1992.
• R.D. Adams, M. Victor, H.A. Ropper, H.B. Brown, “Principles of Neurology” 8th ed. USA Mc Graw Hill Co. 34, 660-746, 2006.
• S. Balkan, “Serebrovasküler Hastalıklar (In Turkish)”, Güneş Kitabevi, 2005.
• A.R. Folsom, W.D. Rosamond, E. Shahar, L.S. Cooper, N. Aleksic, F.J. Nieto, M.L. Rasmussen K.K. Wu, “Prospective study of markers of hemostatic function with risk of ischemic stroke. The Atherosclerosis Risk in Communities (ARIC) Study Investigators” Circulation, 100, 736-742, 1999.
• T. Ohira, E. Shahar, L.E. Chambless, W.D. Rosamond, T.H. Jr. Mosley, A.R. Folsom, “Risk factors for ischemic stroke subtypes: The Atherosclerosis Risk in Communities study” Stroke, 37, 2493-2498, 2006.
• J. Broderick, T. Brott, R. Kothari, R. Miller, J. Khoury, A. Pancioli, J. Gebel, D. Mills, L. Minneci, R. Shukla, “The Greater Cincinnati/Northern Kentucky Stroke Study: preliminary first-ever and total incidence rates of stroke among blacks” Stroke, 29, 415-421, 1998.
• C.T. Sawin, D. Chopra, F. Azizi, J.E. Mannix, P. Bacharach, “The aging thyroid. Increased prevalence of elevated serum thyrotropin levels in the elderly” JAMA: The Journal of the American Medical Association, 242, 247-250, 1979.
• C.T. Sawin, W.P. Castelli, J.M. Hershman, P. McNamara, P. Bacharach, “The aging thyroid. Thyroid deficiency in the Framingham Study” Archives of Internal Medicine, 145, 1386-1388, 1985.
• A.R. Cappola, L.P. Fried, A.M. Arnold, M.D. Danese, L.H. Kuller, G.L. Burke, R.P. Tracy, P.W. Ladenson, “Thyroid status, cardiovascular risk, and mortality in older adults” JAMA: The Journal of the American Medical Association, 295, 1033-1041, 2006.
• V. Kotsis, M. Alevizaki, S. Stabouli, V. Pitiriga, Z. Rizos, M. Sion, N. Zakopoulos, “Hypertension and hypothyroidism: results from an ambulatory blood pressure monitoring study” Journal of Hypertension, 25, 993-999, 2007.
• I. Klein, K. Ojamaa, “Thyroid hormone and the cardiovascular system” New England Journal of Medicine, 344, 501-509, 2001.
• F. Osman, J.A. Franklyn, R.L. Holder, M.C. Sheppard, M.D. Gammage, “Cardiovascular manifestations of hyperthyroidism before and after antithyroid therapy: a matched case-control study” Journal of the American College of Cardiology, 49, 71-81, 2007.
• J. Faber, N. Wiinberg, S. Schifter, J. Mehlsen, “Haemodynamic changes following treatment of subclinical and overt hyperthyroidism” European Journal of Endocrinology, 145, 391-396, 2001.
• J.P. Walsh, A.P. Bremner, M.K. Bulsara, P. O'Leary, P.J. Leedman, P. Feddema V. Michelangeli, “Subclinical thyroid dysfunction and blood pressure: a communitybased study” Clinical Endocrinology, 65, 486-491, 2006.
• B. Biondi, S. Fazio, C. Carella, G. Amato, A. Cittadini, G. Lupoli, L. Sacca, A. Bellastella, G. Lombardi, “Cardiac effects of long term thyrotropin-suppressive therapy with levothyroxine” Journal of Clinical Endocrinology & Metabolism, 77, 334-338, 1993.
• R. Benfante, K. Yano, L.J. Hwang, J.D. Curb, A. Kagan, W. Ross, “Elevated serum cholesterol is a risk factor for both coronary heart disease and thromboembolic stroke in Hawaiian Japanese men. Implications of shared risk” Stroke, 25, 814-820, 1994.
• L.H. Duntas, “Thyroid disease and lipids” Thyroid, 12, 287-293, 2002.
• A.M. Kanaya, F. Harris, S. Volpato, E.J. Perez-Stable, T. Harris, D.C. Bauer, “Association between thyroid dysfunction and total cholesterol level in an older biracial population: the health, aging and body composition study” Archives of Internal Medicine, 162, 773-779, 2002.
• F. Monzani, N. Caraccio, M. Kozakowa, A. Dardano, F. Vittone, A. Virdis, S. Taddei, C. Palombo, E. Ferrannini, “Effect of levothyroxine replacement on lipid profile and intima-media thickness in subclinical hypothyroidism: a double-blind, placebo controlled study” Journal of Clinical Endocrinology and Metabolism, 89, 2099-2106, 2004.
• K. Sreedhar, B. Srikant, L. Joshi, G. Usha, “Lipid profile in non-diabetic stroke-a study of 100 cases” Journal of the Association of Physicians of India, 58, 547-551, 2010.
• V. Bittner, R. Hardison, S.F. Kelsey, B.H. Weiner, A.K. Jacobs, G. Sopko, “Bypass Angioplasty Revascularization Investigation. Non-high-density lipoprotein cholesterol levels predict five-year outcome in the Bypass Angioplasty Revascularization Investigation (BARI)” Circulation, 106, 2537-2542, 2002.
• P.M. Ridker, N. Rifai, N.R. Cook, G. Bradwin, J.E. Buring, “Non-HDL cholesterol, apolipoproteins A-I and B100, standard lipid measures, lipid ratios, and CRP as risk factors for cardiovascular disease in women” JAMA: The Journal of the American Medical Association, 294, 326-333, 2005.
• J.F. Meschia, C. Bushnell, B. Boden-Albala, L.T. Braun, D.M. Bravata, S. Chaturvedi, M.A. Creager, R.H. Eckel, M.S.V. Elkind, M. Fornage, L.B. Goldstein, S.M. Greenberg, S.E. Horvath, C. Iadecola, E.C. Jauch, W.S. Moore, J.A. Wilson, “American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Functional Genomics and Translational Biology; Council on Hypertension. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association” Stroke, 45, 3754-3832, 2014.
• [H. Khan, A.K. Afridi, A. Saadia, “A hospital based study on stratification of risk factors of stroke in Peshawar” Pakistan Journal of Medical Sciences, 22, 304-307, 2006.
• A. Tanveer, “Localization and management in Cerebrovascular accident: a comparison of clinical assessment versus C.T scan” Journal of the College of Physicians and Surgeons Pakistan, 3, 5-6, 1996.
• A. Mahmood, M.A. Sharif, M.N. Khan, U.Z. Ali, “Comparison of serum lipid profile in ischaemic and haemorrhagic stroke” Journal of the College of Physicians and Surgeons Pakistan, 20, 317-320, 2010.
• E.K. Çoban, “Gençlerde iskemik serebrovasküler olay risk belirlemesinde Trigliserit/HDL oranı iyi bir öngörücü olabilir mi? (In Turkish)” Medical Bulletin of Sisli Etfal Hospital, 52, 201-205, 2018.
• A.C. Nirmala, T.N. Mamatha, P. Shree, B.H. Avinash, “Study of lipid profile in non-diabetic stroke in young” Scholars Journal of Applied Medical Sciences, 3, 1259, 2015.
• C.M. Ballantyne, A.G. Olsson, T.J. Cook, M.F. Mercuri, T.R. Pedersen, J. Kjekshus, “Influence of low high-density lipoprotein cholesterol and elevated triglyceride on coronary heart disease events and response to simvastatin therapy in 4S” Circulation, 104, 3046-3051, 2001.
• F. Barzi, A. Patel, M. Woodward, C.M.M. Lawes, T. Ohkubo, D. Gu, T.H. Lam, H. Ueshima, “Asia Pacific Cohort Studies Collaboration. A comparison of lipid variables as predictors of cardiovascular disease in the Asia Pacific region” Annals of Epidemiology, 15, 405-413, 2005.
• J.H. Park, J. Lee, B. Ovbiagele, “Non-traditional serum lipid variables and recurrent stroke risk” Stroke, 45, 3269-3274, 2014.
• R.A. Kreisberg, S. Kasim, “Cholesterol metabolism and aging” American Journal of Medicine, 82, 54-60, 1987.
• A. Ferrara, E. Barrett-Connor, J. Shan, “Total, LDL, and HDL cholesterol decrease with age in older men and women. The Rancho Bernardo Study 1984-1994” Circulation, 96, 37-43, 1997.