WCIM 2014 SEOUL KOREA 95
Poster Session
The Korean Journal of Internal Medicine Vol. 29, No. 5 (Suppl. 1)
PS 0187 Endocrinology
The Relationship Between Serum Estradiol Level and Bapwv in Postmenopausal Women
Nanhee CHO1, Nam-Keong KIM1, Gyeongim YU1, Donghoon SHIN2, Hochan CHO1 Keimyung University DongSan Medical Center, Korea1, Keimyung University School of Medicine, Korea2 Background: The number of postmenopausal women is increasing with aging and cardiovascular disease (CVD) is more prevalent recently. There may be the protective effect of endogenous estrogen on CVD in spite of some limitations. In the present study, we investigate the relationship between serum estradiol level and brachial-ankle PWV (baPWV) as non-invasive indicator of CVD in postmenopausal women.
Methods: Among We recruited 714 Korean postmenopausal women from (February 2012 to December 2013). Metabolic parameters, clinical characteristics, biochemical markers, serum estradiol, and baPWV were obtained in each subject. Statistical analy- sis was performed using SPSS version 20.0 (SPSS Inc., Chicago, IL, USA)
Results: Among 714 subjects (Mean age 67.52±9.24), The mean serum estradiol score was 23.3 ± 34.33, with a range of 7 to 418. Age, SBP, uric acid, BUN and creatinine were found to be signifi cantly associated with a higher baPWV levels. Women with a higher estradiol level had a signifi cantly lower risk of having a higher baPWV levels (P
< 0.05).
Conclusions: Postmenopausal women with a higher serum estradiol level had a re- duced baPWV levels independent of age and other coronary risk factors. This supports a higher level of serum estradiol may alleviate the calcifi ed-plaque burden of coronary arteries in postmenopausal women.
PS 0189 Endocrinology
High Normal TSH Levels Association with Metabolic Syndrome Components in Type 2 Diabetic Patients
Petrosyan L.1, Kyu Yeon Hur2
Department of Endocrinology, Diabetes and Metabolism, Yerevan State Medical University, Armenia1, Department of Endocrinology and Metabolism, Samsung Medical Center, Korea2
Objective: Obesity and insulin resistance are key features of the metabolic syndrome (MetS). The purpose of our study was to compare MetS components association with low normal and high normal TSH levels in type 2 diabetic patients and to access dia- betes control in patients with high-normal TSH levels.
Methods: A total of 120 subjects who met metabolic syndrome by NCEP – ATP III cri- teria were recruited for this study from November 2012 to June 2014 .Subjects were included in the study with TSH values between 0.3 and 4.5 mU/l, who did not take any thyroid medication and had a similar iodine diet. The study subjects were weighed and their anthropometric indices were taken. Lipid parameters, fasting plasma glucose, HbA1c, eGFR, blood pressure (BP) were documented, and TSH were measured by an electrochemiluminescence immunoassay. Statistical analysis was performed by using SPSS 18(P value <0.05 was considered signifi cant).
Results: Serum TSH levels were significantly and positively associated with BMI, systolic and diastolic BP, serum triglyceride and HbA1c levels, whereas negatively with eGFR. Subjects with a TSH in a higher normal range (2.5-4.5mU/I, n=58) had a signifi cantly higher BMI (26.7±3 vs. 24.1±2.7 adjusted for age and sex (P < 0.001). The research shows, that when TSH is in low normal range, the number of patients with non- compensated diabetes (HbA1c >7%) decreases from 27.5% to 12.5% (P = 0.02, adjusted for age and sex). In addition, we found no association between TSH levels and medications used for the treatment of diabetes, dyslipidemia and hypertension.
Conclusion: High normal TSH levels were signifi cantly associated with components of metabolic syndrome in type 2 diabetic subjects. Number of patients with non-com- pensated diabetes increased when TSH was in high-normal range. We suggest low normal TSH concentrations in insulin-resistant subjects with high risk of developing cardiovascular disease.
PS 0190 Endocrinology
Severe Hypothyroidism after Thyroidectomy Due to Toxic Multinodular Goiter
Rio WIRONEGORO1, Ari SUTJAHJO1 Medical Faculty of Airlangga University, Indonesia1
Case Report : A 37 years old woman came to endocrinology clinic with signs and symptoms of hypothyroidism. The patient was diagnosed with toxic multinodular goiter 6 years ago and due to massive size of the goiter in concert with hyperthyroid signs and symptoms, thyroidectomy was performed. After the procedure, due to not well-informed, the patient consider that she was already cured and decided not to went back to the endocrinology clinic for thyroid function monitoring. Six year after, she start having complaint such as weight gain, swelling feet, puffy face, sleepiness, constipation, diffi cult to concentrate, feeling depressed and intolerance to cold for the last 6 month. Her thyroid function revealed TSH level was 375,9 mU/L with FT4 level was 0,1 ng/dL. Lipid profi le showed total cholesterol was 388 mg/dL and LDL was 251 mg/dL. We start treating the patient by giving information and education regarding hypothyroidism, supply her with levothyroxine 100 mcg/day and suggest the patient to come to endocrinology clinic every 4-6 weeks for thyroid function monitoring.
Conclusions: Although seemingly simple and often ignored, failing to give information and education could cause a detoriation effect for the patient.
PS 0191 Endocrinology
In Circulation Increased Antithyroid Peroxidase Anti- body and Matrix Metalloproteinase-9 Levels at Patients with Metabolic Syndrome
Sibel SERIN1, Yildiz OKUTURLAR2, Asuman GEDIKBASI2, Irem KILIÇ UTKU2, Sema UCAK BASAT1, Ozlem HARMANKAYA2
Umraniye Educational and Research Hospital, Turkey1, Bakirköy Educational and Research Hospital, Turkey2
Objective: Frequent changes in parameters like blood pressure, plasma lipid changes, waist circumference which are accepted as a metabolic syndrome (MS) are observed in thyroid patients with hypothyroid. In this study we investigated serum levels of TPO which is the diagnosis of hypothyroid and prognosis criteria antithyroid peroxidase antibody (Anti-TPO) in patients with MS and we analysed the correlation with matrix metalloproteinases-9 (MMP-9) which is accepted as an indicator of infl ammation in MS.
Method: 51 patients with MS and 35 controls were enrolled in the study. Age, body mass index (BMI), waist circumference and hypertension (HT) values of both group were recorded in the beginning. Medical records of HT were noted and cardiovascular diseases in their family were queried. Insulin, glucose, HOMA-IR, total cholesterol, LDL, HDL, TG, TSH and Anti-TPO levels were measured. Blood samples for measuring MMP- 9 were stored at -80°C. Measurement of MMP-9 was performed by using solid phase platinum ELISA kits (Biosource).
Results: Study was performed with 51(59,3%) MS group and 35(40,7%) control group. Both Anti-TPO and MMP-9 levels of patients with MS were statistically and signifi cantly higher than the levels of control group (p<0.01 for both group). There is a statistically signifi cant correlation (positive, 83.2%) between MMP-9 and TPO in pa- tients with MS (p<0.01). There is a statistically signifi cant correlation (positive, 37.5%) between MMP-9 and TPO in controls (p<0.05).
Discussion: Researching Anti-TPO in patients with MS might be an indicator of higher rate of both hypothyroid and MS. High levels of both MMP-9 (>76 mg/ml) and TPO show that TPO can be used as a cheaper and more easily provided marker in patients with MS without acute thyroid. Anti-TPO follow-up might be necessary in MS diagno- sis and monitoring.
