Yıl 2016,
Cilt: 7 Sayı: 26, 0 - 0, 30.06.2016
Öz
Amaç: Kronik venöz yetmezlik (KVY), varis oluşumu ve ven kapaklarındaki işlev bozukluğu ile karakterizedir. Tiroid hormonlarındaki eksikliğin damar duvar bileşenlerinde değişikliklere yol açtığı deneysel modellerle gösterilmiştir. Literatürde konuyla ilgili klinik çalışma bulunmamaktadır. Bu çalışmada; primer kronik venöz yetmezlikli (KVY) hastalarda tiroid fonksiyon bozukluğu prevelansı ve tiroid hormon seviyelerinin sağlıklı kontroller ile kıyaslanması amaçlanmıştır.
Gereç ve Yöntem: Klinik ve radyolojik verilerle primer KVY tanısı konan hastalardan, son bir yıl içerisinde kan tiroid hormon seviyeleri bakılan 96 hasta, retrospektif olarak dahil edildi. Bilinen tiroid hastalığı olmayan, sağlıklı erişkinlerden oluşan 94 hasta, kontrol grubu olarak alındı.
Bulgular: Toplam 180 hastanın yaş ortalaması 44,76 (aralık 18-77) idi. Hasta ve kontrol grubu arasında yaş ve cinsiyet açısından farklılık yoktu. Tutulan damarların sıklığı vena safena manga %81,2, vena safena parva %4,1, perforan ven %4,1, derin ven %0,1 idi. KVY hastalarının %12,5’inde tiroid fonksiyon bozukluğu olup, bunlardan %7,2’sinde subklinik hipotiroidizm, %5,2’sinde subklinik hipertiroidizm saptandı. Kontrol ile hasta grubu arasında serbest tiroksin düzeyi açısından fark izlenmezken, tiroid stimulan hormon düzeyi hasta grubunda anlamlı olarak yüksekti (p<0,05).
Sonuç: KVY’li hastalarda tiroid fonksiyonları ve hormon seviyeleri ilk defa araştırılmış ve normal erişkinlere kıyasla tiroid fonksiyon bozukluğu prevelansında ve tiroid stimulan hormon düzeylerinde artış bulunmuştur. KVY gelişimi için, bozulmuş tiroid fonksiyonları özellikle hipotiroidizm risk oluşturabilir. Geniş kapsamlı ve prospektif çalışmalara ihtiyaç vardır.
Anahtar kelimeler: Hipotiroidizm, Kronik venöz yetmezlik, Tiroid hormonları
Kaynakça
- REFERANSLAR
- Criqui MH, Jamosmos M, Fronek A, Denenberg JO, Langer RD, Bergan J, et al. Chronic venous disease in an ethnically diverse population: the San Diego Popu-lation Study. Am J Epidemiol. 2003;158:448-56.
- McLafferty RB, Passman MA, Caprini JA, Rooke TW, Markwell SA, Lohr JM, et al. Increasing awareness about venous disease: the American Venous Forum expands the National Venous Screening Program. J Vasc Surg. 2008;48:394–9.
- Da Silva A, Navarro MF, Batalheiro J. Theimportance of chronic venous insufficiency: various preliminary data on its medico-social consequences. Phlebologie. 1992;45:439–43.
- Eberhardt RT, Raffetto JD. Chronic venous insuffici-ency. Circulation. 2005;111:2398-409.
- Sansilvestri-Morel P, Rupin A, Jaisson S, Fabiani JN, Verbeuren TJ, Vanhoutte PM. Synthesis of collagen is dysregulated in cultured fibroblasts derived from skin of subjects with varicose veins as it is in venous smo-oth muscle cells. Circulation. 2002;106:479-83.
- Lim CS, Davies AH. Pathogenesis of primary varicose veins. Br J Surg.2009; 96: 1231–42.
- Atta HM. Varicose veins: role of mechanotransduc-tion of venous hypertension. Int J Vasc Med. 2012;2012:538627.
- Labropoulos, Nicos, and Luis R. Leon. "Duplexevalua-tion of venousinsufficiency." Seminars in vascularsur-gery. Vol. 18. No. 1. WB Saunders, 2005.
- Asboe-Hansen. Endocrine control of connective tissue. Am J Med. 1959;26:470-84.
- Moulakakis KG, Sokolis DP, Perrea DN, Dontas I, Do-sios T, Poulakou MV, et al. The effects of hypothyroi-dism on the mechanical properties and histomorpho-logical structure of the thoracic aorta. Angiology. 2010;61:259-68.
- Matsuoka LY, Wortsman J, Uitto J, Hashimoto K, Kupchella CE, Eng AM, et al. Altered skin elastic fibers in hypothyroid myxedema and pretibial myxedema. Arch Intern Med. 1985;145:117-21.
- Raffetto JD, Khalil RA. Mechanisms of varicose vein formation: valve dysfunction and wall dilation. Phle-bology 2008;23:85–98.
- Labropoulos N, Tiongson J, Pryor L, Tassiopoulos AK, Kang SS, Ashraf Mansour M, et al. Definition of ve-nous reflux in lower-extremity veins. J Vasc Surg 2003;38:793-8.
- Turton EP, Scott DJ, Richards SP, Weston MJ, Berridge DC, Kent PJ, et al. Duplex-derived evidence of reflux after varicose vein surgery: Neo-reflux or neovascu-larization? Eur J Vasc Endovasc Surg 1999;17:230-3.
- Gloviczki P, Comerota AJ, Dalsing MC, Eklof BG, Gilles-pieDL, Gloviczki ML, et al. Society for Vascular Sur-gery; American Venous Forum. Thecare of patients with varicose veins and associated chronic venous di-seases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 2011;53:2S–48S.
- Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, Spencer C et al. Serum TSH, T4, and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Exami-nation Survey (NHANES III). The Journal of Clinical En-docrinology & Metabolism 2002;87:489-99.
- Hergenç G, Onat A, Albayrak S, Karabulut A, Türkmen S, Sari I, et al. TSH levels in Turkishadults: Prevalences and associations with serum lipids, coronary heart di-sease and metabolic syndrome. Turkish Journal of Medical Sciences, 2005;35:297-304.
- Canaris GJ, Manowitz MR, Mayor G, Ridgway EC 2000 The Colorado thyroid disease prevalence study. Arch Intern Med 2000;160:526–534
- Evans CJ, Fowkes FG, Ruckley CV, Lee AJ. Prevalence of varicose veins and chronic venous insufficiency in men and women in the general population: Edin-burgh Vein Study. Journal of epidemiology and com-munity health.1999;53:149–53.
- Giannattasio C, Rivolta MR, Failla M, Mangoni AA, Stella ML, Mancia G. Large and medium sized artery abnormalities in untreated and treated hypothyroi-dism. Eur Heart J. 1997;18:1492-8.
- Taddei S, Caraccio N, Virdis A, Dardano A, Versari D, Ghiadoni L, et al. Impaired endothelium-dependent vasodilatation in subclinical hypothyroidism: benefi-cial effect of levothyroxine therapy. J Clin Endocrinol Metab. 2003;88:3731-7.
- Taddei S, Caraccio N, Virdis A, Dardano A, Versari D, Ghiadoni L, et al. Low-grade systemic inflammation causes endothelial dysfunction in patients with Has-himoto’s thyroiditis. J Clin Endocrinol Metab. 2006;91:5076-82.
- Lekakis J, Papamichael C, Alevizaki M, Piperingos G, Marafelia P, Mantzos J, et al Flow-mediated, endothe-lium-dependent vasodilation is impaired in subjects with hypothyroidism, borderline hypothyroidism, and high-normal serum thyrotropin (TSH) values. Thyroid. 1997;7:411-4
- Jung SC, Lee W, Chung JW, Jae HJ, Park EA, Jin KN, Park JH. Unusual Causes of Varicose Veins in the Lower Extremities: CT Venographic and Doppler US Findings. Radiographics, 2009;29:525-36.
Yıl 2016,
Cilt: 7 Sayı: 26, 0 - 0, 30.06.2016
Öz
Kaynakça
- REFERANSLAR
- Criqui MH, Jamosmos M, Fronek A, Denenberg JO, Langer RD, Bergan J, et al. Chronic venous disease in an ethnically diverse population: the San Diego Popu-lation Study. Am J Epidemiol. 2003;158:448-56.
- McLafferty RB, Passman MA, Caprini JA, Rooke TW, Markwell SA, Lohr JM, et al. Increasing awareness about venous disease: the American Venous Forum expands the National Venous Screening Program. J Vasc Surg. 2008;48:394–9.
- Da Silva A, Navarro MF, Batalheiro J. Theimportance of chronic venous insufficiency: various preliminary data on its medico-social consequences. Phlebologie. 1992;45:439–43.
- Eberhardt RT, Raffetto JD. Chronic venous insuffici-ency. Circulation. 2005;111:2398-409.
- Sansilvestri-Morel P, Rupin A, Jaisson S, Fabiani JN, Verbeuren TJ, Vanhoutte PM. Synthesis of collagen is dysregulated in cultured fibroblasts derived from skin of subjects with varicose veins as it is in venous smo-oth muscle cells. Circulation. 2002;106:479-83.
- Lim CS, Davies AH. Pathogenesis of primary varicose veins. Br J Surg.2009; 96: 1231–42.
- Atta HM. Varicose veins: role of mechanotransduc-tion of venous hypertension. Int J Vasc Med. 2012;2012:538627.
- Labropoulos, Nicos, and Luis R. Leon. "Duplexevalua-tion of venousinsufficiency." Seminars in vascularsur-gery. Vol. 18. No. 1. WB Saunders, 2005.
- Asboe-Hansen. Endocrine control of connective tissue. Am J Med. 1959;26:470-84.
- Moulakakis KG, Sokolis DP, Perrea DN, Dontas I, Do-sios T, Poulakou MV, et al. The effects of hypothyroi-dism on the mechanical properties and histomorpho-logical structure of the thoracic aorta. Angiology. 2010;61:259-68.
- Matsuoka LY, Wortsman J, Uitto J, Hashimoto K, Kupchella CE, Eng AM, et al. Altered skin elastic fibers in hypothyroid myxedema and pretibial myxedema. Arch Intern Med. 1985;145:117-21.
- Raffetto JD, Khalil RA. Mechanisms of varicose vein formation: valve dysfunction and wall dilation. Phle-bology 2008;23:85–98.
- Labropoulos N, Tiongson J, Pryor L, Tassiopoulos AK, Kang SS, Ashraf Mansour M, et al. Definition of ve-nous reflux in lower-extremity veins. J Vasc Surg 2003;38:793-8.
- Turton EP, Scott DJ, Richards SP, Weston MJ, Berridge DC, Kent PJ, et al. Duplex-derived evidence of reflux after varicose vein surgery: Neo-reflux or neovascu-larization? Eur J Vasc Endovasc Surg 1999;17:230-3.
- Gloviczki P, Comerota AJ, Dalsing MC, Eklof BG, Gilles-pieDL, Gloviczki ML, et al. Society for Vascular Sur-gery; American Venous Forum. Thecare of patients with varicose veins and associated chronic venous di-seases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 2011;53:2S–48S.
- Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, Spencer C et al. Serum TSH, T4, and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Exami-nation Survey (NHANES III). The Journal of Clinical En-docrinology & Metabolism 2002;87:489-99.
- Hergenç G, Onat A, Albayrak S, Karabulut A, Türkmen S, Sari I, et al. TSH levels in Turkishadults: Prevalences and associations with serum lipids, coronary heart di-sease and metabolic syndrome. Turkish Journal of Medical Sciences, 2005;35:297-304.
- Canaris GJ, Manowitz MR, Mayor G, Ridgway EC 2000 The Colorado thyroid disease prevalence study. Arch Intern Med 2000;160:526–534
- Evans CJ, Fowkes FG, Ruckley CV, Lee AJ. Prevalence of varicose veins and chronic venous insufficiency in men and women in the general population: Edin-burgh Vein Study. Journal of epidemiology and com-munity health.1999;53:149–53.
- Giannattasio C, Rivolta MR, Failla M, Mangoni AA, Stella ML, Mancia G. Large and medium sized artery abnormalities in untreated and treated hypothyroi-dism. Eur Heart J. 1997;18:1492-8.
- Taddei S, Caraccio N, Virdis A, Dardano A, Versari D, Ghiadoni L, et al. Impaired endothelium-dependent vasodilatation in subclinical hypothyroidism: benefi-cial effect of levothyroxine therapy. J Clin Endocrinol Metab. 2003;88:3731-7.
- Taddei S, Caraccio N, Virdis A, Dardano A, Versari D, Ghiadoni L, et al. Low-grade systemic inflammation causes endothelial dysfunction in patients with Has-himoto’s thyroiditis. J Clin Endocrinol Metab. 2006;91:5076-82.
- Lekakis J, Papamichael C, Alevizaki M, Piperingos G, Marafelia P, Mantzos J, et al Flow-mediated, endothe-lium-dependent vasodilation is impaired in subjects with hypothyroidism, borderline hypothyroidism, and high-normal serum thyrotropin (TSH) values. Thyroid. 1997;7:411-4
- Jung SC, Lee W, Chung JW, Jae HJ, Park EA, Jin KN, Park JH. Unusual Causes of Varicose Veins in the Lower Extremities: CT Venographic and Doppler US Findings. Radiographics, 2009;29:525-36.
Toplam 25 adet kaynakça vardır.
Ayrıntılar
| Bölüm | Original Articles |
|---|---|
| Yazarlar | |
| Yayımlanma Tarihi | 30 Haziran 2016 |
| Gönderilme Tarihi | 1 Mart 2016 |
| Yayımlandığı Sayı | Yıl 2016 Cilt: 7 Sayı: 26 |
Cited By
Cutaneous findings in patients with chronic venous insufficiency
Journal of Cosmetic Dermatology
Fadime Kılınç
https://doi.org/10.1111/jocd.14337
