Метаболічний синдром і тиреоїдна дисфункція

Abstract

Незважаючи на велику кількість існуючих літературних даних і результатів клінічних досліджень , враховуючи високу поширеність патології щитоподібної залози і метаболічного синдрому в популяції, вивчення зв'язку цих захворювань є актуальним з метою поліпшення діагностики та лікування; Несмотря на большое количество существующих литературных данных и результатов клинических исследований в этой области, учитывая высокую распространенность патологии щитовидной железы и метаболического синдрома в популяции, изучение связи этих заболеваний является актуальным с целью улучшения диагностики и лечения; Today metabolic syndrome (MS) is one of the priority issues of medicine and leads to negative social and health consequences. Subclinical thyroid dysfunction (TG) can lead to the formation of metabolic syndrome components. Among the new candidates for the role of metabolic syndrome components —thyroid-stimulating hormone (TSH), a marker of the functional state of thyroid axis. All major components of the metabolic syndrome is closely related to the functional state of the thyroid gland (TG). In active influence on energy balance, lipid and carbohydrate metabolism, weight thyroid hormones influence the cardiovascular system including blood pressure (BP), blood coagulation. Thyroid dysfunction (TD), according to many epidemiological studies, is quite common in the population. According to the Ministry of Health of Ukraine, over the past 5 years, the number of patients with thyroid dysfunction increased 5 times, more than 3, 5 million people in Ukraine are at the dispensary with various thyroid disorders and 70% of Ukraine's population suffers from iodine deficiency. The prevalence of hypothyroidism in the population, according to various researchers, is from 0.1 to 10% and is characterized by a significant increase among older women due to the presence of first regions with iodine deficiency as well, is important genetic predisposition, unfavorable environmental conditions, smoking, increasing the number of consumed drugs. Men rarely hypothyroidism register, its prevalence is only 2% and increases with age prevalence of hypothyroidism is greater than hyperthyroidism, 7-10 times. General worldwide prevalence of hypothyroidism manifest in all population reached 2.3% of cases, whereas subclinical hypothyroidism (CG) in women regardless of age averaged 10% and over 60 increases to 20%. Men rarely hypothyroidism register, its prevalence is only 2% and increases with age CG clinical significance due to the fact that during the first year 5-15% of SG becomes manifest in form of cardiovascular complications in 70-80% of cases. At manifest hypothyroidism the cardiovascular diseases (CVD) have progressed faster. Patients with subclinical hypothyroidism and cardiovascular disease are more likely to exercise than euthyroid. Individuals with subclinical thyroid disease have a higher risk of death. It is known, that the presence thyreopathy in women 45-55 years increases the risk of their metabolic syndrome over the next five years, especially in the presence of progressive obesity in combination with hyperglycemia, bilateral ovariectomy and burdened heredity of obesity, hypertension and diabetes. The total incidence of thyroid pathology in the first five years of menopause is independent of its cause, the maximum in the first year and reduced by fourth-fifth year. In the structure of morbidity leading diffuse endemic goiter (43.2%), especially in the first year, as after natural and after surgical menopause. At menopause duration more than one year thyreopathy iodine deficiency were more common after surgery than after natural menopause. The incidence of hypothyroidism due to autoimmune thyroiditis after surgical menopause maximum in the first year, and then of course —in the first two years. Among the new candidates for the role of metabolic syndrome components - thyroid-stimulating hormone (TSH), thyroid functional status marker. All major axis components of the metabolic syndrome is closely related to the functional state of the thyroid gland (TG). In active influence on energy balance, lipid and carbohydrate metabolism [, weight, thyroid hormones largely determine the cardiovascular system, including blood pressure (BP), blood coagulation in euthyroid conditions. Showing involved of thyroid hormones in the formation of insulin resistance (IR) . Over-production of thyroid hormones, accompanied of sympathetic activity associated with IP, with euthyroid normal insulin secretion. Role of hypothyroidism of MS confirmed IP 75% of women with hypothyroidism compensation. Euthyroid found negative correlation with T4 index HOMA-IR and atherogenic lipids. These data support the role of TSH as one of the components of metabolic syndrome. Thyroid hormones have a direct effect on the contractile function of the myocardium, and through interaction with the sympathetic nervous system changes the peripheral circulation. T3 is "kardiospecific” hormone and promotes left ventricular hypertrophy, coronary vessels spasm, prolonging ischemia by increasing oxygen consumption. So, given the high prevalence of thyroid disease and metabolic syndrome in the population, the study of the relationship of these diseases is urgent to improve diagnosis and treatment.