锌在Graves病患者心血管并发症发生中的作用

L. Kvitkova, Квиткова Людмила Владимировна, D. S. Vinichenko, Виниченко Дарья Сергеевна, D. Borodkina, Бородкина Дарья Андреевна, S. F. Zinchuk, Зинчук Сергей Фадеевич, N. Fomina, Фомина Наталья Викторовна, Sergey S. Maximov, Максимов Сергей Алексеевич
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摘要

Backgraund。弥漫性中毒性甲状腺肿(DTZ)患者心血管并发症的发生是甲状腺病学的一个现实问题。(SSS)在DTZ患者中的作用。目标评估缺锌在Graves病患者心血管并发症形成中的作用。方法。本研究纳入113例诊断为DTZ的25-60岁女性:54.0% (n = 61)平均严重程度为甲状腺毒症,46.0% (n = 52)严重。病程1-5年。对照组37例,年龄25 ~ 60岁,无甲状腺病理及CCC。评估所有患者血中促甲状腺激素(TTG)水平、游离甲状腺素(超过T4)水平、促甲状腺激素受体抗体(AT to RTTG)浓度;头发中锌的浓度;甲状腺超声(超声)、超声心动图(EchoCG)、心电图日监测(CM ECG)。结果。DTZ组66.4% (n = 75)患者发质缺锌,对照组27.0% (n = 10)患者发质缺锌(p = 0.01)。更常见的是,重度DTZ患者缺锌发生率为82.7% (n = 43),房颤发生率为77.4% (n = 24), CHF发生率为78.8% (n = 41)。采用logistic回归方法建立了CHF的诊断模型和分点危险因素表,包括头发中锌含量的定义。建议对所有DTZ患者使用表来确定CHF的风险程度,DTZ治疗中发生CHF的风险为平均和高,其中包括锌制剂。结论。所获得的数据允许考虑缺锌增加严重DTZ患者发生AF和CHF的可能性,需要诊断和纠正。
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Thе role of zinc in the development of cardiovascular complications in patients with Graves’ disease
Backgraund. The development of cardiovascular complications in patients with diffuse-toxic goiter (DTZ) is an actual problem of thyroidology. (SSS) in patients with DTZ. Aims. To assess the contribution of zinc deficiency in the formation of cardiovascular complications in patients with Graves’ disease. Methods. The study included 113 women aged 25–60 years with the diagnosis of DTZ: 54.0% ( n = 61) with an average severity of thyrotoxicosis, 46.0% ( n = 52) with severe. Duration of the disease is 1–5 years. The control group consisted of 37 women aged 25–60 years without pathology of the thyroid gland and CCC. All patients were evaluated: in the blood – the level of thyroid-stimulating hormone (TTG), free thyroxine (over T4), the concentration of antibodies to the thyroid-stimulating hormone receptor (AT to RTTG); in the hair – the concentration of zinc; ultrasound (ultrasound) of the thyroid gland, echocardiography (EchoCG), daily monitoring of electrocardiography (CM ECG). Results. At DTZ deficiency of zinc in hair was observed in 66.4% ( n = 75), in the control group – in 27.0% ( n = 10) patients ( p = 0.01). More often, zinc deficiency was found at a severe degree of DTZ in 82.7% ( n = 43), atrial fibrillation (AF) in 77.4% ( n = 24) cases, in CHF – 78.8% ( n = 41) cases. The diagnostic model and the table of risk factors of CHF in points, including the definition of the level of zinc in the hair, are developed with the help of logistic regression. It is advisable to use the table for all patients with DTZ to determine the degree of CHF risk, with an average and high risk of developing CHF in the treatment of DTZ, it is shown to include zinc preparations. Conclusion. The obtained data allow to consider that the zinc deficiency increases the probability of development of AF and CHF in patients with DTZ of severe severity, needs diagnostics and correction.
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Associations of thyroid status and thyroperoxidase antibodies with serum trace elements Features of achieving compensation of hypothyroisis in pregnant women Structural and morphologic characteristics of nodular goiter in chronic iodine deficiency status Investigation of neural network models application in EU-TIRADS thyroid nodules classification for personalization of thyroid gland ultrasound diagnostic Press release from the Endocrine Society ENDO 2022 Annual Conference
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