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Journal of Medical Biochemistry
2017, vol. 36, br. 2, str. 127-136
jezik rada: engleski
vrsta rada: izvorni članak
objavljeno: 28/01/2020
PMC ID: PMC5471645
doi: 10.1515/jomb-2017-0007
Uticaj rane supstitucije za supkliničku hipotireozu na biohemijske parametre u krvi i kvalitet života
aVojnomedicinska akademija, Beograd
bVojnomedicinska akademija, Klinika za urgentnu internu medicinu, Beograd
cVojnomedicinska akademija, Klinika za grudnu hirurgiju, Beograd
dPrimary Medical Centre 'Dr Simo Milošević', Belgrade
eVojnomedicinska akademija, Institut za radiologiju, Beograd
fKlinički centar Srbije, Beograd
gKlinički centar Srbije, Klinika za endokrinologiju dijabetes i bolesti metabolizma, Beograd

e-adresa: pandrcmilena@yahoo.com

Sažetak

Uvod: Supklinička hipotireoza (SCH) definiše se kao povišen TSH uz normalne vrednosti tiroksina. Podaci o efektima rane supstitucije na psihofizički status individua sa SCH nisu dovoljno konzistentni da bi podržali njeno uvođenje. Metode: Klinički i biohemijski parametri, kao i kvalitet života mereni su pre intervencije i 3 meseca nakon postizanja eutiroidnog stanja. Rezultati: Zabeležena je značajna redukcija telesne mase (p=0,030), sistolnog i dijastolnog krvnog pritiska (p=0,024, p = 0,019), homocisteina (p < 0,001), leukocita i neutrofila u krvi (p= 0,011, p=0,001), INR-a (p=0,049), nivoa K (p= 0,040, p= 0,013), HbA1c (p= 0,001), insulinemije bazno (p<0,001) i insulinske rezistencije merene HOMA indeksom (p<0,001), lipidnih parametara (ukupnog holesterola (p< 0,001), LDL-holesterola (p<0,001), triglicerida (p=0,007), apoB (p= 0,022), Lp(a) (p<0,001), LDL/HDL (p=0,008), LAP (p=0,04) i apoB/apoA1 (p<0.023)), TSH (p<0,001) i tAbs (p<0.001). Učestalost masne jetre (sa 20% na 2,9%, p=0,016), hiperlipidemije (sa 85% na 65,7%, p=0,001) i metaboličkog sindroma (sa 34,3% na 2,9%, p=0,070) značajno je snižena. Statistički značajna pozitivna povezanost nađena je između prosečne doze levotiroksina i promena u fizičkom funkcionisanju (r=0,391, p=0,020), vitalnosti (r= 0,393, p=0,020), mentalnom zdravlju (r=0,374, p=0,027) i ukupnoj dimenziji mentalnog zdravlja (r=0,376, p=0,026). Sa porastom doze levotiroksina, prethodno navedeni skorovi SF 36 su rasli (r= 0,296, p=0,084). Zaključak: Rana supstitucija supkliničke hipotireoze poboljšava brojne kliničke i biohemijske parametre, koji su u vezi sa kardiovaskularnim rizikom. Kvalitet života je takođe poboljšan i korelira jedino sa dozama levotiroksina, sugerišući indirektnu vezu između dubine hipotiroidnog stanja i kvaliteta života.

Ključne reči

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