Faculty of Medicine
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Item type:Publication, Influence of the Subclinical Hypothyroidism on the Left Ventricular Systolic and Diastolic Function (pilot study)(OMICS Publishing Group, 2014); ; ; Introduction: The clinically manifested hypothyroidism is associated with systolic and diastolic dysfunction. Studies investigating the left ventricular function in subclinical hypothyroidism (ScH) have shown controversial results. The aim of the study was to assess whether ScH is associated with the left ventricular systolic and diastolic dysfunction. Material and methods: Seventeen consecutive patients with newly diagnosed ScH and 20 healthy euthyroid patients as controls were analyzed. The two groups were appropriate by: age, sex, and body mass index. Laboratory analyses were performed in all patients - determination of TSH, free thyroxin (FT4), free triijodothyronine (FT3), antibodies directed to thyroid peroxidase (TPOAb) and antitiroglobulin antibodies (TgAb), and the assessment of left ventricular systolic and diastolic function by M-mode, two-dimensional echocardiography, pulse, continuous and color-Doppler, advanced echocardiographic modalities Tissue Doppler (TDI) and two-dimensional speckle tracking. Results: ScH patients had statistically significant lower ejection fraction, smaller ratio s/d (where s is the systolic velocity and d is the diastolic velocity through the pulmonary veins) and lower negative longitudinal global strain compared with the control group (62.1 ± 2.1 vs. 58.7 ± 6.2%, p<0.05, 1.27 ± 0.12 vs. 1.06 ± 0.20, p<0.001, -0.21 ± 0.01 versus -0.19 ± 0.01%, p<0.05, respectively). There was a statistically significant negative correlation of TSH with s/d and S/ TDI (r = 0.43 and r = 0.26, p<0.05, respectively). There was a statistically significant negative correlation of free thyroxine with myocardial performance index (r = -0.17, p<0.05), and a positive correlatin with s/d (r =0.48, p<0.05). Conclusion: ScH was associated with a statistically significant reduction in global systolic and global longitudinal systolic function of the left ventricle. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Dyslipidaemia and hypertension in patients with subclinical hypothyroidism(Macedonian Academy of Sciences and Arts/De Gruyter, 2009-12); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Association between foetal growth and different maternal metabolic characteristics in women with gestational diabetes mellitus(Macedonian Academy of Sciences and Arts/De Gruyter, 2009-12); ; Dimitrovski, ChedomirObjective: The aim of the study was to investigate the association between foetal growth and different maternal metabolic characteristics in women with gestational diabetes mellitus (GDM). Methods: The study group included 200 consecutive pregnant women who attended the Endocrinology, Diabetes and Metabolic Disorders Outpatient Department in the period from 02.2006 to 02.2009 with singleton pregnancy and GDM diagnosed following ADA criteria. The following parameters were studied: pre-pregnancy maternal body mass index (BMI), 3-hours 100g oral glucose tolerance test (OGTT) results, glycosylated haemoglobin (HbA1c), total lipids (TL), total cholesterol (TH), triglycerides (TG), HDL- and LDL-cholesterol levels at admission. Neonatal birth weight and the prevalence of being large for gestational age (LGA) was an end-point. Results: We found a significant association between birth weight and pre-pregnancy BMI, HDL-C and birth weight of a large child born previously. Birth weight of a large child born previously was the strongest independent predictor for LGA. The prevalence of LGA (from 27% to 80%) was related to a number of altered maternal characteristics. Conclusion: Pre-pregnancy BMI, HDL-C and birth weight of a large child born previously are the independent predictors for LGA, but results of glucose levels during OGTT are not useful in the prediction of LGA in GDM pregnancies. Probably more factors and other maternal metabolic parameters than glucose levels during OGTT are responsible for the risk of LGA. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Gestational Diabetes Mellitus - the impact of maternal body mass index and glycaemic control on baby's birth weight(Macedonian Academy of Sciences and Arts/De Gruyter, 2009-12); ; ; Objectives. To asses the influence of the maternal BMI and glycaemic control in women with GDM on the baby's birth weight (BW). Material and methods: We analysed 180 women with GDM. Macrosomia has been defined as BW > 4000 gm, small for gestational age < 2700 gm and appropriate for gestational age between both. According to the baby´s BW the pregnant women were divided into three groups: group 1 (G1) with BW < 2700 gm (n = 26); group 2 (G2) with BW between 2700 to 4000 gm (n = 117), and group 3 (G3) with BW > 4000 gm (n = 37). We also analysed BMI (kg/m²), HbA1c (%), PPG (mmol/L) and time of delivery (WG). Results: Comparisons between G1 and G2 showed: BMI (30.7 ± 5 & 31 ± 5.2; p < 0.7), HbA1c (6.4 ± 0.8 & 5.1 ± 0.8, p < 0.002), PPG (8.2 ± 1.7 & 6.9 ± 1.5, p < 0.02), time of delivery (35.2 ± 3.8 & 38.6 ± 1.5, p < 0.0001) and BW (2289 ± 504 & 3474 ± 334, p < 0.0001). Comparisons between G2 and G3 showed: BMI (31 ± 5. 2 & 33.4 ± 6.1; p < 0.02), HbA1c (5.2 ± 1.1 & 6.4 ± 2.3, p < 0.02), PPG (6.9 ± 1.5 & 8.2 ± 1.9, p < 0.02), time of delivery (38.6 ± 1.5 & 39.3 ± 1.4, p < 0.01) and BW (3474 ± 334 & 4431 ± 302, p < 0.0001). Comparisons between G1 and G3 showed the difference at delivery time and the baby's BW (p < 0.0001). Conclusions: Maternal obesity and PPG contribute to macrosomia and also PPG to SGE. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Prevalence of thyroid dysfunction and autoimmunity in pregnant women with gestational diabetes and diabetes type 1(Macedonian Academy of Sciences and Arts/De Gruyter, 2010-12); ; The aim of the present study was to determine the prevalence of abnormal thyroid function and antithyroid antibodies during pregnancy in women with diabetes type 1 and gestational diabetes mellitus (GDM). - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The effect of thyroid substitution therapy on serum lipids in patients with a mild form of subclinical hypothyroidism(Publicidad Permanyer, SLU, 2023-02-23); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Using 75 g OGTT in Prediction for Macrosomia in Gestational Diabetes Mellitus(OMICS Publishing Group, 2016); ; ; Velkoska Nakova, ValentinaGestational Diabetes mellitus (GDM) is defined as carbohydrate intolerance with diوٴerent degrees of severity which occurs or is recognized for the first time during pregnancy. Fetal birth weight above the 90th percentile for gestational week and newborns weight equal or higher than 4000 g is defined as macrosomia [1]. About 15-45% of babies born from mothers with GDM can have macrosomia, which is 3-fold higher in comparison to normoglycemic controls (12%). Macrosomic infants from mothers with GDM are related to risk of developing overweight, obesity in adulthood, and type 2 diabetes mellitus and cardiovascular diseases later in life. Several studies showed that epigenetic alterations of diوٴerent genes of the fetuses of a GDM mother in utero could result in transgenerational transmission of GDM and type 2 diabetes mellitus [1]. Нus, hyperglycemia begets hyperglycemia. Нere is no doubt that maternal hyperglycemia plays a very important role in fetal overgrowth [1,2]. Нe first hour aіer beginning of the meal is associated as best predictor of subsequent macrosomia [2]. Unlike maternal hyperglycemia, obesity is the strongest and independent predictor for fetal macrosomia [3,4]. Maternal prepregnancy body mass index (BMI) [1], pregnancy weight gain [2], maternal height, maternal age at delivery, hypertension and cigarette smoking have a significant impact. Нe predictive ability of the glucose levels from the 2-h 75-g OGTT in terms of pregnancy outcomes has been investigated little until the HAPO study [5]. Нus, the objective of the mini report is to evaluate the association between glucose levels of 75-g OGTT and perinatal outcomes, in 118 pregnant women who were prospectively screened for GDM between 24 and 28 weeks of pregnancy [6]. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Adrenal Cyst-Diagnostic Dilemma: Case report(2022); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Does mild form of subclinical hypothyroidism needs treatment?(Bioscientifica, 2022-08-17); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Echocardiographic differences between the mild form of subclinical hypothyroidism and healthy subjects(Bioscientifica, 2024-05-06); ; ; Background: Treatment of subclinical hypothyroidism (ScH) when TSH is between the upper reference value and 7mU/L, especially in patients younger than 65 years is controversial. Objectives: To compare the risk factors for atherosclerosis and echocardiographic parameters in patients with ScH1 (4, 2≤TSH≤7mU/L) to euthyroid subjects and patients with ScH2 (TSH>7mU/L). Material and Methods: Prospectively 54 consecutive patients with newly diagnosed ScH (19 with TSH≤7mU/L (ScH1) and 35 with TSH>7mU/L (ScH2)) started for the first time with levothyroxine therapy, and 30 healthy subjects were recruited from the outpatient department of the University Clinic of Endocrinology in Skopje, R. of N. Macedonia. Laboratory analyses and an echocardiography study were done at the first visit and after 5 months in a euthyroid stage in patients with ScH. Results: The mean age and TSH value in ScH group were 43.1±12.4y., and 8.71± 1, 9mU/L. Compared to healthy controls, patients with ScH1 had a higher mean triglycerides and non-HDL-C ratio (1.52±0.9 vs 1.1±0.6, and 4.3±1.1 vs 3.79±0.9, P<0.05), lower E/A ratio (1.05 ± 0.25 vs 1.26 ± 0.36, P<0.05), higher E/e’ sep. ratio (8.56 ± 2.63 vs 6.04 ± 1.64, P< 0.01), higher myocardial performance index (MPI) (0.47 ± 0.09 vs 0.43 ± 0.07, P< 0.05), lower global longitudinal strain (GLS) (-19.34 ± 2.0 vs -20.9 ± 1.7%, P< 0.05), and lower S wave derived by tissue Doppler imaging (0.074 ± 0.01 vs 0.092 ± 0.01 m/s, P< 0.01). Compared to ScH2, patients with ScH1 have lower GLS but without statistical significance. Levothyroxine treatment (L-T4T) in patients with ScH1 contributed to higher EF (61.9 ± 5.2 vs 63.1 ± 4.6%, P< 0.05), lower E/e’ sep. ratio (8.56 ± 2.63 vs 7.21 ± 2.23, P< 0.05), and lower MPI (0.47 ± 0.09 vs 0.43 ± 0.05%, P< 0.05), compared to values in ScH1 patients at baseline. The same parameters were improved in the ScH2 group after L-T4T. Conclusions: In a small study, patients with ScH1 vs healthy individuals had subtle changes in certain parameters that indicate involvement of diastolic function of the left ventricle in ScH, and these parameters improved after L-T4T.