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Pogostejše pojavljanje srčno-žilnih zapletov pri bolnikih s hipertirozo zaradi bazedovke kot pri bolnikih s hipertirozo zaradi subakutnega tiroiditisa
Get PDFBackground: Hyperthyroidism, as well as systemic inflammation, are associated with a higher incidence and complications of cardiovascular disease. Both in Graves’ disease and subacute thyroiditis, patients are hyperthyroid. However, in Graves’ disease, there is an autoimmune process in the thyroid, and in subacute thyroiditis, hyperthyroidism is accompanied by systemic inflammation. It is not known if the rate of cardiovascular complications is higher in the course of Graves’ disease or subacute thyroiditis. Methods: We performed a retrospective study of all hyperthyroid patients newly diagnosed with Graves’ disease or subacute thyroiditis between January 1st 2018 and December 31st 2021 at the Department of Nuclear Medicine, University Medical Centre Ljubljana. Cardiovascular complications in the period 3 months before or after diagnosis were registered. Values are expressed as mean (SD). Results: The sample analysis included 1028 patients (247 with subacute thyroiditis, 781 with Graves’ disease). The two groups did not significantly differ by sex, age, and body mass index. A cardiovascular complication was registered in 78 patientsthe incidence was significantly higher in Graves’ disease than in subacute thyroiditis (74 vs. 4, p<0.001). Compared to patients with subacute thyroiditis, patients with Graves’ disease had significantly lower TSH: 0.010 (0.006) vs. 0.024 (0.044) mIU/L (p<0.001), higher free T4: 44.1 (26.6) vs. 37.0 (14.7) pmol/L (p<0.001), higher incidence of diabetes: 4.3 vs. 0.4% (p=0.001), arterial hypertension: 12.2 vs. 5.7% (p=0.004) and smoking: 26.7 vs. 8.7% (p<0.001). In a logistic regression model, a significantly higher likelihood for cardiovascular complications was found in Graves’ disease vs. subacute thyroiditis (odds ratio 5.82, p=0.001), in patients with arterial hypertension (odds ratio 2.83, p=0.002), and in those with higher body mass index (odds ratio 0.92, p=0.043). Conclusion: We report a higher incidence of cardiovascular complications in hyperthyroid patients with Graves’ disease in comparison to hyperthyroid patients with subacute thyroiditis. Patients with Graves’ disease were more severely hyperthyroid and had more adverse cardiovascular risk factors.Izhodišče: Povezava med hipertirozo in večjim tveganjem za pojav in zaplete srčno-žilnih bolezni je znana, prav tako pa tudi povezava med okužbami oz. vnetjem in srčno-žilnimi dogodki. Pri subakutnem tiroiditisu se v klinični sliki prepletata tako hipertiroza kot sistemsko vnetje, pri bazedovki pa gre za avtoimunski vnetni proces, ki je omejen na ščitnico. Zaenkrat ni znano, ali se srčno-žilni dogodki pogosteje pojavljajo pri bolnikih s hipertirozo zaradi bazedovke ali zaradi subakutnega tiroiditisa.Metode: V retrospektivni raziskavi smo zbrali podatke vseh bolnikov s hipertirozo in bazedovko ali subakutnim tiroiditi-som, ki so bili na Kliniki za nuklearno medicino UKC Ljubljana prvič obravnavani v obdobju med januarjem 2018 in de-cembrom 2021, in so v obdobju 3 mesecev pred postavitvijo diagnoze ali po njej doživeli srčno-žilni dogodek. Vrednosti so izražene kot povprečje (SD).Rezultati: V analizo je bilo vključenih 1.028 bolnikov (247 s subakutnim tiroiditisom, 781 z bazedovko). Skupini se po spo-lu, starosti in indeksu telesne mase nista statistično pomembno razlikovali. Srčno-žilni dogodek je doživelo 78 bolnikov, od tega statistično značilno več v skupini z bazedovko (4 s subakutnim tiroiditisom, 74 z bazedovko, p<0,001). Bolniki z bazedovko so imeli v primerjavi z bolniki s subakutnim tiroiditisom značilno nižji TSH: 0,010 (0,006) proti 0,024 (0,044) mIU/L (p<0,001), višji prosti T4: 44,1 (26,6) proti 37,0 (14,7) pmol/L (p<0,001), večjo pojavnost sladkorne bolezni: 4,3 % proti 0,4 % (p=0,001), arterijske hipertenzije: 12,2 % proti 5,7 % (p=0,004) in kajenja: 26,7 % proti 8,7 % (p<0,001). Model logistične regresije je pokazal, da je tveganje za pojav srčno-žilnega dogodka značilno večje v skupini z bazedovko kot v skupini s subakutnim tiroiditisom (razmerje obetov 5,82, p=0,001), pri bolnikih z arterijsko hipertenzijo (razmerje obetov 2,83, p=0,002) in višjim indeksom telesne mase (razmerje obetov 0,92, p=0,043).Zaključek: Srčno-žilni dogodki se pojavljajo statistično značilno pogosteje pri bolnikih s hipertirozo in bazedovko kot pri bolnikih s hipertirozo in subakutnim tiroiditisom. Bolniki z bazedovko so bolj hipertirotični in imajo več neugodnih dejav-nikov tveganja za razvoj srčno-žilnih bolezn
Razprave / Akademija znanosti in umetnosti v Ljubljani, Filozofsko-filološko-historični razred
Get PDFAddressing climate challenges through the valorisation of calamity wood in the alps-adriatic region
Get PDFThe WoodInnovate project addresses pressing challenges facing the forest-wood value chain in the Alps-Adriatic region, which are intensifying due to climate change. Rising temperatures and frequent natural disasters are degrading wood quality and increasing pest outbreaks, particularly from bark beetles. These environmental shifts jeopardize forest ecosystems, reduce the economic viability of timber harvesting, and compromise regional sustainability. WoodInnovate aims to assess and enhance the utilization of storm- and pest-damaged wood through advanced modification techniques, innovative product design, and strategic cross-border collaboration. The project explores climate-resilient tree species and determines optimal uses for lower-grade wood. Stakeholder involvement is essential, including academic institutions, forestry clusters, and industry partners from Italy and Slovenia. Activities include pilot tests, prototype development, knowledge transfer, and regional workshops. The ultimate goal is to transform wood waste from environmental catastrophes into valuable resources, fostering a circular economy and reinforcing forest resilience. The project contributes to climate adaptation strategies while promoting economic revitalization through sustainable material innovation. By enabling cross-sector collaboration, WoodInnovate not only strengthens the forest-wood value chain but also supports EU green objectives, making wood from damaged trees a tool for environmental and social progress
