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Wisnu W., Alwi I., Nafrialdi N., Harimurti K., Pemayun T.G.D., Jusman S.W.A., Santoso D.I.S., Harahap A.R., Suwarto S., Subekti I. |
57200425452;15055173800;57395824800;23473513200;57208091289;36518792100;6604001213;57395521700;8443626100;24336854300; |
The Differential Effects of Propylthiouracil and Methimazole as Graves’ Disease Treatment on Vascular Atherosclerosis Markers: A Randomized Clinical Trial |
2021 |
Frontiers in Endocrinology |
12 |
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796194 |
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https://www.scopus.com/inward/record.uri?eid=2-s2.0-85122186237&doi=10.3389%2ffendo.2021.796194&partnerID=40&md5=f92b3a12a849c6a2e102b7358c8abd20 |
Division of Endocrine, Metabolism and Di, abetes, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia; Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia; Department of Pharmacology and Therapeutics, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia; Division of Endocrine, Metabolism, and Diabetes, Department of Internal Medicine, Faculty of Medicine, Diponegoro University, Semarang, Indonesia; Department of Biochemistry and Molecular Biology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; Department of Medical Physiology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; Eijkman Institute for Molecular Biology, Jakarta, Indonesia; Division of Tropical and Infectious Disease, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia |
Wisnu, W., Division of Endocrine, Metabolism and Di, abetes, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia; Alwi, I., Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia; Nafrialdi, N., Department of Pharmacology and Therapeutics, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; Harimurti, K., Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia; Pemayun, T.G.D., Division of Endocrine, Metabolism, and Diabetes, Department of Internal Medicine, Faculty of Medicine, Diponegoro University, Semarang, Indonesia; Jusman, S.W.A., Department of Biochemistry and Molecular Biology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; Santoso, D.I.S., Department of Medical Physiology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; Harahap, A.R., Eijkman Institute for Molecular Biology, Jakarta, Indonesia; Suwarto, S., Division of Tropical and Infectious Disease, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia; Subekti, I., Division of Endocrine, Metabolism and Di, abetes, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia |
Background: Hyperthyroidism is related to vascular atherosclerosis. Propylthiouracil (PTU) and methimazole, other than their antithyroid effects, may have different mechanisms in preventing atherogenesis in Graves’ disease. Objective: This study aimed to investigate the effect of antithyroid drugs on markers of vascular atherosclerosis in Graves’ hyperthyroidism. Methods: This study was a single-blind, randomized clinical trial conducted on 36 patients with Graves’ disease in Cipto Mangunkusumo General Hospital, Jakarta, Indonesia, from June 2019 until July 2020. Graves’ disease was diagnosed from clinical manifestation of hyperthyroidism with diffuse goiter and then confirmed by thyroid stimulation hormone (TSH), free T4 (fT4), and TSH-receptor antibody (TRAb) measurements. Participants were randomly assigned to either a PTU or a methimazole treatment group and followed up for 3 months. Markers of vascular atherosclerosis were represented by adhesion molecules [intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and E-selectin], carotid artery stiffness [pulse wave velocity (PWV)], and thickness [carotid intima media thickness (cIMT)]. Results: By the end of the study, 24 participants reached euthyroid condition (13 from the PTU group and 11 from the methimazole group). After 3 months of follow-up, in the PTU group, we noticed an improvement of ICAM-1 [pretreatment: 204.1 (61.3) vs. posttreatment: 141.6 (58.4) ng/ml; p = 0.001], VCAM-1 [837 (707–977) vs. 510 (402–630) ng/ml; p < 0.001] and E-selectin [32.1 (24.1–42.7) vs. 28.2 (21.6–36.8) ng/ml; p = 0.045] in the PTU group. In the methimazole group, only VCAM-1 improvement [725 (565–904) vs. 472 (367–590); p = 0.001] was observed. Meanwhile, we found no significant changes in PWV or cIMT in either group. Conclusion: Antithyroid treatment in Graves’ disease leads to improvement in adhesion molecules, with a lesser effect on methimazole, whereas there were no significant changes in PWV or cIMT. PTU may have a better mechanism compared with methimazole in terms of improving adhesion molecules. Copyright © 2021 Wisnu, Alwi, Nafrialdi, Harimurti, Pemayun, Jusman, Santoso, Harahap, Suwarto and Subekti. |
adhesion molecules; carotid intima media thickness; Graves’ disease; hyperthyroidism; methimazole; propylthiouracil; pulse wave velocity; vascular atherosclerosis |
cell adhesion molecule 1; endothelial leukocyte adhesion molecule 1; propylthiouracil; thiamazole; thyrotropin; adolescent; adult; arterial stiffness; Article; atherosclerosis; blood pressure; clinical article; controlled study; coronavirus disease 2019; echography; electrochemiluminescence immunoassay; enzyme linked immunosorbent assay; female; follow up; Graves disease; human; hyperthyroidism; inflammation; male; middle aged; physical examination; pregnancy; pulse wave velocity; randomized controlled trial; young adult |
Frontiers Media S.A. |
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