Биомаркеры системного воспаления и раннего сосудистого старения у лиц с субклиническим гипотиреозом и бессимптомным атеросклерозом коронарных артерий

Abstract

The study included 170 people of working age without clinical signs of coronary heart disease. 2 groups were formed: 120 patients with subclinical hypothyroidism (SH), 50 patients who did not have disturbances in thyroid hormonal status. The mean age of the patients was: 53,27 ± 9,3 years and 49,21± 9,07 years. The groups were comparable in age, gender, smoking status and the presence of arterial hypertension. In patients with SH, the proportion of individuals with atherogenic IIa and IIb type hyperlipidemia was 91.7% (n=110) vs 68.0% (n=34) in individuals without thyroid dysfunction (χ2=15.26; p=0.0001). Multivessel atherosclerotic lesions (2 or more) of the coronary arteries were diagnosed in 25.0% (n=30) of individuals with SH who considered themselves absolutely healthy (F=0.074; p=0.0001). A direct, moderate correlation between SH and the atherogenic type of hyperlipidemia (r=0.52; p<0.05), inflammatory markers, MMP-9 activity (r=0.30; p<0.05), MMP-9/TIMP-1 balance (r=0.30; p<0.05), the presence of multivessel coronary artery disease (r=0.38; p<0.05) were established; an inverse, moderate correlation between telomerase activity and the MMP-9 level (r=-0.31; p<0.05), MMP-9/TIMP-1 index (r = -0.30; p<0.05), the values of the "new" inflammation biomarkers SIRI (r= -0.31; p<0.05) and AISI (r= -0.30; p<0.05) were established. The obtained relationships between subclinical hypothyroidism and dyslipidemia, the extent of coronary atherosclerosis, telomerase activity, biomarkers of inflammation and degradation of the extracellular matrix; between the activity of matrix metalloproteinase type 9, inflammatory response, telomerase concentration, atherogenic IIa and IIb hyperlipidemia indicate a significant role of thyroid dysfunction in the pathogenesis of atherosclerotic remodeling.