ANALYSIS OF CHARACTERISTICS OF LIPID METABOLISM DISORDERS IN PATIENTS WITH ACUTE CORONARY SYNDROME AND THEIR ASSOCIATION WITH THYROID FUNCTION
DOI:
https://doi.org/10.11603/1811-2471.2024.v.i1.14390Keywords:
acute coronary syndrome, myocardial infarction, unstable angina, thyroid function, hypothyroidism, subclinical hypothyroidism, thyroid-stimulating hormone, lipid metabolismAbstract
SUMMARY. The paper presents the results of a study of characteristics of lipid metabolism in patients with acute coronary syndrome (ACS) and their association with thyroid-stimulating hormone (TSH) levels.
The aim – to study the characteristics of lipid metabolism disorders in patients with ACS and their association with the TSH levels.
Material and Methods. The study includes 125 patients with ACS aged 36 to 81 (mean age – 60,98± 0,81 years old). The patients were divided into two groups according to thyroid function. Group one (I) included 51 individuals (40.8 %) – hypothyroid patients (TSH level>4 μIU/ml), mean age – 62.51±1.18 years old. Group II included 74 individuals (59.2 %) – euthyroid patients (TSH level 0.4-4 μIU/ml), mean age – 59.93±1.08 years old. The proportion of patients with unstable angina (UA), among all examined individuals, was 28.8 %, and with myocardial infarction (MI) – 71.2 %. More specifically, in Group I, the proportion of patients with UA was 23.53 %, and with MI – 76.47 %. In Group II, the proportion of patients with UA was 32.43 %, and with MI – 67.57 %, p>0.05 between Groups I and II. The proportion of women in Group I was 27.45 % (n=14), and the proportion of men – 72.55 % (n=37). In Group II, the proportions were 29.73 % (n=22) and 70.27 % (n=52) respectively.
The following indicators of lipid metabolism were determined: total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and non-high-density lipoprotein cholesterol (non-HDL-C). The TSH level was determined to assess thyroid function in the patients examined.
Results. At the study initiation, mean TC, LDL-C, TG, and non-HDL-C levels were significantly higher in Group I patients compared to Group II patients: TC – by 25.17 % (5.76±1.19 mmol/l (I) vs 4.31±1.30 (ІІ), р<0.001), LDL-C – by 31.64 % (3.54±1.10 mmol/l (І) vs 2.42±1.08 (ІІ), р<0.001), TG – by 21.95 % (2.05±1.61 mmol/l (І) vs 1.60±1.24 (ІІ), р<0.05), and non-HDL-C – by 25.78 % (4.46±1.18 mmol/l (І) vs 3.31±1.31 (ІІ) р<0.001) respectively.
The proportion of individuals with TC, LDL-C, and non-HDL-C levels above target ones was also significantly higher in hypothyroid individuals (I): by 39.46 % (92.16±3.76 vs 52.70±5.80 %), 16.96 % (98.04±1.94 vs 81.08±4.55 %), and 10.34 % (94.12±3.29 vs 83.78±4.28 %) respectively as compared to euthyroid patients (II).
The assessment of the association of the mean TSH levels with lipid metabolism indicators shows a moderate direct correlation between the TSH and TC levels (correlation coefficient (r)=0.335, p<0.05), and TSH and LDL-C levels (r=0.384, p<0.01) in the group of hypothyroid patients (I). Such changes were not observed in euthyroid individuals (II).
Conclusions. Mean lipid (TC, LDL-C, TG, and non-HDL-C) major pro-atherogenic fraction levels were significantly higher, by 20–30 %, in the group of hypothyroid patients with ACS (I) compared to euthyroid patients (II). The proportion of individuals with TC, LDL-C, and non-HDL-C levels above target ones was significantly higher among patients with ACS and TSH above 4.0 μIU/ml (I) compared to those with TSH below 4.0 μIU/ml (II) by 39.46 %, 16.96 %, and 10.34 % respectively. A moderate direct correlation was established between the TSH and TC levels (correlation coefficient (r)=0.335, p<0.05), and TSH and LDL-C levels (r=0.384, p<0.01) in the group of hypothyroid patients (I). Such changes were not observed in euthyroid individuals (II).
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