open access

Vol 57, No 6 (2006)
Original papers
Published online: 2006-11-29
Submitted: 2013-02-15
Get Citation

The level of cotinine - marker of tobacco smoking, in patients with hyperthyroidism

Agata Czarnywojtek, Małgorzata Zgorzalewicz-Stachowiak, Ewa Florek, Wojciech Piekoszewski, Izabela Warmuz-Stangierska, Izabela Kulińska-Niedziela, Krzesisława Komar-Rychlicka, Jerzy Sowiński
Endokrynologia Polska 2006;57(6):612-618.

open access

Vol 57, No 6 (2006)
Original papers
Published online: 2006-11-29
Submitted: 2013-02-15

Abstract

Introduction: Orbitopathy associated with Graves’ disease TAO (thyroid associated orbitopathy) is likewise connected with environmental factors including tobacco smoking. Tobacco smoking increases the risk of ophthalmologic pathology and leads to the orbital tissue damage due to the hypoxia. The aim of the study was to correlate the concentration of urinecotinine (marker of tobacco smoking) in Graves’ disease patients with TAO with points received on the Fagerström questionnaire.
Materials and methods: Thirty women with different degree of exacerbation of TAO in Graves’ disease (34.28 ± 12.04 yr.) were examined. As control we used 29 women with Graves’ disease without TAO (29.35 ± 12.33 yr.). The diagnosis was established according to level of TSH and level of thyrotropin receptor antibodies (TRAb). Measure of tobacco smoking or exposure to second hand tobacco smoke ETS (environmental tobacco smoke) carried out according to the Fagerström questionnaire, and measured cotinine level (the major metabolite of nicotine in urine). The level of clinical ophtalmopathy was measured according to the CAS (Clinical Activity Score) scale and degree of progression of TAO according to American Thyroid Association (NOSPECS scale). Additionally increase of exophthalmus was measured using the Hertl’s exophthalmometer.
Results: In the group with TAO: 19 (63.3%) persons had mild exophthalmos (according to CAS), medium in 13 (43.3%) patients, and pronounced exophthalmous in 10 (33%) patients. There was statistically significant difference in the level of TRAb (18.4 &plusmn; 8.2 vs. 5.1 &plusmn; 3.4 IU/l; p < 0.0001) between TAO and controls. There was no correlation between TSH (0.6 &plusmn; 0.02 vs. 0.4 &plusmn; 0.04; p = 0.18) and fT4 (38.8 &plusmn; 29.3 vs. 26.1 &plusmn; 17.3; p = 0.026) in both analyzed groups. Smokers and non-smokers with TAO had no statistically significant in level of TRAb (Mann-Whitney test p = 0.16). No correlation was found between smoking tobacco (cotinine level) and the level of TRAb in patients with TAO (Pearson r = 0.28 p = 0.58). There was a statistically significant difference between the level of urine cotinine in smoking patients with TAO in the highest level of ophthalmopathy exacerbation (> 24 mm; &#8805; 4 points according to CAS) and those without TAO (Mann-Whitney&#8217;s test p = 0.04).
Conclusions: 1. In patients with Graves&#8217; disease with TAO the highest score of tobacco smoking has been found in persons with the highest ophthalmopathy exacerbation.
2. Estimation of cotinine concentration in urine is the most objective and useful method of tobacco smoking.

Abstract

Introduction: Orbitopathy associated with Graves&#8217; disease TAO (thyroid associated orbitopathy) is likewise connected with environmental factors including tobacco smoking. Tobacco smoking increases the risk of ophthalmologic pathology and leads to the orbital tissue damage due to the hypoxia. The aim of the study was to correlate the concentration of urinecotinine (marker of tobacco smoking) in Graves&#8217; disease patients with TAO with points received on the Fagerström questionnaire.
Materials and methods: Thirty women with different degree of exacerbation of TAO in Graves&#8217; disease (34.28 &plusmn; 12.04 yr.) were examined. As control we used 29 women with Graves&#8217; disease without TAO (29.35 &plusmn; 12.33 yr.). The diagnosis was established according to level of TSH and level of thyrotropin receptor antibodies (TRAb). Measure of tobacco smoking or exposure to second hand tobacco smoke ETS (environmental tobacco smoke) carried out according to the Fagerström questionnaire, and measured cotinine level (the major metabolite of nicotine in urine). The level of clinical ophtalmopathy was measured according to the CAS (Clinical Activity Score) scale and degree of progression of TAO according to American Thyroid Association (NOSPECS scale). Additionally increase of exophthalmus was measured using the Hertl&#8217;s exophthalmometer.
Results: In the group with TAO: 19 (63.3%) persons had mild exophthalmos (according to CAS), medium in 13 (43.3%) patients, and pronounced exophthalmous in 10 (33%) patients. There was statistically significant difference in the level of TRAb (18.4 &plusmn; 8.2 vs. 5.1 &plusmn; 3.4 IU/l; p < 0.0001) between TAO and controls. There was no correlation between TSH (0.6 &plusmn; 0.02 vs. 0.4 &plusmn; 0.04; p = 0.18) and fT4 (38.8 &plusmn; 29.3 vs. 26.1 &plusmn; 17.3; p = 0.026) in both analyzed groups. Smokers and non-smokers with TAO had no statistically significant in level of TRAb (Mann-Whitney test p = 0.16). No correlation was found between smoking tobacco (cotinine level) and the level of TRAb in patients with TAO (Pearson r = 0.28 p = 0.58). There was a statistically significant difference between the level of urine cotinine in smoking patients with TAO in the highest level of ophthalmopathy exacerbation (> 24 mm; &#8805; 4 points according to CAS) and those without TAO (Mann-Whitney&#8217;s test p = 0.04).
Conclusions: 1. In patients with Graves&#8217; disease with TAO the highest score of tobacco smoking has been found in persons with the highest ophthalmopathy exacerbation.
2. Estimation of cotinine concentration in urine is the most objective and useful method of tobacco smoking.
Get Citation

Keywords

tobacco smoking; hyperthyroidism; Graves’ disease; cotinine

About this article
Title

The level of cotinine - marker of tobacco smoking, in patients with hyperthyroidism

Journal

Endokrynologia Polska

Issue

Vol 57, No 6 (2006)

Pages

612-618

Published online

2006-11-29

Bibliographic record

Endokrynologia Polska 2006;57(6):612-618.

Keywords

tobacco smoking
hyperthyroidism
Graves’ disease
cotinine

Authors

Agata Czarnywojtek
Małgorzata Zgorzalewicz-Stachowiak
Ewa Florek
Wojciech Piekoszewski
Izabela Warmuz-Stangierska
Izabela Kulińska-Niedziela
Krzesisława Komar-Rychlicka
Jerzy Sowiński

Important: This website uses cookies.tanya dokter More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Via MedicaWydawcą serwisu jest  "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl