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Učestalost drugih endokrinih poremećaja u hipotiroidizmu
aUniverzitet u Beogradu, Medicinski fakultet, KBC 'Bežanijska kosa'
bnema

e-adresajbjekic@yahoo.com
Projekat:
Uloga steroidnih hormona u neuroendokrinoj adaptaciji na stres i patofiziologiji metaboličkog sindroma - molekularni mehanizmi i kliničke implikacije (MPNTR - 41009)

Ključne reči: hipotireoza; supklinička hipotireoza; TSH; FT4; endokrini poremećaji
Sažetak
Hipotiroidizam predstavlja stanje snižene proizvodnje, poremećene raspodele ili izostanka dejstva tiroidnih hormona. Klinička dijagnoza hipotiroidizma nije uvek jednostavna zbog nespecifičnosti kliničkih manifestacija. Određivanje TSH u serumu predstavlja test prve linije za dijagnozu hipotiroidizma. Cilj rada je bio da se utvrdi prisustvo drugih endokrinih oboljenja i poremećaja u bolesnika sa supkliničkom (nivo TSH od 5 do 10 mIU/l) ili kliničkom (TSH veći od 10 mIU/l) formom hipotiroidizma. Analizirano je 50 bolesnika (35 sa kliničkom hipotireozom i 15 sa supkliničkom formom bolesti). Kod svih bolesnika su utvrđeni antropometrijski podaci (starost, pol, telesna težina i visina, indeks telesne mase, arterijski krvni pritisak i puls) i klinički znaci hipotireoze (kožne promene, poremećaj menstrualnog ciklusa). Iz uzorka krvi na tašte određivani su FT4, sTSH, glikemija, lipidi, jonizovani kalcijum, PTH, kortizol, ACTH, prolaktin, gonadotropini, estradiol u žena u reproduktivnom periodu i testosteron kod muškaraca. Kožne promene bile su retko zastupljene. Oligomenoreja je bila češće prisutna u supkliničkoj hipotireozi, a menopauza u kliničkoj formi bolesti. Vrednosti krvnog pritiska su bile normalne kod svih bolesnika. Kod bolesnika sa kliničkom hipotireozom u odnosu na bolesnike sa supkliničkom formom bile su više vrednosti TSH (19.5 ± 5.7 vs. 5.9 ± 0.3 mIU/l) i viša doza primenjivanog L-tiroksina (81.2 ± 4.6 vs. 21.4 ± 3.5 mg/dan). Poremećaj glikoregulacije bio je prisutan kod 18% bolesnika. Ukupni holesterol i LDL je bio statistički neznačajno viši kod bolesnika sa hipotiroidizmom u odnosu na supkliničku formu bolesti, dok se vrednosti FT4, kalcijuma, PTH, kortizola, ACTH, gonadotropina, estradiola i testosterona nisu razlikovale među grupama. Ukazano je na proaterogenu povezanost nivoa estradiola i triglicedira kod žena sa kliničkom formom bolesti.
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O članku

jezik rada: srpski, engleski
vrsta rada: neklasifikovan
DOI: 10.5937/medgla1243029B
objavljen u SCIndeksu: 01.05.2012.

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