@article{
author = "Popin-Tarić, Marija and Gluvić, Zoran and Samardžić, Vladimir and Vasić-Vlaisavljević, Anita and Tica-Jevtić, Jelena and Panić, Anastasija and Sudar-Milovanović, Emina and Tomašević, Ratko and Isenović, Esma R.",
year = "2015",
abstract = "Uvod: Poznat je uticaj manifestnih tireoidnih disfunkcija na promene u koštanoj masi koji se ispoljava kroz izmene u koštanom prometu, koje dovode do promena koštane gustine i mogućeg povećanog rizika od pada i preloma. Takođe, uticajem na metaboličke parametre, prevashodno na lipide, tireoidne disfunkcije predstavljaju važan uzrok akceleracije ateroskleroze i povećanja cerebrovaskularnog i kardiovaskularnog rizika. Ovom studijom je ispitivan metabolički profil i koštana gustina kod pacijenata sa dijagnostikovanom supkliničkom tireoidnom disfunkcijom. Materijal i metode: Pilot studija preseka obuhvatila je 45 selektovanih ispitanica, koje su ispunile inkluzione kriterijume. Na osnovu nivoa tireo-stimulišućeg hormona (TSH) i slobodnog tiroksina (fT4) ispitanice su svrstane u 3 grupe, po 15 ispitanica u svakoj grupi: -grupa: supklinička hipotireoza (SHipo), grupa: supklinička hipertireoza (SHiper), i grupa: eutireodna-tj. kontrolna grupa. Od faktora rizika, praćeni su godine života, podaci o menopauzi i prethodnim prelomima, a od metaboličkih parametara indeks telesne mase (engl. Body Mass Index, BMI), obim struka (OS), obim kuka (OK), nivo tri-glicerida i nivo ukupnog holesterola. Kod svih ispitanica je merena koštana gustina na lumbalnoj kičmi i levom kuku (LK) i izražena u T skorovima. Dobijeni podaci su analizirani koriščćenjem statističkog paketa SPSS za Windows. Statistički značajnom je smatrana verovatnoća manja od 0,05 (p<0,05). Rezultati: Grupe ispitanica su se značajno razlikovale po nivoima ukupnog holesterola, kao i T skorovima lumbalne kičme i LK. Smanjena koštana gustina je registrovana kod 35 (77,8%) ispitanica. Vrednosti T skorova lumbalne kičme i LK su unutargrupno međusobno korelisali. Od faktora rizika, postojanje prethodnih preloma i menopauze, značajno utiču na T skorove, što nije slučaj ni sa jednim metaboličkim parametrom. Najniži T skorovi, kao i sa kliničkog aspekta najznačajnija dislipidemija, su registrovani u grupi SHipo. Diskusija: U okviru ove pilot studije pokazano je smanjenje koštane gustine u populaciji ispitanica sa supkliničkim tireoidopatijama, najviše izražena u SHipo grupi. U istoj grupi je zabeležen i klinički najaterogeniji lipidni profil (hiperholesterolemija). Metabolički parametri kao i hormoni nisu uticali na T skorove lumbalne kičme i LK. Zaključak: Supkliničke tireoidne disfunkcije su povezane sa smanjenjem koštane gustine, izražene kroz T skorove na lumbalnoj kičmi i LK, i na njih nisu uticali metabolički parametri. Pravovremenom dijagnostikom i lečenjem tireoidnih disfunkcija, moguće je usporiti gubitak koštane mase, smanjiti rizik kako od pada tako i od preloma, pri čemu korekcijom lipidnog disbalansa se može smanjiti potencijalni cerebrovaskularni i kardiovaskularni rizik., Introduction. It is well-known that overt thyroid dysfunctions have an influence on bone mineral density (BMD). It is noticed as a change in bone turnover and BMD, with subsequent increased risk of fall-induced fractures. Additionally, promoting the lipid profile derangement, subclinical thyroid dysfunction seems to be an important factor of atherosclerosis acceleration and the risk of cerebrovascular and cardiovascular incidents. In this study we examined the relationship between some of osteoporosis risk factors, metabolic parameters and BMD, in subclinical thyroidopathies. Material and Methods. Pilot cross-sectional study involved 45 females selected on fulfilled inclusion criteria. Three groups of 15 examinees were formed, based on TSH and fT4 serum levels (SHypo, SHyper, and euthyroid-control). As for risk factors, age, records on menopause and history of past fractures as well as metabolic parameters Body Mass Index (BMI), waist and hip circumference, cholesterol and triglyceride levels were observed. The entire study population was referred to DEXA (Dual Energy X Ray Absorptiometry) scan for BMD measurement on lumbar spine (LS) and left hip (LH), expressed through T scores. The obtained data were analyzed by SPSS for Windows 18.0 statistical package. The level of statistical significance was 0.05. Results. The groups of patients differed on cholesterol levels and LS/LH T scores. Decreased BMD was detected in 35 (77.4%) patients. Intergroup correlations of LS/LH T scores were registered. A history of past fractures and records on menopause significantly influenced LS/LH T scores, which was not the case with metabolic parameters. Both the lowest T scores and clinically important dyslipidemia were presented in SHypo group. Discussion. The pilot study pointed out a decrease in BMD (mostly on osteopenia level) in subclinical, presumably hypothyroid disorder. The presence of hypercholesterolemia was detected in the same group. Metabolic parameters and thyroid hormones (TSH and fT4) did not have an effect on BMD. Conclusion. Subclinical thyroid dysfunctions are associated with a decrease in BMD, mostly presented as osteopenia, with a higher degree of severity in SHypo group. There is no registered influence of metabolic parameters on LS/LH T scores. It can be possible to slow down progression of decrease in BMD and subsequent fracture risk, with proper diagnostics and management of subclinical thyroid dysfunctions. Additionally, with correction of lipid disorders, cardiovascular and cerebrovascular risk could be minimized.",
journal = "Medicinska istraživanja",
title = "Korelacija metaboličkog profila i koštane gustine kod netretiranih ispitanica obolelih od supkliničkih tireoidnih disfunkcija - pilot studija, Correlation of metabolic profile and Bone mineral density in treatment: Naive females with subclinical thyroid dysfunction: A pilot study",
volume = "49",
number = "2",
pages = "50-57",
doi = "10.5937/MedIst1502050P"
}
