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Cardiovascular Manifestations of Primary Hypothyroidism

Authors: Ahmed Shaker Al-Zaidi --- Adil S .Abdul-Ghafour --- Abdulla J Minshed Al-Farttoosi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2010 Volume: 9 Issue: 2 Pages: 113-119
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية


ABSTRACT:BACKGROUND:Primary hypothyroidism accounts for 90 to 95 %of all cases of hypothyroidism. Thyroid hormone deficiency increases systemic vascular resistance, decreases contractility and slow the heart rate .OBJECTIVE: To investigate cardiac changes in primary hypothyroidism.METHODS:In this prospective study 36 patients with untreated primary hypothyroidism were compared with 30 healthy persons. Cardiovascular evaluation of all subjects had been made both clinically and by the following studies :Chest X-Ray, electrocardiography, serum lipid and Echocardiography.RESULTS::The main cardiac manifestations of hypothyroidism were: Easy fatigability( 88.9 %(, exertional dyspnea )75%o),obesity or gaining weight( 66.7 %(, sinus bradycardia ) 47.2 %(and peripheral edema(11.1 %(Electrocardiography showed sinus bradycardia in( 47%( low QRS voltage in )33.3%( , flat or inverted T wave(27.8%), prolonged QT interval )19.5%), first degree heart block in( 19.5 %(.Echocardiography showed the following :a decrease in global systolic function, asymmetric sepalhypertrophy in )91.6%) Pericardial effusion in )38.8%).Low QRS voltage was found to be related to thyroxin level and age of the patient .No correlation was found between heart rate and thyroxin level.CONCLUSION:Primary hypothyroidism accompanied by significant changes in cardiovascular system which may explain the development of premature coronary artery disease in these patients.

The Role of Metformin in patients with Primary Hypothyroidism

Authors: ,Anmar Alharganee *** --- ,Marwah Isam Abdulrahman **, --- Khalid Ibrahim Al-Lehibi* ,
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2019 Volume: 15 Issue: 1 Pages: 79-85
Publisher: Baghdad University جامعة بغداد


Background: Insulin resistance is present in 50% or more of patients with primary hypothyroidism. Metformin can decrease TSH levels in these patients by a complex matter, this can be of great help in clinical practice.Objective: This study was designed to evaluate the effect of metformin in reducing TSH levels in patients with primary hypothyroidism.Methods: Hundred patients with primary hypothyroidism, 82 females, 18 males were included in this study, everyone was followed up for two months after adding metformin 850 mg twice daily in addition to thyroxin.Results: 36 patients (36%) have a normal baseline TSH and no change after 2 months, 64 patients (64%)have a change in TSH either a decrease(49 patients ,79.56%) or an increase (15 patients , 23.44 % ).Conclusion: Metformin therapy is highly effective in reducing TSH levels in patients with primary hypothyroidism

Influence of Primary Hypothyroidism on Serum Leptin Level

Authors: Aras A. Abdullah --- Abdul Hussein A. Farage --- Maryam S. Mohammad
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2010 Volume: 9 Issue: 2 Pages: 120-124
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية


ABSTRACT: BACKGROUND: Leptin is the protein product of the ob gene, secreted by adipocytes. It has been suggested that it may plays an important role in regulating appetite and energy expenditure, but beside that, little is known about the physiological actions of leptin in humans. OBJECTIVE: To evaluate a possible influence of primary hypothyroidism on serum leptin levels. METHODS: Fifty-six newly diagnosed patients with primary hypothyroidism (40 females and 16 males) and 32 normal controls matched for age, ethnic status and body mass index (BMI) were studied. Body mass index (BMI; kg/m2), thyroid function(using enzyme-linked immunoflourescent assay) and serum levels of leptin, thyroid autoantibodies (measured by enzyme-linked immunosorbant assay) and lipid profile(measured by enzymatic colourimeteric assays) were assessed in all studied subjects. RESULTS: No significant difference in serum leptin levels was recorded between hypothyroid patients and controls (16.3±14.9; 14.8 ± 12.9, P> 0.05), but women in each group had significant higher leptin concentrations than men (patients: 19.6 ±16.3 vs. 8.3 ±5.0; controls: 19.0 ±14.4 vs. 7.7 ±4.1; P< 0.05). Serum levels of cholesterol (p<0.002), LDL-cholesterol (p<0.004) and atherogenic ratio (p<0.03) were generally higher in patients than controls. The serum leptin concentration correlated positively with BMI within both patients (r=0.32; p<0.016) and controls (r=0.28; p<0.024). However, no association was demonstrated between values of serum T3, T4, TSH, triglyceride, HDL-cholesterol and thyroid auto antibodies. CONCLUSION: Circulating thyroid hormones do not appear to play any significant effect on leptin levels in patients with primary hypothyroidism.

Study of adult onset spontaneous primary hypothyroidism in Salahaddin Province
دراسة من بداية عفوية الكبار الابتدائي الغدة الدرقية inSalahaddin محافظة

Author: Akram M. Ali
Journal: The Medical Journal of Tikrit University المجلة الطبية لجامعة تكريت ISSN: 18131638 Year: 2006 Volume: 1 Issue: 121 Pages: 22-27
Publisher: Tikrit University جامعة تكريت


It is generally believed that primary hypothyroidism in adults is the sequel of autoimmune
atropic thyroiditis, also there are many studies which have show high prevalence of
hypothyroidism in association with endemic goiter. However there are no data available on
primary hypothyroidism in adults from this area. The aim of this study is to identify prevalence of
hypothyroidism in Salahaddin Province. The record of patients of primary hypothyroidism seen at
Tikrit General hospital in Salahaddin over a period of four-years (Jan. 1996-Dec.1999) were
analyzed. Hormonal investigation like T3, & T4 & TSH (thyroid stimulating hormone). 62
patients with spontaneous primary hypothyroidism out of which 47 females and 23 males , overall
male to female ratio was 1:2, a proximately 60 %of the patients presented in the third and fourth
decades. Hormonal data analysis revealed that one third of patient had low T3, low T4 and
elevated T.S.H. 40% of patients had normal T3, low T4 and elevated T.S.H and about 28% of
patients had normal T3, T4 but elevated TSH. Salahaddin province has a significant environmental
iodine deficiency, & this may lead to preponderance of this condition in these population.
Key words: T3, T4, TSH, sign, symptoms, hypothyroidism.

ويعتقد عموما أن قصور الغدة الدرقية الابتدائي في البالغين هو تتمة من المناعة الذاتية الغدة الدرقية />

مستشفى تكريت العام في صلاح الدين على مدى فترة السنوات الأربع (يناير 1996، Dec.1999)
وتحليلها. الهرمونية تحقيق مثل T3 T4 و، و TSH (تحفيز هرمون الغدة الدرقية). 62
والمرضى الذين يعانون من قصور الغدة الدرقية الابتدائي العفوي منها 47 من الإناث والذكور 23، وعموما
ونسبة الذكور إلى الإناث كانت 1:2، 1٪ المجاورة بشكل مباشر 60 من المرضى التي قدمت في الثالث والرابع
عقود من الزمن. وكشفت الهرمونية وتحليل البيانات أن ثلث المريض كان، وانخفاض T3 TSH T4 و />

كبير عن نقص اليود، وهذا قد يؤدي الى رجحان هذا الشرط في هذه السكان
الكلمات الدالة:.، T3 T4، TSH، علامة، والأعراض، قصور الغدة الدرقية.

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