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International journal of endocrinology 8 (72) 2015

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Vascular Endothelial Growth Factor Levels in Patients with Hypothyroidism

Authors: Didushko O.M. - State Higher Educational Institution «Ivano-Frankivsk National Medical University», Ivano-Frankivsk, Ukraine

Categories: Endocrinology

Sections: Clinical researches

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Summary

Метою дослідження було визначення рівня васкулоендотеліального фактора росту у хворих на первинний гіпотиреоз. При обстеженні 133 пацієнтів з маніфестним гіпотиреозом виявлено, що суттєво зростав рівень васкулоендотеліального фактора росту в плазмі крові хворих як з ожирінням, так і
без ­нього, проте найвищі показники зафіксовані у хворих із гіпотиреозом на тлі автоімунного тиреоїдиту та з ожирінням. Отримані кореляційні зв’язки вказують на взаємообтяжуючий вплив гіпофункції щитоподібної залози, ожиріння та гіперхолестеринемії на розвиток ендотеліальної дисфункції у хворих на первинний гіпотиреоз, зокрема зростання рівня васкулоендотеліального фактора росту.

Целью исследования было определение уровня васкулоэндотелиального фактора роста у больных первичным гипотиреозом. При обследовании 133 пациентов с манифестным гипотиреозом выявлено, что существенно повышен уровень васкулоэндотелиального фактора роста в плазме крови больных как с ожирением, так и без него, однако более высокие показатели были зафиксированы у больных с гипотиреозом на фоне аутоиммунного тиреоидита и с ожирением. Полученные корреляционные связи указывают на взаимоотягощающее влияние гипофункции щитовидной железы, ожирения и гиперхолестеринемии на развитие эндотелиальной дисфункции у больных первичным гипотиреозом, в частности рост уровня васкулоэндотелиального фактора роста.

The objective of the investigation was to determine the levels of vascular endothelial growth factor in patients with primary hypothyroidism. Having examined 133 patients with manifested hypothyroidism, we discovered that levels of vascular endothelial growth factor significantly increased in blood plasma of both obese and non-obese patients, but the highest indices have been found in patients with hypothyroidism resulting from autoimmune thyroiditis and with obesity. The obtained correlations indicate mutually aggravating effect of thyroid hypofunction, obesity and hypercholesterolemia on the development of endothelial dysfunction in patients with primary hypothyroidism, in particular on the increase of vascular endothelial growth factor levels.


Keywords

гіпотиреоз, васкулоендотеліальний фактор росту, тиреотропний гормон.

гипотиреоз, васкулоэндотелиальный фактор роста, тиреотропный гормон.

hypothyroidism, vascular endothelial growth factor, thyroid stimulating hormone.

Playing an important role in the sustention of endothelial stability and physiological neoangiogenesis vascular endothelial growth factor (VEGF) simultaneously takes an active part in the processes of neovascularization in pathological processes, particularly in the development of atheromas and neoplastic processes during oncogenesis. A series of researches reveal the data that highlight the relations between VEGF levels and lipid metabolism indices as well as inflammation factors. Besides, higher VEGF levels are found in patients with abdominal obesity. According to other investigations, significantly higher VEGF levels are found in patients with AH as nephropathy develops.

The objective of the investigation was to determine the levels of vascular endothelial growth factor in patients with primary hypothyroidism.

Materials and methods. The research encompassed 133 patients with manifested hypothyroidism who subject to regular medical endocrinology check-up in Ivano-Frankivsk outpatient clinics, as well as in endocrinology department of Ivano-Frankivsk regional clinical hospital. The average age of patients was 56 ± 8 years; and the duration of officially confirmed anamnesis of hypothyroidism was 7.88 ± 2.3 years. The control group involved 20 people having none thyroid pathology, 9 men and 11 women among them.

To achieve our goal the levels of VEGF in patients with hypothyroidism were estimated and compared to the data in control group involving people without any thyroid pathology. Criteria of inclusion to the research were: previously confirmed diagnosis of hypothyroidism (primary or decompensated primary hypothyroidism) with TSH level exceeding the uppermost margin of referent scale (4.0 mIE/L) accompanied by decreased levels of free T4 (<10.3 pmol/L) and free T3 (<2.3 pmol/L); 3) patient’s consent to participate in the investigation.

Results. According to the findings of the research, VEGF levels in blood plasma of patients under study have proved to be significantly higher than in patients from control group. Thus, considerably increased level of this mediator in comparison to control group has been revealed in patients with hypothyroidism resulting from autoimmune thyroiditis without obesity (46.46±1.39 ng/ml) (р<0.05), while in patients with hypothyroidism resulting from autoimmune thyroiditis accompanied by obesity it has reached 48.09±1.82 ng/ml (р<0,05). Statistically significant rise of chemokine levels has also been observed in the group of patients with postoperative hypothyroidism: 43.00±1.45 pg/ml (р<0.05) in patients without excessive weight and 45.76±2.51 pg/ml (р<0.05) in obese patients with postoperative hypothyroidism. Thus, the most expressed changes of VEGF secretion have been noticed in obese patients with hypothyroidism resulting from autoimmune thyroiditis, which is also proved by other researches.

Correlation analysis has shown the presence of positive mean correlation between TSH and VEGF levels in blood plasma of patients from group I (r=0.448, p<0.05). In patients from group II this correlation has appeared direct and strong (r=0.76, p<0.05), and in patients from group III and group IV it has been qualified as direct relatively strong (r=0.314, p<0.05) and direct moderate (r=0.505, p<0.05) respectively. Patients of group I and Group II have shown a direct mean correlation between VEGF levels and antibodies to TPO: r=0.51 and r=0.581 (p<0.05) respectively, but in patients of group III and group IV such correlation has not been found, which is reflected in other researchers’ works.

There has also been revealed a direct correlation between VEGF levels and total cholesterol levels: moderate (r=0.31, p<0.05) in patients from group I, considerable (r=0.63, p<0.05) in patients from group II, moderate (r=0.486, p<0.05) in patients from group III, and considerable (r=0.619, p<0.05) in patients from group IV.

Conclusions: With manifested hypothyroidism levels of VEGF in blood plasma are significantly higher in both obese and not obese patients; however, the highest indices have been found in obese patients with manifested hypothyroidism resulting from autoimmune thyroiditis. Discovered correlations have determined mutually aggravating effect of thyroid hypofunction, obesity and hypercholesterolemia on the development of endothelial dysfunction in patients with primary hypothyroidism and particularly on the increase of VEGF levels. 


Bibliography

1. Гавриленко Т.И., Рыжкова Н.А., Пархоменко А.Н. Сосудистый эндотелиальный фактор роста в клинике внутренних заболеваний и его патогенетическое значение // Український кардіологічний журнал. — 2011. — № 4. — С. 87-95.

2. Коваль C.Н., Милославский Д.К., Снегурская И.А. и др. Терапевтический ангиогенез при заболеваниях внутренних органов — возможности и перспективы // Вісник проблем біології і медицини. — 2013. — Т. 1(104). — С. 20-27.

3. Лупинская З.А., Зарифьян А.Г., Гурович Т.Ц., Шлейфер С.Г. Эндотелий. Функция и дисфункция. — Бишкек: КРСУ, 2008. — 373 c.

4. Орлова М.М., Родионова Т.И. Диагностическая значимость исследования сывороточной концентрации и мочевой экскреции некоторых цитокинов при манифестном гипотиреозе // Цитокины и воспаление. — 2012. — № 2(11). — С. 24-28.

5. Середюк В.Н. Ефективність інгібіторів ангіотензинперетворювального ферменту і блокаторів рецепторів ангіотензину-ІІ у хворих із хронічним легеневим серцем за динамікою васкулоендотеліального фактора росту // Український терапевтичний журнал. — 2010. — № 4. — С. 67-71.

6. Asselbergs F.W., de Boer R.A., Diercks G.F. et al. Vascular endothelial growth factor: the link between cardiovascular risk factors and microalbuminuria? // Int. J. Cardiol. — 2004. — Vol. 93 (2–3). — Р. 211-215.

7. Ayerden Ebinz F., Haksun E., Ulver D.B. et al. The relationship between vascular endothelial growth factor (VEGF) and microalbuminuria in patients with essential hypertension // Intern. Med. — 2008. — Vol.47, № 17. — Р. 1511-1516.

8. Biselli P.M., Guerzoni A.R., de Godoy M.F. et al. Vascular endothelial growth factor genetic variability and coronary artery disease in Brazilian population // Heart Vessels. — 2008. — Vol. 23(6). — 371-375.

9. Hansen A.H., Nielsen J.J., Saltin B., Hellsten Y. Exercise training normalizes skeletal muscle vascular endothelial growth factor levels in patients with essential hypertension // J. Hypertens. — 2010. — Vol.28(6). — Р. 1176-1185.

10. Ferrara N. Vascular endothelial growth factor // Arterioscler. Thromb.Vasc. Biol. — 2009. — Vol. 29. — P. 789-791.

11. Siervo M., Ruggiero D., Sorice R. et al. Angiogenesis and biomarkers of cardiovascular risk in adults with metabolic syndrome // J. Intern. Med. — 2010. — Vol. 268(4). — P. 338-347.

12. Trape J.C., Morales R., Molina X. et al. Vascular endothelial growth factor serum concentrations in hypercholesterolemic patients // Scand. J. Clin. Lab. Invest. — 2006. — Vol. 663. — P. 261-267.

13. Wada H., Satoh N., Kitaoka S. et al. Soluble VEGF receptor-2 is increased in sera of subjects with metabolic syndrome in association with insulin resistance // Atherosclerosis. — 2010. — Vol. 208(2). — P. 512-517.

14. Zorenal K., Mys’liwska J., Mys’liwiec M. et al. Association between vascular endothelial growth factor and hypertension in children and adolescents type I diabetes mellitus // J. Hum. Hypert. — 2010. — Vol. 24. — Р. 755-762.


1. Gavrilenko TI, Ryizhkova NA, Parhomenko AN. Sosudistyi endotelialnyi faktor rosta v klinike vnutrennih zabolevaniy i ego patogeneticheskoe znachenie. Ukrayinskyi kardiologichnyi zhurnal. 2011; 4: 87-95.

2. Koval CN, Miloslavskiy DK, Snegurskaya IA. Terapevticheskiy angiogenez pri zabolevaniyah vnutrennih organov – vozmozhnosti i perspektivy. Visnyk problem biologiyi y meditsyny. 2013; 1(104): 20-7.

3.  Lupinskaya Z.A., Zarifyan A.G., Gurovich T.Ts., Shleyfer S.G. Endoteliy. Funktsiya i disfunktsiya. – Bishkek: KRSU, 2008. – 373 c.

4. Orlova MM, Rodionova TI. Diagnosticheskaya znachimost issledovaniya syivorotochnoy kontsentratsii i mochevoy ekskretsii nekotoryih tsitokinov pri manifestnom gipotireoze. Tsitokinyi i vospalenie. 2012; 2 (11): 24-28.

5. Seredyuk VN. Efektyvnist ingibitoriv angiotenzinperetvoryuvalnogo fermentu i blokatoriv retseptoriv angiotenzynu-II u hvoryh iz hronichnym legenevym sertsem za dynamikoyu vaskuloendotelialnogo faktora rostu. Ukrayinskyi terapevtychnyi zhurnal. 2010; 4: 67-71.

6. Asselbergs FW, de Boer RA, Diercks GF. Vascular endothelial growth factor: the link between cardiovascular risk factors and microalbuminuria? Int. J. Cardiol. 2004; 93(2-3): 211-5.

7.    Ayerden Ebinz F, Haksun E, Ulver DB. The relationship between vascular endothelial growth factor (VEGF) and microalbuminuria in patients with essential hypertension. Intern. Med. 2008; 47 (17): 1511-6.

8.  Biselli PM, Guerzoni AR, de Godoy MF. Vascular endothelial growth factor genetic variability and coronary artery disease in Brazilian population. Heart Vessels. 2008; 23(6): 371-5.

9.  Hansen AH, Nielsen JJ, Saltin B, Hellsten Y. Exercise training normalizes skeletal muscle vascular endothelial growth factor levels in patients with essential hypertension. J. Hypertens. 2010; 28(6): 1176-85.

10.  Ferrara N. Vascular endothelial growth factor. Arterioscler. Thromb.Vasc. Biol. 2009; 29: 789-91.

11.  Siervo M. Ruggiero D. Sorice R. Angiogenesis and biomarkers of cardiovascular risk in adults with metabolic syndrome. J. Intern. Med. 2010; 268(4): 338-47.

12.  Trape JC, Morales R, Molina X. Vascular endothelial growth factor serum concentrations in hypercholesterolemic patients. Scand. J. Clin. Lab. Invest. 2006; 663: 261-7.

13.  Wada H, Satoh N, Kitaoka S. Soluble VEGF receptor-2 is increased in sera of subjects with metabolic syndrome in association with insulin resistance. Atherosclerosis. 2010; 208(2): 512-7.

14.  Zorenal K, Mys’liwska J, Mys’liwiec M.. Association between vascular endothelial growth factor and hypertension in children and adolescents type I diabetes mellitus. J. Hum. Hypert. 2010; 24: 755-62.

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