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Errata corrige
VIII
XVIII S.I.S.A.NationalCongress
ERRATA CORRIGE In addition to the contents already published in the "Abstracts from the XVIII S.I.S.A. National Congress" section of issue 5, we hereby add two further abstracts presented at the congress.
Subclinical hypothyroidism and insulin-resistance M. Baldini*, S. Bozzoni, A. Orsatti, L. Burdick*, L. Cantalamessa* UO Medieina Interna I, IRCCS Ospedale Maggiore Milano, *Dipartimento di. Medicina Interna, Universi~ degli Studi, Milano Introduction. Subclinical hypothyroidism (SH) is an endocrine disease characterized by normal levels of Fr3/FT4 and elevated TSH. It is associated with hypertension and dyslipidemia; and some evidence indicates this condition as a risk factor for atherosclerosis (AS), similarly to overt thyroid failure (Cappola, 2003). A dysmetabolic condition recognizedly associated to AS is insulin-resistance (IR) and a recent study reported a high prevalence of SH and IR in patients with rheumatoid arthritis (RA) (Dessin, 2004), It is not known if the above reported relationship can apply to SH patients without RA; conversely, IR is not a reported complication of clinical hypothyroidism. Patients and Methods. Blood glucose and insulin levels were tested in 12 patients with SH before and after treatment. IR was evaluated in all of them as HOMA index, The patients with obesity, immunological diseases, elevated serum concentrations of glucose, cholesterol or triglycerides as well as those taking antidiabetic or lipid-lowering drugs were excluded. Results. As shown in the Table, HOMA index did not indicate insulin resistance in patients with SH, and there was no significant difference before and after replacement with levothyroxine. Blood glucose mg/dL
HbAlc %
Blood insulin mU/ml 7.44±3.84
HOMA
Pre-treatment 87.25 ± 10.45 4.72 ± 0.45 1.61 ±0.89 Mean ± SD Post-treatment 89.35 ± 8.98 4.53 ± 0.48 6.92± 4.93 1.69 ± 0.22 Mean ± SD Table 1. Glucose metabolism in 12 patients with subclinical hypothyroidism before and after treatment with LT4 (p>0.05 for all comparisons). Discussion and Conclusion. The association of mild thyroid failure with IR was not confirmed in our series of SH patients. Based on our results SH appears to behave similarly to overt hypothyroidism in respect of glucose metabolism.
Cardiovascular prevention: effectiveness of cardiovascular risk screening in working population; prevalence of high risk, new diagnosis in apparently healthy subjects and evaluation of correct diagnosis in patients presenting risk factors or events R. Bernardi, S. Naseetti, A. Fiorito, L. Laghi, A. Miconi, R. Brillante, M. Scurti, E. Grandi, A. Gaddi Atherosclerosis Centre "GC Descovich"-Clinical medicine and Applied biotechnology-University of Bologna Aim: to observe the prevalence of cardiovascular high risk in a working population using Framiugham score, make new diagnosis in apparently healthy subjects and to evaluate uncorrected diagnosis in patients with defined pathology or risk factors. MMerials and methods: in 295 volunteers working in a research institute (Men-195, Women=100) between 24 and 71 years old we evaluated plasma lipids, systolic (SBP) and diastolic blood pressure (DBP), Body Mass Index (BMI), fasting glycaemia, uric acid, fibrinogen, ECG and smoke habits; besides we submitted a questionnaire to find out own and familial anamnesis, lifestyle habits and knowledge of eventually pre-existent pathologies. We selected 80 people (27,1% of whole population) using these parameters: high cardiovascular risk (>20%), BMI>30, SBP>I35mmHg and DBP>85mmHg, Total Cholesterol>199mg/dl, glycaemia>109 mg/dl. Results: in the whole population we find 37 subjects with cardiovascular risk 20% or more (12,9%); besides analysing 80 selected people, 29 were without any diagnosis (36,2%), 32 had uncorrected or uncompleted diagnosis (40%) and only 18 had the pre-existent diagnosis confirmed (22,5%). Conclusions: in this study more than 27% of population appeared "not cardiovascular safe", and in the selected group about only 1 to 5 people had correct or completed diagnosis. Cardiovascular risk screening should be a good way to make an effective cardiovascular prevention in population.
XVIII S.I.S.A.NationalCongress
ERRATA CORRIGE In addition to the contents already published in the "Abstracts from the XVIII S.I.S.A. National Congress" section of issue 5, we hereby add two further abstracts presented at the congress.
Subclinical hypothyroidism and insulin-resistance M. Baldini*, S. Bozzoni, A. Orsatti, L. Burdick*, L. Cantalamessa* UO Medieina Interna I, IRCCS Ospedale Maggiore Milano, *Dipartimento di. Medicina Interna, Universi~ degli Studi, Milano Introduction. Subclinical hypothyroidism (SH) is an endocrine disease characterized by normal levels of Fr3/FT4 and elevated TSH. It is associated with hypertension and dyslipidemia; and some evidence indicates this condition as a risk factor for atherosclerosis (AS), similarly to overt thyroid failure (Cappola, 2003). A dysmetabolic condition recognizedly associated to AS is insulin-resistance (IR) and a recent study reported a high prevalence of SH and IR in patients with rheumatoid arthritis (RA) (Dessin, 2004), It is not known if the above reported relationship can apply to SH patients without RA; conversely, IR is not a reported complication of clinical hypothyroidism. Patients and Methods. Blood glucose and insulin levels were tested in 12 patients with SH before and after treatment. IR was evaluated in all of them as HOMA index, The patients with obesity, immunological diseases, elevated serum concentrations of glucose, cholesterol or triglycerides as well as those taking antidiabetic or lipid-lowering drugs were excluded. Results. As shown in the Table, HOMA index did not indicate insulin resistance in patients with SH, and there was no significant difference before and after replacement with levothyroxine. Blood glucose mg/dL
HbAlc %
Blood insulin mU/ml 7.44±3.84
HOMA
Pre-treatment 87.25 ± 10.45 4.72 ± 0.45 1.61 ±0.89 Mean ± SD Post-treatment 89.35 ± 8.98 4.53 ± 0.48 6.92± 4.93 1.69 ± 0.22 Mean ± SD Table 1. Glucose metabolism in 12 patients with subclinical hypothyroidism before and after treatment with LT4 (p>0.05 for all comparisons). Discussion and Conclusion. The association of mild thyroid failure with IR was not confirmed in our series of SH patients. Based on our results SH appears to behave similarly to overt hypothyroidism in respect of glucose metabolism.
Cardiovascular prevention: effectiveness of cardiovascular risk screening in working population; prevalence of high risk, new diagnosis in apparently healthy subjects and evaluation of correct diagnosis in patients presenting risk factors or events R. Bernardi, S. Naseetti, A. Fiorito, L. Laghi, A. Miconi, R. Brillante, M. Scurti, E. Grandi, A. Gaddi Atherosclerosis Centre "GC Descovich"-Clinical medicine and Applied biotechnology-University of Bologna Aim: to observe the prevalence of cardiovascular high risk in a working population using Framiugham score, make new diagnosis in apparently healthy subjects and to evaluate uncorrected diagnosis in patients with defined pathology or risk factors. MMerials and methods: in 295 volunteers working in a research institute (Men-195, Women=100) between 24 and 71 years old we evaluated plasma lipids, systolic (SBP) and diastolic blood pressure (DBP), Body Mass Index (BMI), fasting glycaemia, uric acid, fibrinogen, ECG and smoke habits; besides we submitted a questionnaire to find out own and familial anamnesis, lifestyle habits and knowledge of eventually pre-existent pathologies. We selected 80 people (27,1% of whole population) using these parameters: high cardiovascular risk (>20%), BMI>30, SBP>I35mmHg and DBP>85mmHg, Total Cholesterol>199mg/dl, glycaemia>109 mg/dl. Results: in the whole population we find 37 subjects with cardiovascular risk 20% or more (12,9%); besides analysing 80 selected people, 29 were without any diagnosis (36,2%), 32 had uncorrected or uncompleted diagnosis (40%) and only 18 had the pre-existent diagnosis confirmed (22,5%). Conclusions: in this study more than 27% of population appeared "not cardiovascular safe", and in the selected group about only 1 to 5 people had correct or completed diagnosis. Cardiovascular risk screening should be a good way to make an effective cardiovascular prevention in population.