Öz
Giriş: Tiroid bezinden salgılanan tiroid hormonları vücudun tüm sistemleri üzerine etkilidir. Magnezyum çoğu enzimin kofaktörü olup önemli bir katyondur. Tiroid hormonları ile magnezyum ilişkisi günümüzde halen gizemini korumaktadır. Sunulan bu çalışmada magnezyum ile tiroid stimüle edici hormon (TSH) ve serbest tiroksin (sT4) ilişkisinin araştırılması amaçlanmıştır. Yöntem: Bu araştırma Prof. Dr. Cemil Taşcıoğlu Şehir Hastanesi Dahiliye Polikliniğine herhangi bir sebeple başvuran ve serum magnezyum seviyesi ile tiroid fonksiyon testleri çalışılmış hastaları kapsayan retrospektif bir çalışma olarak planlanmıştır. Araştırma kapsamında bilgi işlem birimi aracılığıyla hastane veri sistemindeki kayıtlar kullanılarak 01.10.2018-01.10.2020 tarihleri arasında dahiliye polikliniğine başvuran hastaların dosyaları incelendi. Araştırmaya alınma kriterlerine uyan 18 yaş üzerindeki 2704 hasta ile çalışma tamamlandı.Bulgular: Katılımcıların %76’sı (n=2061) kadın, %24’ü (n=643) erkek olup, yaş ortalamaları 43,31±15,34 (min=18, max=95) yaş idi. Erkek cinsiyette serum magnezyum değeri (p<0,001), serbest T4 (p=0,021) kadın cinsiyetten istatistiksel olarak anlamlı derecede daha yüksekti. TSH değeri ise kadınlarda erkeklerden (p=0,004) istatistiksel olarak anlamlı derecede daha yüksekti. Serum magnezyum değeri ile TSH arasında korelasyon yok iken (r=0,028, p=0,139), serbest T4 arasında negatif yönde zayıf güçte önemli bir ilişki var idi (r=-0,052, p=0,006). Serbest T4 ile TSH arasında negatif yönde orta güçte önemli bir korelasyon tespit edildi (r=-0,273**, p<0,001). Sonuç: Bu çalışmanın iki sonucu vardır. Birincisi; kadın hipotiroidik hastalarda serum magnezyum düzeyi mutlaka bakılmalıdır. İkincisi; hipertiroidi hastası olmayan çalışma grubumuzda magnezyum düzeyi ile sT4 düzeyi arasında saptadığımız negatif yöndeki ilişki bize magnezyum düzeyi arttıkça sT4 düzeyinin düştüğünü gösterir. Bu durum magnezyumun sT4’ün yıkımında rol oynayabileceğini muhtemelen de deiyodinaz enzim aktivitesini artırdığı olasılığını düşündürmektedir.
Anahtar Kelimeler
Magnezyum tiroid serbest tiroksin tiroid stimüle edici hormon
Kaynakça
- 1. Albi E, Krüger M, Hemmersbach R, Lazzarini A, Cataldi S, Codini M, et al. Impact of Gravity on Thyroid Cells. Int J Mol Sci. 2017;18(5):972.
- 2. Kolanu BR, Vadakedath S, Boddula V, Kandi V. Activities of Serum Magnesium and Thyroid Hormones in Pre-, Peri-, and Post-menopausal Women. Cureus. 2020;12(1):e6554.
- 3. Zheltova AA, Kharitonova MV, Iezhitsa IN, Serebryansky EP, Evsyukov OY, Spasov AA et al. Low magnesium diet alters distribution of macroelements and trace elements in tissues and organs of female rats. J Trace Elem Med Biol. 2017;39:36-42.
- 4. MoránMR, Mendía LES, Gómez CIG, Romero FG. Oral Magnesium Supplementation and Metabolic Syndrome: A Randomized Double-Blind Placebo-Controlled Clinical Trial. Adv Chronic KidneyDis. 2018;25(3):261-266.
- 5. SamuelsMH, KolobovaI, AntosikM, NiederhausenM, PurnellJQ, Schuff KG. Thyroid Function Variation in the Normal Range, Energy Expenditure, and Body Composition in L-T4-Treated Subjects. J Clin Endocrinol Metab. 2017;102(7):2533-2542.
- 6. Kravchenko V, Andrusyshyna IM, Luzanchuk IA, Polumbryk MO, TarashchenkoYM. Association Between Thyroid Hormone Status and Trace Elements in Serum of Patients with Nodular Goiter. Biol Trace Elem Res. 2020;196(2):393-399.
- 7. Klatka M, Grywalska E, Partyka M, Charytanowicz M, Rolinski J. Impact of methimazole treatment on magnesium concentration and lymphocytes activation in adolescents with Graves’ disease. Biol Trace Elem. Res. 2013;153:155–170.
- 8. Sridevi D, Dambal AA, Challa AS, Padaki SK. A Study of serum magnesium, calcium and phosphorus in hypothyroidism. IJCBR. 2016;3:236–239
- 9. Wang K, Wei H, Zhang W, Li Z, Ding L, Yu T, et al. Severely low serum magnesium is associated with increased risks of positive anti-thyroglobulin antibody and hypothyroidism: A cross-sectionalstudy. SciRep. 2018;8(1):9904.
- 10. Ihnatowicz P, Drywień M, Wątor P, Wojsiat J. The importance of nutritional factors and dietary management of Hashimoto's thyroiditis. Ann Agric Environ Med. 2020;27(2):184-193.
- 11. Dolan K, Finley H, Gasta M, Houseman S. Managing Hashimoto's Thyroiditis Through Personalized Care: A Case Report. Altern Ther Health Med. 2018;24(3):56-61.
- 12. Kawicka A, Ilow BR. Metabolic disorders and nutritional status in autoimmune thyroid diseases. Postepy Hig Med Dosw. 2015;69:80-90.
- 13. Talebi S, Ghaedi E, Sadeghi E, Mohammadi H, Hadi A, Clark CCT, et al. Trace Element Status and Hypothyroidism: A Systematic Reviewand Meta-analysis. BiolTrace Elem Res. 2020;197(1):1-14.
- 14. Baydas B, Karagoz S, Meral I. Effects of oral zinc and magnesium supplementation on serum thyroid hormone and lipid levels in experimentally induced diabetic rats. BiolTrace Elem Res. 2002;88(3):247-53.
- 15. Chandra AK, Goswami H, Sengupta P. Effects of magnesium on cytomorphology and enzyme activities in thyroid of rats. Indian J ExpBiol. 2014;52(8):787-92.
- 16. Abbas AM, Sakr HF. Effect of magnesium sulfate and thyroxine on inflammatory markers in a rat model of hypothyroidism. Can J Physiol Pharmacol. 2016;94(4):426-32.
Öz
Introduction: Thyroid hormones secreted from the thyroid gland are effective on all systems of the body. Magnesium, an important cation, is the cofactor of most of the enzymes. The relationship between thyroid hormones and magnesium remains a mystery today. This study aims to investigate the relationship between serum magnesium and thyroid-stimulating hormone (TSH) and free thyroxine (fT4) levels. Method: This retrospective study was conducted on patients who applied to the Internal Medicine Outpatient Clinic of Cemil Taşcıoğlu City Hospital for any reason and whose serum magnesium level and thyroid function tests were evaluated. The hospital records of the patients who applied to the internal medicine outpatient clinic between 01.10.2018 and 01.10.2020 were examined. The study was accomplished with 2704 patients over the age of 18 who met the inclusion criteria. Results: Of the participants, 76% (n=2061) were female, 24% (n = 643) were male, and their average age was 43.31 ± 15.34 (min = 18, max = 95) years. Serum magnesium (p <0.001) and free T4 (p = 0.021) levels in male patients were statistically significantly higher than the female patients. TSH values were statistically significantly higher in females than males (p = 0.004). While there was not any correlation between serum magnesium and TSH levels (r = 0.028, p = 0.139), there was a weak negative correlation between magnesium and fT4 levels (r = -0.052, p = 0.006). A moderate negative correlation was found between fT4 and TSH levels (r = -0.273 **, p <0.001). Conclusion: This study has two conclusions. First; serum magnesium level should be measured in women with hypothyroidism. Second; the negative relationship found between magnesium and fT4 levels in our study group without hyperthyroidism shows us that as the magnesium level increases, the fT4 level decreases. This suggests the possibility that magnesium may play a role in the clearance of fT4 and possibly increase the deiodinase enzyme activity.
Anahtar Kelimeler
Magnesium thyroid free thyroxine thyroid stimulating hormone
Kaynakça
- 1. Albi E, Krüger M, Hemmersbach R, Lazzarini A, Cataldi S, Codini M, et al. Impact of Gravity on Thyroid Cells. Int J Mol Sci. 2017;18(5):972.
- 2. Kolanu BR, Vadakedath S, Boddula V, Kandi V. Activities of Serum Magnesium and Thyroid Hormones in Pre-, Peri-, and Post-menopausal Women. Cureus. 2020;12(1):e6554.
- 3. Zheltova AA, Kharitonova MV, Iezhitsa IN, Serebryansky EP, Evsyukov OY, Spasov AA et al. Low magnesium diet alters distribution of macroelements and trace elements in tissues and organs of female rats. J Trace Elem Med Biol. 2017;39:36-42.
- 4. MoránMR, Mendía LES, Gómez CIG, Romero FG. Oral Magnesium Supplementation and Metabolic Syndrome: A Randomized Double-Blind Placebo-Controlled Clinical Trial. Adv Chronic KidneyDis. 2018;25(3):261-266.
- 5. SamuelsMH, KolobovaI, AntosikM, NiederhausenM, PurnellJQ, Schuff KG. Thyroid Function Variation in the Normal Range, Energy Expenditure, and Body Composition in L-T4-Treated Subjects. J Clin Endocrinol Metab. 2017;102(7):2533-2542.
- 6. Kravchenko V, Andrusyshyna IM, Luzanchuk IA, Polumbryk MO, TarashchenkoYM. Association Between Thyroid Hormone Status and Trace Elements in Serum of Patients with Nodular Goiter. Biol Trace Elem Res. 2020;196(2):393-399.
- 7. Klatka M, Grywalska E, Partyka M, Charytanowicz M, Rolinski J. Impact of methimazole treatment on magnesium concentration and lymphocytes activation in adolescents with Graves’ disease. Biol Trace Elem. Res. 2013;153:155–170.
- 8. Sridevi D, Dambal AA, Challa AS, Padaki SK. A Study of serum magnesium, calcium and phosphorus in hypothyroidism. IJCBR. 2016;3:236–239
- 9. Wang K, Wei H, Zhang W, Li Z, Ding L, Yu T, et al. Severely low serum magnesium is associated with increased risks of positive anti-thyroglobulin antibody and hypothyroidism: A cross-sectionalstudy. SciRep. 2018;8(1):9904.
- 10. Ihnatowicz P, Drywień M, Wątor P, Wojsiat J. The importance of nutritional factors and dietary management of Hashimoto's thyroiditis. Ann Agric Environ Med. 2020;27(2):184-193.
- 11. Dolan K, Finley H, Gasta M, Houseman S. Managing Hashimoto's Thyroiditis Through Personalized Care: A Case Report. Altern Ther Health Med. 2018;24(3):56-61.
- 12. Kawicka A, Ilow BR. Metabolic disorders and nutritional status in autoimmune thyroid diseases. Postepy Hig Med Dosw. 2015;69:80-90.
- 13. Talebi S, Ghaedi E, Sadeghi E, Mohammadi H, Hadi A, Clark CCT, et al. Trace Element Status and Hypothyroidism: A Systematic Reviewand Meta-analysis. BiolTrace Elem Res. 2020;197(1):1-14.
- 14. Baydas B, Karagoz S, Meral I. Effects of oral zinc and magnesium supplementation on serum thyroid hormone and lipid levels in experimentally induced diabetic rats. BiolTrace Elem Res. 2002;88(3):247-53.
- 15. Chandra AK, Goswami H, Sengupta P. Effects of magnesium on cytomorphology and enzyme activities in thyroid of rats. Indian J ExpBiol. 2014;52(8):787-92.
- 16. Abbas AM, Sakr HF. Effect of magnesium sulfate and thyroxine on inflammatory markers in a rat model of hypothyroidism. Can J Physiol Pharmacol. 2016;94(4):426-32.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | İç Hastalıkları |
| Bölüm | Orijinal Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 10 Eylül 2021 |
| Gönderilme Tarihi | 18 Mayıs 2021 |
| Yayımlandığı Sayı | Yıl 2021 Cilt: 15 Sayı: 3 |
Sağlığın ve birinci basamak bakımın anlaşılmasına ve geliştirilmesine katkıda bulunacak yeni bilgilere sahip yazarların İngilizce veya Türkçe makaleleri memnuniyetle karşılanmaktadır.