Changes of serum concentrations of asymmetric dimethylarginine (ADMA) and N-terminal-pro-B-type natriuretic peptide (NT-proBNP) during the treatment of newly diagnosed Graves' patients

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: MON 437-470-Non-neoplastic Thyroid Disorders
Monday, June 17, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board MON-449
Hyo-Jeong Kim*1, Ji Young Park1, Jung Ah Lim1, Wen Hao Wu2 and So-Young Park3
1School of Medicine, Eulji University, Seoul, South Korea, 2Eulji Medi-Bio Research Institute, Eulji University, Seungnam, South Korea, 3College of Medicine, Yeungnam Un, Namgu, Daegu, South Korea
Cardiovascular manifestations are frequent findings in patients with thyroid hormone disorders. Endothelial and myocardial dysfunction as well as abnormal thyroid hormone levels may be responsible for increased cardiovascular risk in Graves’ disease(GD). Asymmetric dimethylarginine(ADMA), an endogenous inhibitor of nitric oxide synthase, and N-terminal-pro-B-type natriuretic peptide(NT-proBNP), secreted from the cardiac ventricles, are new markers of endothelial and myocardial dysfunction, respectively. The aim of this study was to assess the changes in serum ADMA and NT-proBNP levels during the treatment and to investigate the relationship among those markers and thyroid hormones in newly diagnosed GD patients. Thirty-nine patients with GD(42.8±11.7 years) and 19 age-matched euthyroid subjects(40.3±11.9 years) were evaluated prospectively for 6 months in this study. We classified them into three subgroups (G1: the newly diagnosed GD patients, G2: same patients of G1 subgroup after treatment of 6 months, Controls: euthyroid controls). Serum ADMA and NT-proBNP were measured by ELISA and ECLISA methods, respectively. Mean serum free T4 and TSH levels of G1 subgroup were significantly high and low compared to the G2 subgroup and controls, respectively (G1, G2 vs. Controls, 6.57±2.31, 1.40±0.60 vs. 1.24±0.21 ng/dL, P <0.001 for free T4 ; 0.01±0.00, 1.67±2.39 vs. 3.00±1.55 µIU/mL, P =0.001 for TSH). Mean serum fasting glucose was significantly higher, however, mean total cholesterol, triglyceride, LDL cholesterol and HDL cholesterol levels were significantly lower in the G1 subgroup than in the latter two subgroups. Mean serum ADMA levels was higher in the G1 than in the G2 and control subjects (G1, G2 vs. Controls, 1.28±0.33, 0.89±0.21 vs. 0.72±0.15 μM, P <0.001). Mean serum NT-proBNP levels was also higher in the G1 than in the G2 subgroup and controls(G1, G2 vs. Controls, 165.9±158.2, 30.8±26.8 vs. 28.9±11.6 pg/ml, respectively, P =0.001). Serum free T4 level was positively associated with both of serum ADMA(r=0.779, P <0.001) and serum NT-proBNP(r=0.533, P <0.001). In conclusion, both serum ADMA and NT-proBNP levels increased in GD patients and decreased to the levels of euthyroid controls after antithyroid medications. Furthermore, those changes were related to free thyroxine levels. Further investigation are required to address the question of whether those changes can affect the cardiovascular dysfunction of GD patients.

1) Schultz M et al., Clin Endocrinol 2004; 60: 54. 2) Arikan E et al., J Endocrinol Invest 2007; 30 :186.

Nothing to Disclose: HJK, JYP, JAL, WHW, SYP

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