Role of copper in the development of cardiovascular pathology in patients with diffuse-toxic goiter


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Аннотация

Objective. To evaluate the contribution of the copper status in the progression of thyrotoxicosis severity and the development of cardiovascular complications in patients with diffuse toxic goiter. Methods. The study included 113 women with diffuse toxic goiter aged 25 to 60 years; 61 (54.0%) of them had moderate thyrotoxicosis, 52 (46.0%) - severe thyrotoxicosis. Duration of the disease was 1 to 5 years. The control group included 37 women aged 25 to 60 years without pathology of the thyroid gland and cardiovascular system. Blood thyroid-stimulating hormone (TSH) level, free thyroxine (fT4) level, the thyroid-stimulating hormone receptor antibody (anti-THSr) levels, as well as hair copper concentration, were assessed. All patients underwent ultrasound examination of the thyroid gland, echocardiography, and 24-hour Holter ECG monitoring. Results. At baseline, all patients achieved subclinical thyrotoxicosis against the background of thyroostatic therapy. With moderate thyrotoxicosis, the mean TSH level was 0.07 (0.03-0.13) lU/l at baseline; fT4 - 18.5 (16.0-19.5) pmol/l; with severe thyrotoxicosis - 0.06 (0.03-0.12) lU/l (p=0.70), and 18.0 (16.7-19.0) pmol/l (p=0.40), respectively. With moderate severity of diffuse-toxic goiter (DTG), all patients (61 [100.0%]) had an increase in the hair copper level to 21.0 (17.0, 23.0) pg/g was revealed. In majority of patients with severe DTG -40 (76.9%) - reduced hair cooper level 7.0 (5.5-8.0) pg/g was revealed. In the comparison group, the indicators of 4 (10.8%) patients were 13.0 (11.1-15.5) pg/g (p=0.01). Hair copper deficiency in chronic heart failure (CHF) was detected in 40 (76.9%) patients, in atrial fibrillation - in 21 (67.7%) patients. Conclusion. The data obtained allow to consider that copper deficiency contributes to the progression of thyrotoxicosis severity and increases the probability of development of AF and CHF in patients with severe DTG.

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Авторлар туралы

L. Kvitkova

Kemerovo State Medical University; Kemerovo Regional Clinical Hospital n.a. S.V. Belyaev

SPIN-код: 4678-1318

Daria Vinichenko

Kemerovo State Medical University

Email: haracternay6@yandex.ru
SPIN-код: 2074-0194
Postgraduate Student

D. Borodkina

Kemerovo Regional Clinical Hospital n.a. S.V. Belyaev

SPIN-код: 8666-3500

S. Zinchuk

Kemerovo State Medical University

SPIN-код: 3199-8459

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