Features of the influence of subclinical hypothyroidism on the cardiovascular system.

Authors

  • N. O. Pertseva
  • K. М. Еiner

DOI:

https://doi.org/10.26641/2307-0404.2017.4.117667

Keywords:

Subclinical hypothyroidism, lipid metabolism, postprandial hyperlipemia, endothelial dysfunction, variability of arterial pressure, tissue dopplerography, segmenary diastolic function

Abstract

Dysfunction of the thyroid gland has serious consequences for the state of the cardiovascular system. In conditions of deficiency of thyroid hormones, the production of a number of cellular enzymes decreases, that leads to the development of dyslipidemia, insulin resistance, endothelial dysfunction, arterial hypertension, abnormalities in the blood coagulation system, oxidative stress. is a risk factor for cardiovascular disease because associated with dyslipidemia, insulin resistance, arterial hypertension, oxidative stress, endothelial dysfunction, disorders in the blood coagulation system and, thus, atherosclerosis. Subclinical hypothyroidism, as a risk factor for cardiovascular disease, does not have a specific symptomatology, it remains unrecognized for a long time, and by the time the development of manifest hypothyroidism leads to irreversible changes in the cardiovascular system. Detection of abnormalities at the phase of subclinical hypothyroidism and the timely assignment of replacement therapy will avoid an additional risk of cardiovascular pathology. The absence of a unified position in regard to subclinical hypothyroidism does not allow to adopt clear clinical recommendations. Data on the efficacy and need for levothyroxine replacement therapy are contradictory due to the absence of randomized clinical trials. This review article examines mechanisms of the influence of subclinical hypothyroidism on various types of metabolism, methods of diagnosing disorders caused by subclinical hypothyroidism and their modification under the influence of replacement therapy.

 

Author Biographies

N. O. Pertseva

SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine»
Department of Endocrinology
Pastera str., 26, Dnipro, 49000, Ukraine

K. М. Еiner

SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine»
Department of Endocrinology
Pastera str., 26, Dnipro, 49000, Ukraine

References

1. Vernygorodsky VS, Fetisova NM, Verni­gorod­skaya MV. [Proinflammatory cytokines and their role in the development of cardiovascular complications in patients with hypothyroidism]. Rus. Med-biol. Known. them. Acad. IP Pavlova. 2013;2:93-96. Russian. doi: http://dx.doi.org/10.17816/PAVLOVJ2013293-96.

2. Nekrasova TA. [Features of hemodynamics in patients with autoimmune thyroiditis and subclinical hy­pothyroidism in different age groups]. Probl. of Endo­crinology. 2011;3:21-24. Available from: http://cyber­leninka.ru/article/n/osobennosti-gemodinamiki-u-bolnyh-s-autoimmunnym-tireoiditom-i-subklinicheskim-gipotireozom-v-raznyh-vozrastnyh-gruppah. Russian.

3. Pan'kiv VI. [Iodine deficiency and subclinical thyroid disturbance]. Pain. Joints. Spine. 2016;2:72-73. Ukrainian.

4. Pankіv VІ, Gavrilyuk VM. [Subclinісal hypo­thyroidism: state of the problem and treatment ap­proaches]. Health of Ukraine; 2015. Ukrainian.

5. Petunina NA, Trukhina LV. [Hypothyroidism]. Rus. med. Journal. 2013;12:664-6. Available from: https://www.rmj.ru/articles/endokrinologiya/Gipotireoz_1. Russian.

6. Podzolkov AV, Fadeev VV. [Estimation of dy­namics of lipid spectrum parameters and early predictors of endothelial dysfunction in primary hypothyroidism as a function of TSH level within the reference range]. Clinic. and experiment. Thyroidology. 2010;3:54-59. Available from: http://cyberleninka.ru/article/n/otsenka-dinamiki-po­kazateley-lipidnogo-spektra-i-rannih-prediktorov-endotelialnoy-disfunktsii-pri-pervichnom-gipotireoze-v-zavisimosti (дата обращения: 15.10.2017). Russian.

7. Rymar OD, Mustafina SV, Simonova GI. [Diag­nostic value of the determination of blood lipids at high-normal and subclinical levels of thyroid-stimulating hormone for prevention and treatment of lipid metabolism disturbances]. Clinical. And experiment. Thyroidology. 2010;10:34. Available from: http://vidar.ru/Artic­le.asp?fid=KET_2010_4_34. Russian.

8. Fadeev VV. [Based on the clinical recommen­dations of the American Association of Clinical En­docrinologists and the American Thyroid Association for the Diagnosis and Treatment of Adult Hypothyroidism]. Clinic. and the experiment. Thyroidology. 2012;8(3):1–8. Available from: http://thyronet.rusmedserv.com/fi­les/Fi­le/klinrek2012-1.pdf. Russian.

9. Fadeev VV. [Modern principles of diagnosis and treatment of hypothyroidism]. Med. Council. 2013;4:7. Available from: https://cyberleninka.ru/article/v/sov­remennye-printsipy-diagnostiki-i-lecheniya-gipotireoza-1. Russian.

10. Karmisholt J, Andersen S, Laurberg P, Scand J. Analytical goals for thyroid function tests when monitoring patients with untreated subclinical hy­pothyroidism Clin Lab Invest. 2010;72(6):4-8. doi: 10.3109/00365511003782778.

11. Andersen MN, Olsen AS, Madsen JC, Kristensen SL, Faber J, Torp-Pedersen C, Gislason GH, Selmer CJ. Long-Term Outcome in Levothyroxine Treated Patients With Subclinical Hypothyroidism and Concomitant Heart Disease. Clin Endocrinol Metab. 2016;101(11):170-7. doi: 10.1210/jc.2016-2226.

12. Ye Y, et al. Association between subclinical hy­pothyroidism and blood pressure – a meta– analysis of observational studies. Endocr. Pract. 2014;20(2):150-8. doi: 10.4158/EP13237.OR.

13. Baumgartner C, Blum MR, Rodondi N. Subcli­nical hypothyroidism: summary of evidence in 2014. Swiss Med Wkly. 2014;23:144.

14. Biondi B. Mechanisms in endocrinology: Heart failure and thyroid dysfunction. Eur. J. Endocrinol. 2012;167(5):609-18. PMID: 22956554, doi: 10.1530/EJE-12-0627.

15. Biondi B. Natural history, diagnosis and mana­ge­ment of subclinical thyroid dysfunction Best Pract. Res. Clin. Endocrinol. Metab. 2012;26(4):431-46. PMID: 22863386, doi: 10.1016/j.beem.2011. 12.004.

16. Chen Х. Evaluation of left ventricular diastolic function using tissue Doppler echocardiography and con­ventional doppler echocardiography in patients with sub­clinical hypothyroidism aged <60 years: a meta–analysis J. Cardiol. 2013;61(1):8-15. doi: 10.1016/j.jjcc.2012.08.017.

17. Danzi S, Klein I. Thyroid disease and the cardio­vascular system. Endocrinol. Metab. Clin. N. Am. 2014;43(2):517-28. doi: 10.1016/j.ecl.2014.02.005.

18. Duntas LH, Brenta G. The effect of thyroid disor­ders on lipid levels and metabolism Med. Clin. North. Am. 2012; 96(2):269–281. doi: 10.1016/j.mcna.2012.01.012.

19. Karthick N. Dyslipidaemic changes in women with subclinical hypothyroidism. J. Clin. Diagn. Res. 2013;7(10):22-25. doi: 10.7860/JCDR/2013/5777.3448.

20. Masaki М. Elevated arterial stiffness and diastolic dysfunction in subclinical hypothyroidism. Circ. J. 2014;78(6):149-150. PMID: 24694766.

21. Vignera S, et. al. Endothelial dysfunction and subclinical hypothyroidism: a brief review. J. Endocrinol. Invest. 2012;35(1):96-103. doi: 10.3275/8190. Epub 2011 Dec 16.

22. Canaris GJ, Tape TG, Wigton RS. Thyroid disease awareness is associated with high rates of identifying subjects with previously undiagnosed thyroid dysfunction. BioMed Central Public Health. 2013;13:351. doi: 10.1186/1471-2458-13-351

23. .Granata R, Isgaard J. (eds) «Cardiovascular Di­sease and Thyroid Function»: Cardiovascular Issues in Endocrinology. Front Horm Res. Basel, Karger. 2014;43:45–56.

24. Kowalska I. Insulin sensitivity, plasma adiponec­tin and sICAM–1 concentrations in patients with sub­clinical hypothyroidism: response to levothyroxine the­rapy. En­docrine. 2011;40(1):95-101. doi: 10.1007/s12020-011-9446-5. Epub 2011 Mar 18.

25. Kaliaperumal R, William E, Selvam T. Rela­tionship between lipoproteine and Thyroid Hormones in Hypothyroid Patients. Clin. Diagn. Res. 2014;8(2):37-39. doi: 10.7860/JCDR/2014/7817.4001.

26. Kim YA, Park YJ. Prevalence and Risk Factors of Subclinical Thyroid Disease. Endocrinol. Metab. Seoul. 2014;29(1):20-29. doi: 10.3803/EnM.2014.29.1.20.

27. Leonidas H. Duntas, Gabriela Brenta. The Effect of Thyroid Disorders on Lipid Levels and Metabolism. Medical Clinics of North America. 2012;962(2):269-81. doi: 10.1016/j.mcna.2012.01.012. Epub 2012 Feb 14.

28. Simon HS., Pearce, Georg Brabant, Leonidas H. Duntas, Fabio Monzani, Robin P. Peeters, Salman Razvi, Jean-Louis Wemeau. 2013 ETA Guideline: Management of Subclinical Hypothyroidism Eurоpean Thyroid Journal. 2013;2:215-228. doi: 10.1007/s12020-013-9928-8. Epub 2013 Mar 23.

29. Rotondi М, et al. Raised serum TSH in morbid–obese and non–obese patients: effect on the circulating lipid profile. Endocrine. 2014;45(1):92-97. doi: 10.1007/s12020-013-9928-8. Epub 2013 Mar 23.

30. Hernández-Mijares A. Relation between lipopro­tein subfractions and TSH levels in the cardiovascular risk among women with subclinical hypothyroidism. Clin. Endocrinol. 2013;78(5):777-82. doi: 10.1111/cen.12064.

31. Jian WX. Relationship between thyroid–stimu­lating hormone and blood pressure in the middle–aged and elderly population. Singapore Med. J. 2013;54(7):401-405. PMID: 23900471.

32. Blum MR, Bauer DC, Collet TH, Fink HA, Cap­pola AR, da Costa BR, et al. Subclinical thyroid dys­function and fracture risk: a meta-analysis. JAMA. 2015;313(20):55-65. doi: 10.1001/jama.2015.5161.

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Published

2017-12-06

How to Cite

1.
Pertseva NO, Еiner KМ. Features of the influence of subclinical hypothyroidism on the cardiovascular system. Med. perspekt. [Internet]. 2017Dec.6 [cited 2024Mar.29];22(4):49-55. Available from: https://journals.uran.ua/index.php/2307-0404/article/view/117667

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Section

CLINICAL MEDICINE