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Dr. Adrian Man
The importance of total seric homocysteine assesment at pacients with „induced” hypothyroidism Mariana Purice, Florin Alexiu, Valeria Lungu, Mihaela Giurcaneanu, Petrica Museteanu, Leonard Dumitriu
Abstract: Homocysteine is a thiol-containing amino acid, exported to the circulation as a result of the methilation in the metabolicalical processes. Impaired reactions at the level of cellular membrane can induce a hypo or hyper accumulation of circulating homocysteine. Several elevated concentrations of the homocysteine (tHcy) are found in subjects with homocystenuria. Patients with homocystenuria exhibit mental retardation, early arterioscleroses and arterial and venous thromboembolism. Other less sever genetic defects, leading to moderate elevated levels of tHcy, are also found. Epidemiological research has shown that elevated levels of tHcy is an independent risk factor of cardiovascular and cerebral diseases, as well as in the aging processes. The purpose of our study was to evaluate the level of the total serum homocysteine for 18 patients with thyroid neoplasm during the treatment with radio iodine (131 I). These patients are considered as being with “induced hypothyroidism” due to the fact that four weeks before, and during the radio therapy, they stop the substitution with thyroid hormones and serum TSH levels are >50 μUI/ml. For the determination of total homocysteine, we used an enzyme immunoassay (DRG International, Inc USA). In addition, serum cholesterol level was also determined for all the patients (Cobas Mira automated analys-er). We found that 67% of these patients had significantly high serum tHct values if compared with the control (p<0.01). Between them, 5 patients (39 %) had the concentration between 15-20 μmol/l and 8 patients (32%) had tHcy > 20μmol/l (normal range is 5-15 μmol/l). Elevated concentrations of the total serum homocysteine (tHcy) in hypothyroidism could be considered as an independent risk factor of cardiovascular disease for these patients. Compared with cholesterol and its fractions determination, the total homocysteim is a more sensible parameter for the evaluation of this risk for patients with sever hypothyroidism. It could also help in the follow up of the level of therapy for sever hypothyroidism and in the prevention of the early arterioscleroses. For our future study regarding the aging processes, the method of tHcy measuring was also applied for the determination of this molecule in the rat serum (n=10). We obtained reproducible results on an animal model.
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Purice M, Alexiu F, Lungu V, Giurcaneanu M, Museteanu P, Dumitriu L. The importance of total seric homocysteine assesment at pacients with „induced” hypothyroidism. Rev Romana Med Lab. 2005;1(1):27-32
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