Sex-Specific Associations between Thyroid Status, Inflammation and Hemostasis Biomarkers in Patients with Subacute Thyroiditis

Author:

Vekic Jelena1,Klisic Aleksandra23ORCID,Kotur-Stevuljevic Jelena1ORCID,Milinkovic Neda1,Gluscevic Sanja4ORCID,Ciftel Serpil5,Mercantepe Filiz6ORCID

Affiliation:

1. Department for Medical Biochemistry, University of Belgrade Faculty of Pharmacy, 11000 Belgrade, Serbia

2. Faculty of Medicine, University of Montenegro, 81000 Podgorica, Montenegro

3. Center for Laboratory Diagnostics, Primary Health Care Center, 81000 Podgorica, Montenegro

4. Department of Neurology, Clinical Center of Montenegro, 81000 Podgorica, Montenegro

5. Department of Endocrinology and Metabolism, Erzurum Regional Training and Research Hospital, 25100 Erzurum, Turkey

6. Department of Endocrinology and Metabolism, Faculty of Medicine, Recep Tayyip Erdogan University, 53200 Rize, Turkey

Abstract

Background: Subacute thyroiditis (SAT) is characterized by profound inflammation and fluctuations in thyroid hormones which may affect the hemostasis balance. This study investigates sex-specific associations between thyroid status, inflammation and hemostasis biomarkers in SAT. Methods: We included 52 patients (40 women and 12 men) treated with non-steroidal anti-inflammatory drugs (NSAID) or methylprednisolone (MPS). Free thyroxine (fT4), thyroid stimulating hormone, C-reactive protein, complete blood count and routine hemostasis parameters were assessed. Results: Both men and women were in hyperthyroid state and had comparable levels of inflammatory biomarkers. A shortened activated partial thromboplastin time (aPTT) was observed in 16.7% of the men and 10% of the women (p = 0.562), and a shortened prothrombin time (PT) was observed in 33% of the men and 12.5% of the women (p = 0.094). In men, aPTT positively correlated with fT4 (r = 0.627; p < 0.05), while PT positively correlated with leukocyte-based inflammatory indices in women (p < 0.05). NSAID-treated patients had lower aPTTs and platelet counts than those treated with MPS (p < 0.05). Principal component analysis extracted “proinflammatory”, “prothrombotic” and “antithrombotic” factors, but the “proinflammatory” factor was the independent predictor of elevated fT4 in women (OR = 2.705; p = 0.036). Conclusions: Our data demonstrated sex-specific associations of thyroid status and inflammatory biomarkers with hemostasis parameters in SAT. Routine hemostasis screening tests may help in monitoring the changes in the hemostasis system over the course of SAT.

Funder

Ministry of Education, Science and Innovation, Montenegro and the Ministry of Education, Science and Technological Development, Republic of Serbia

Publisher

MDPI AG

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