International Journal of Scientific & Engineering Research, Volume 6, Issue 5, May-2015 1007
ISSN 2229-5518
Evaluation of Thyroid hormone and lipid profile in patients with myocardial infarction and find the relation between them
Israa Burhan Raoof, Raghad abdulmahdi,Ayad Kareem Khan
Myocardial infarction (MI) associated with iatrogenic hyperthyroidism where myocardial bridge can be possibly life threatening [1,2]. The most common cardiovascular manifestations of thyrotoxicosis recognized as angina pectoris, atrial fibrillation, myocardial infarction and heart failure [3]. MI known as a heart attack, results from the interruption of blood supply to a part of the heart, that causing heart cells to die. This is most commonly due to occlusion of a coronary artery following the rupture of vulnerable atherosclerotic plaque which collection of lipids in the walls of artery [4]. The diagnosis of MI is usually based on clinical symptoms and on electrocardiographic (ECG) findings of the patient [5].Also myocardial infarction refers to coronary syndrome [6] that due to coronary artery disease.[7] the Risk factors of Myocardial infarction include high blood pressure, smoking obesity, high blood cholesterol, poor diet, and excessive alcohol[8] low-density lipoprotein (LDL) cholesterol, endothelial dysfunction and increased central arterial stiffness [9,10]. Lipids consider the primary targets of oxidative stress. Lipid peroxidation of the cellular structures, a consequence of increased oxygen free radicals, that play an important role in atherosclerosis and
microvascular complications of DM [11]. Hyperthyroidism is an overproduction of the thyroid hormones T3 and T 4 . This condition is most commonly caused by the development of Graves' disease, an autoimmune disease in which anomalous antibodies stimulate the thyroid to secrete excessive quantities of thyroid hormones.[12]
The aim of this study was to measured the level of T3 ,T4 ,TSH in patients with myocardial infarction and find the correlation between these parameters in sera of control groups and patients with myocardial infarction .
Blood sampling were taken from 12 patients with myocardial infarction and 12 controls. 5 ml of Blood sample were collected from all patients. A questionnaire was designed with different questions including duration of myocardial infarction, heart disease, family history, drug duration, weight, height, smoking, usage of drugs , and hyperthyroidism for all patients groups, and controls group. The distribution of patients according to hypertension, smoking and and drugs was in Table (1):
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International Journal of Scientific & Engineering Research, Volume 6, Issue 5, May-2015 1008
ISSN 2229-5518
was determine by using enzymatic method[14]
HDL was determine by HDL kit [15]
usually derived by friedwalds formula [16] LDL = Total cholesterol – [HDL + TG/5]
density lipoprotein was determine by using formula of friedwalds: [17]
VLDL-Ch = TG/5
by Human Free T3 ELISA Kit [18]
Human Free T4 ELISA Kit [19]
TSH was determine by Human Free T4 ELISA Kit [20]
Results are expressed as Mean±SD. and significant differences between means were assessed by student t- test using the available statistical software packages (Microsoft SPSS), statistical significance was set at P≤0.05, P≤0.01,..
Table (1) showed mean value of Age and BMI was significantly increase in patients with myocardial infarction compared with control groups.
parameters | Mean+ st control | Mean +st Patients | p.value |
Ch (mg/dl) | 116.81+19.54 | 250.81+39 .19 | 0.001 |
TG (mg/dl) | 92.63+3.64 | 160.81+10 0.55 | 0.027 |
HDL (mg/dl) | 53.36+3.90 | 43.36+3.9 0 | 0.001 |
LDL (mg/dl) | 79.63+15.08 | 166.18+41 .43 | 0.000 |
VLDL (mg/dl) | 18.36+0.08 | 37.54+21. 73 | 0.003 |
*Significant using spss for two independent means at significance * (P≤ 0.05), ** (P≤ 0.01) |
The results showed that significantly increased in Cholesterol, TG, LDL and VLDL also significantly decreased in HDL in patient with myocardial infarction when compared to control groups[21] Table (2) . High serum cholesterol level considered as a risk factor for cardiovascular disease [22]. Also Triglyceride another strong risk factor but it found that triglyceride levels stratifying led to more accurate detection of increased risk of coronary disease. [23].In addition elevated LDL is associated with 3-fold increase in the risk of myocardial infarction.[24] Increased VLDL in Myocardial infarction patients and the role of low HDL in the CHD development has been widely accepted.[25].The study showed levels of T3 and T4 was significantly increased while TSH decreased in patient with myocardial infarction when compared to control groups(26) as shown in Table (3) .
Hyperthyroidism is the clinical syndrome caused by increase of circulating free Thyroxine T4 , free Triiodothyronine T3 , or both. It is a common disorder that affects approximately 2% of women and 0.2% of men [26]. Also the diagnosis of hyperthyroidism is confirmed by blood tests that show decreased of thyroid- stimulating hormone (TSH) [27].
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International Journal of Scientific & Engineering Research, Volume 6, Issue 5, May-2015 1009
ISSN 2229-5518
Levels of T4 with (Ch,,VLDL) showed positive significant correlation coefficient also there is negative
correlation coefficient between T4 with HDL in patients with myocardial infarction and control groups as shown in Table (4) and Figure (1,2,3) .
Correlatio n | Ch | HDL | VLDL |
T4 | 0.992 0.000 | -0.885 0.001 | 0.886 0.001 |
* Correlation is significance * (P≤ 0.05), ** (P≤ 0.01) |
The cardiovascular manifestations of hyperthyroidism have been recognized for more than two centuries and are a cornerstone for clinical diagnosis [28]. The peroxidation of lipids is basically damaging because the formation of lipid peroxidation products leads to spread of free radicals reactions.[29]. Where hydroxyl radical can initiate lipid peroxidation, which is a free radical chain reaction leading to damage of membrane structure and function. [30] Free radical- mediated oxidative stress (OS) implicated in the pathogenesis of thyroid disorders [31]. In addition Free radicals have the potential to damage the organism, their generation is inevitable for some metabolic process [32]. Variations in the levels of thyroid hormones can be one of the main physiological modulators of in vivo cellular oxidative stress and due to their known effects on mitochondrial respiration. [33].That thyroid hormones are involve in combating the toxicity of oxidative stress in humans [34].
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International Journal of Scientific & Engineering Research, Volume 6, Issue 5, May-2015 1010
ISSN 2229-5518
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