Mnogi autori odnedavno dovode uvezu postojanje elemenata metaboličkog sindroma(MetSy) kod bolesnika sa subkliničkim hipotiredizmom(SH).Cilj:U ovoj studiji preseka smo prikazali elemente MetSy kod novodijagnosktikovanih bolesnica sa SH ipokušali da utvrdimo njihovu povezanost. Istraživanje je obuhvatilo 70 ispitanica, 50 ispitanica sa novootrkivenim SH, i 20 eutiroidnih kontrola. Grupa bolesnica je prema vrednostima glikemije i posle OGTT testa podeljena na dve grupe, bolesnice koje imaju SH , a bez Diabetes mellitusa tip2 (DMT2), i bolesnice koje imaju i SH i DMT2. Kalkulacije su urađene pomoću EXCEL i Med Calc (verzija 9.3.8.0) programa,i pomoću programa SPSS-verzija 17. Dobili smo sledeće rezultate: Bolesnice su značajno starije u odnosu na kontrolnu grupu, imaju više vrednosti za obim struka(OS) i BMI (Index telesne mase ), značajnoveći procenat osoba sa hipertenzijom (62%) i DMT2 (36%),od toga 14% novootkrivenih sa DMT2, dok u kontrolnoj grupi nije bilo DM. Vrednosti glukoze i HbA1c su više u grupi bolesnica u odnosu na kontrolnu grupu, a nema razlike u insulinemiji i HOMA. Očekivano su vrednosti TSH i Anti TPO-At više, a koncentracije FT4 značajno niže kod ispitanica sa SH u odnosu na kontrolnu grupu.Utvrđeno je da postoji korelacija između koncentracije glukoze i TSH u grupi bolesnica,ali ne i u kontrolnoj grupi.Prevalenca MetSy je 25 % kod kontrola i 62 % kod bolesnica. S obzirom na rezultat naše studije preporučuje se odredjivanje glikemije kod svakog bolesnika kod koga je utvrđen SH,i obrnuto,određivanje tiroidnog statusa kod osoba sa DMT2. Takođe se preporučuje lečenje SH po utvrđenim kriterijumima, jer zajedno sa MetSy imaju veći rizik za razvoj kardiovaskularnog događaja.
Cooper D. Clinical Practice. Subclinical hypothyreoidisum. N Engl J Med. 2001;260–5.
2.
Biondi B, Cooper D. The clinical significance of subclinical thyroid dysfunction. Endocrine Reviews. 2008;(1):76–131.
3.
Surks M, Ortiz, Daniels G, Sawin C, Col N, Cobin R. Subclinical thyroid disease: Scientific review and guidelines for diagnosis and menagment. JAMA. 2004;(2):228–38.
4.
Wiersinga W. TSH: Is there a need to redefine the normal range? The thyroid and caridiovascular risk Georg Thieme Verlag. 2005;24–9.
5.
Ross D. Serum TSH measurement for assesment of thyroid function and disease. Endocrinol Metab Clin North Am. 2001;245–64.
6.
Surks M, Goswami G, Daniels G. The thyreotropin reference range should remain unchanged. Journ Clin Endocrin Metab. 2005;(9):5489–96.
7.
Gharib H, Tutle R, Baskin H, Fishlh, Singer P, Msdermott M. Consesus statament : Sublcilical thyroid dysfunction: a joint stetementon menagment from THE AACE,the ETA and the ES. JCEM. 2005;(1):581–858.
8.
Canarais G, Manowitz N, Mayor G, Ridgway E. The Colorado Thyroid disaes prevalence study. Arh Intern Med. 2000;526–3423.
9.
Duntas L. Changes in lipid profile in overt subclinical hypothyroidism. The thyroid and cardiovascular risk. 2005;37–43.
10.
Diekman T, Lansberg P, Kastelein J, Wirzinga W. Prevalence and correction of hypothiroidism in a large cohort of pacient referred for dyslipidemia. Arhives of Internal Medicine. 1995;(14):1490–5.
11.
Duntas L. Thyroid disease and lipids. Thyroid. 2002;287–93.
12.
Iqbal A, Jorde R, Figenschau Y. Serum lipid levels in relation to serum thyroid stimulating hormone and the effect of thyroxine treatment od serum lipid levels in subject with sublinical hypothiroidism :the Tromso Study. J Inter Med. 2006;(1):53–61.
13.
Biondi B, Klein I. Cardiovascular abnormalities in subclinical and overt hypothyroidism The thyroid and cardiovascular risk. 2005;30–4.
14.
Fusio S, Palmieri E, Lombardi G, Biondi B. Hypothyroidism as a risk factor for cardiovascular disease. Recent Prog Horm Res. 2004;31–50.
15.
Rodondi N, Den Elzen W, Bauer D, Cappola A, Razvi S, Walsh J. Subclinical hypothyroidism and risc of coronary heart disease and mortality. JAMA. 2010;(12):1365–74.
16.
Manzani F, Di Bello V, Caraccio N, Bertini A, Giorgi D, Giusti C, et al. Effect of levothyroxine on cardiac function and structure in subclinical hypothyroidism :double blind, placebo controlled study. JCEM. 2001;(3):1110–5.
17.
Dagre A, Lekakis J, Protogerou A, Douridas G, Papaionnou T, Tryfonopoulos D. Abnormal entotheliel function in female patients with hypothyroidism and bordeline thyroid function. Int J Cardiol. 2007;(3):332–8.
18.
Crowly W, Ridgway E, Bough E, Francis G, Daniels G, Kourides I. Noninvasive evaluation of cardiac function in hypothyroidism : response to gradual thyroxine replacement. N Engl J M. 1997;1–6.
19.
Grundy S, Brewar H, Cleeman J, Smith S, Lenfant C. Definition of metabolic syndrome: Report of National Heart,Lung and Blood Institute/American Heart assotiation/.Conference on scientific issues relatided to deffinition. Circualtion. 2004;(3):433–3837.
20.
International Diabetes Federation Metabolic syndrom.
21.
Groop L, Cha Ndola T, Bruner E, Marmot M. Chronic stres at work and the metabolic syndrome: prospective study. Internat.l Journal of Obesity. 2000;332–521.
22.
Narasimhan M, Raynor J. Evidence based perspectiveon metabolic syndrome and use of antipshychotics drug. Beneffit Trends. 2010;77–88.
23.
Dessein P, Gonzales-Gay M, Woodiwiss A, Joffe B, Norton G, Solomon A. The impact of the metaboloc syndrome on cariovascular risc and disease in Rheumatoid arthritis. Future rheumatology. 2008;(4):335–9.
24.
Gisondi P, Tessari G, Conti A. Prevalence od metabolic syndrome in patients with psoriasis : a hospital-based casecontrole study. British Jornal of dermatology. 2007;68–73.
25.
Garduno-Garcia J Dej A, Garcia U, Lopez-Carasco G, Medoza P, Mehta M, Arellano-Campos R, et al. TSH and free thyroxin concentration are associated with differing metabolic markers in euthyroid subjects. Eur J Endocrin. 2010;(2):273–8.
26.
Erdogan M, Cantazoglu A, Ganidagli S, Kulaksizoglu M. Metabolic syndrome prevalence in subclinical and overt hypothyreoid patients and the relation among metabolic parameters. J Endocrin Invest. 2011;(7):488–92.
27.
Tehrani R, Tohidi F, Rostami F, Asgaris M, Azizi F. The association between subclinical hypothyreoidism and metabolic syndrome: a population based stud. IJEM. 2011;(1):98–105.
28.
Agarwal G, Shudakar M, Sing M, Senthial N, Rajerdam A. The prevalence of thyroid dysfunction among South Indian women with metabolic syndrome. Jour Clin Diag Reaserch. 2011;(2):213–6.
Citation
Copyright
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.
