Assessment of pulmonary ventilatory functions in hypothyroidism

This study was designed in order to assess impairment of pulmonary functions tests [PFT] in patients with hypothyroidism to know if they are obstructive or restrictive ones. Forty female hypothyroid patients selected from the endocrine Outpatient Clinic in Kasr El-Aini Hospital were studied. Twenty normal subjects served as the control group. Serum free T3, free T4 and TSH were measured in all subjects to confirm or exclude hypothyroidism. All subjects were subjected to PFT using the microspiro-HI-SO1. PFT included: Vital capacity [VC], forced vital capacity [FVC], forced expiratory volume-1 [FEV1], peak expiratory flow rate [PEFR], forced expiratory flow 25%, 50% and 75% forced expiratory flow 25-75% and maximum voluntary ventilation [MVV]. The results revealed restrictive lung functions in hypothyroid patients in the form of significant decrease in VC%, FVC%, FEVl and MVV% in association with normal FEV1/FVC% in both controlled and uncontrolled hypothyroid. There was significant decrease in PEFR%, FEF25% and FEF25-75% in uncontrolled hypothyroid compared to normal. There was significant negative correlation between TSH and FVC% [r = 0.4 and p = 0.01], FEV1% [r = -0.4 and p = 0.01], PEFR% [r = -0.3 and p = 0.04] and MVV%, [r = -0.4 and p = 0.01]. it was concluded that hypothyroidism causes a predominant restrictive pattern of ventilatory dysfunction, but mixed pattern might occur. These abnormalities in ventilatory dysfunction ameliorated with thyroxin replacement and controlling hypothyroid state

Tumor necrosis factor-alpha and insulin level in obesity

The aim of this study was to measure the plasma level of TNF-alpha in obese subjects in comparison with lean ones as well as to correlate its level with the serum insulin level. Thirty-five subjects with a wide range of values for the body mass index [BMI 18.5 +/- 63 kg/m2] were included in this study. The subjects were divided into two groups according to BMI. For all subjects, serum total cholesterol triglycerides, high density lipoprotein cholesterol [HDL- C], low density lipoprotein cholesterol [LDL-C], serum insulin and plasma level of TNF-alpha were assayed. All subjects had normal glucose tolerance as determined by WHO criteria. The study concluded that the plasma level of TNF-alpha was found elevated in obese subjects and this elevation was related to BMI and insulin resistance. So, TNF-alpha can be considered as a system regulating insulin action in obesity leading to insulin resistance with all its hazards in these patients

Plasminogen activator inhibitor-1, Von Willebrand factor and thrombomodulin in obesity: new cardiovascular risk factors

The objective of the present study was to investigate the presence of endothelial dysfunction in obesity by measuring the plasma levels of plasminogen activator inhibitor-1 [PAI-1] antigen, von Willebrand [vWF] and thrombomodulin [TM] in obese subjects. Fifty-five healthy subjects, aged 20-60 years with a range body mass index [BMI] of 18.5-63 kg/m2, were evaluated for waist hip ratio [WHR], plasma lipids, PAI-I antigen, vWF and TM. The subjects were divided into two groups according to BM: Group 1 [lean and overweight], 20 subjects with BMI of <30 kg/m2 and group II [obese], 35 subjects with BMI of <30 kg/m2. It was concluded that obesity is associated with an endothelial dysfunction leading to an increase in the plasma concentrations of PAI-1 antigen, vWF and TM, thus providing an additional explanation for the higher cardiovascular risk in individuals with obesity