Objective: Epicardial adipose tissue (EAT) is an adipose tissue located between the myocardial surface and the visceral layer of the pericardium. Epicardial adipose tissue thickness (EATT) is a sign of atherosclerosis. It has been reported that EATT is increased in patients with subclinical hypothyroidism (SCH). It is suggested that EAT may cause coronary atherosclerosis through paracrine and vasocrine pathways mediated by adipokines / cytokines. In this study, it was aimed to evaluate the relationship of EATT in SCH with proinflammatory cytokines (interleukin-6 (IL-6), highly sensitive C-reactive protein (hsCRP), monocyte chemo attractant protein-1 (MCP-1) and tumor necrosis factor-alpha (TNF-alpha)). Material and Methods: A total of 32 cases of SCH and 27 healthy volunteers were prospectively included in the study. EATT were measured by echocardiography. IL-6, hsCRP, MCP-1 and TNF-alpha were measured through simultaneously taken serum samples. Results: EATT was significantly higher in SCH compared to the control group (p=0.05). Groups were similar in terms of age, BMI, totalcholesterol, LDL-cholesterol levels; but only HDL-cholesterol was found to be significantly higher in SCH group (p=0.034). There was no significant difference between the SCH and the control group in terms of IL-6, hsCRP, MCP-1 and TNF-alpha. Conclusion: EATT was found to be increased in SCH. But, serum levels of proinflammatory cytokines were similar between groups. In the SCH group, there was no relationship between EATT and proinflammatory cytokines. Although EATT is an indicator of atherosclerosis, it may have different control mechanisms in SCH in terms of proinflammatory bioactive molecule synthesis and secretion.
Keywords: Subclinical hypothyroidism; epicardial adipose tissue; monocyte chemo attractant protein-1; tumor necrosis factor-alpha
Amaç: Epikardiyal yağ dokusu (EYD), miyokardiyal yüzey ileperikardın visseral tabakası arasında yer alan bir yağ dokusudur. Epikardiyal yağ doku kalınlığı (EYDK) aterosklerozun belirteçlerinden biridir. Subklinik hipotiroidili (SKH) hastalarda, EYDK'nin arttığı bildirilmektedir. EYD'nin adipokin/ sitokin aracılı parakrin ve vazokrin yolaklar ile koroner ateroskleroza neden olabileceği öne sürülmektedir. Ancak SKH'de proinflamatuar sitokinler ile EYDK'nin ilişkisi net değildir. Bu çalışmada, SKH'de EYDK'nin proinflamatuar sitokinler [interlökin (IL-6), yüksek hassasiyetli C-reaktif protein (high sensitivity C-reactive protein 'hs-CRP'), monosit kemoatraktan protein-1 (monocyte chemo attractant protein-1 'MCP-1') ve tümö rnekrozis faktöralfa (TNF-α)] ile ilişkisinin değerlendirilmesi amaçlandı. Gereç ve Yöntemler: SKH tanılı 32 olgu ve 27 sağlıklı gönüllü prospektif olarak çalışmaya dâhil edildi. Olguların EYDK'lari ekokardiyografiile ölçüldü. Eş zamanlı alınan serum örneklerinde IL-6, hs- CRP, MCP-1 ve TNF-α düzeyleri ölçüldü. Bulgular: SKH'li olgularda, EYDK kontrol grubuna göre anlamlı yüksekti (p=0,05). Gruplar yaş, beden kitle indeksi, total kolesterol, düşük yoğunluklu lipoprotein kolesterol düzeyleri açısından benzerdi; ancak yüksek yoğunluklu lipoprotein kolesterol SKH grubunda anlamlı olarak yüksek bulundu (p=0,034). Hasta grubu ve kontrol grubu arasında IL-6, hs-CRP, MCP-1 ve TNF-α açısından anlamlı farklılık saptanmadı. Sonuç: SKH olgularında, EYDK artmış olarak saptandı. Karşıt olarak serum proinflamatuar sitokinlerin düzeyleri kontrol grubundan farklı değildi. Proinflamatuar sitokinlerle EYDK arasında anlamlı ilişki bulunamadı. EYDK, aterosklerozun bir göstergesi olmasına rağmen proinflamatuar biyoaktif molekül sentezi ve salgılanması açısından SKH durumunda farklı kontrol mekanizmalarına sahip olabilir.
Anahtar Kelimeler: Subklinik hipotiroidi; epikardiyal adipoz doku; monosit kemoatraktan protein-1; tümör nekrozis faktör-alfa
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