Abstract
Hyperthyroidism is associated with altered endothelial dysfunction and increased risk of arterial thromboembolism and cardiovascular disease. Von Willebrand factor (vWF) is a marker of endothelial dysfunction. There is controversy in reports that have been published concerning the concentrations of vWF in hyperthyroidism. The aim of this study was to investigate the plasma vWF levels in clinical hyperthyroid patients, as well as its relationship to thyroid hormones fT3, fT4 and TSH compared to control subjects. In this study forty recently diagnosed, non-treated clinical hyperthyroid patients (f=37, m=3) and twenty normal volunteers control (f=18, m=2) were included, and subjected to determination of plasma vWF by ELISA technique and serum fT3, fT4 and TSH by Elecsys cobas e 601 analyzer. The data was statistically analysed by SPSS-10 and p values less than 0.05 were considered significant. Our results showed that there were a significant increase of vWF, fT4 and fT3 levels by 100%, 285% and 100%, respectively, and a significant decrease of TSH levels by 12.9-folds in hyperthyroid patients than in control group. For vWF (mean ± SD, 252.2 ± 66.4 vs 126.4 ± 29.9%, repectively; p=0.001). vWF was significantly positively correlated with fT4 and negatively correlated with TSH. In conclusion, we confirmed that hyperthyroidism was associated with increased vWF levels, a novel marker of endothelial dysfunction, FT4 levels being a predictive of vWF levels. Endothelial dysfunction could contribute to higher risk for thromboembolic and cardiovascular disease.
Highlights
Hyperthyroidism is associated with altered endothelial dysfunction [1], and increased risk of arterial thromboembolism [2], and cardiovascular manifestations [3,4], such as tachycardia, systolic hypertension, heart failure and increased probability of cardiovascular mortality
We evaluated the plasma Von Willebrand factor (vWF) levels in clinical hyperthyroid patients, as well as its relationship to thyroid hormones, fT3, fT4 and Thyroid-stimulating hormone (TSH) compared to control subjects
The patient’s group consisted of 40 recently diagnosed, non-treated hyperthyroid patients (37 females and 3 males). These patients were selected randomly each day from subjects referred to the out-patient’s, and inpatient’s clinics of medical and general surgery departments (n=7) of Kuwait University Hospital (KUH), and from subjects referred to the specialized medical laboratories, Aulaqi (n=12), Med-Lab.(n=11) and Al-Dubhani (n=10), for ELISA thyroid hormones measurements, the diagnosis of clinical hyperthyroidism was based on increased levels of serum fT4 and/or fT3, and decreased TSH levels
Summary
Hyperthyroidism is associated with altered endothelial dysfunction [1], and increased risk of arterial thromboembolism [2], and cardiovascular manifestations [3,4], such as tachycardia, systolic hypertension, heart failure and increased probability of cardiovascular mortality. Clinical studies suggested that endothelial dysfunction was the possible cause of such cardiovascular manifestations [5]. Von Willebrand factor (vWF) is a large multimeric glycoprotein that plays an important role in primary haemostasis by promoting platelet adhesion, by forming a bridge between platelet glycoprotein and exposed collagen in the subendothelium at sites of vascular injury [11]. It acts as plasma carrier for factor VIII, protecting it from premature destruction or rapid proteolysis. We evaluated the plasma vWF levels in clinical hyperthyroid patients, as well as its relationship to thyroid hormones, fT3, fT4 and TSH compared to control subjects
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