The aim of the research was to study structural and functional state of arteries in women with metabolic syndrome (MS) associated to autoimmune thyroiditis (AIT), to improve the efficiency of therapeutic and preventive measures. The study sample included 108 women, 40 of them were with metabolic syndrome, autoimmune thyroiditis and euthyroidism (group I), the second group consisted of 31 women with metabolic syndrome, autoimmune thyroiditis and subclinical hypothyroidism (group II) and control group included 37 women with metabolic syndrome without thyroid disease. Laboratory examination included the study of lipid profile ( cholesterol, low-density lipoproteins, LDL Very Low Density Lipoprotein, VLDL, high-density lipoproteins, HDL, triglycerides, atherogenic index), thyroid hormone levels (ATPO and ATG, fТ4, T3) and thyroid stimulating hormone (TSH). Also, patients were instrumental examination with ultrasound of the brachial artery to assess endothelium dependent and endothelium independent relaxation, the definition of complex intima-media thickness. In addition, it performed ultrasound of the kidneys with renal artery duplex scanning with the assessment of renovascular hemodynamics. All patients of the research showed elevated arterial stiffness endothelial dysfunction and remodeling of the vascular wall. These changes are most pronounced in women with metabolic syndrome associated with autoimmune thyroiditis and subclinical hypothyroidism.
Young men of call-up age with neurocirculatory were asthenia were examined for autonomic regulation of cardiac activity and vasodilatory reserve of the arteries. The functional state of the autonomic nervous system (ANS) was studied with the aid of rythmography with analyse of heart rate variability. The following parameters were studied: vegetative regulation type, responsiveness of departments of ANS and autonomic provision of cardiac activity. The type of vegetative regulation was determined by the mean value of RR interval and indication of the heart rate variability (∆RR). Reactivity of parasympathetic and sympathetic divisions of the ANS and autonomic support of cardiac activity were investigated using breathing test. To ensure vegetative dysadaptation cardiac activity includes reaction with low vegetative coverage of both divisions of the ANS and paradoxical reaction in which there is a decrease in ∆RRmax (instead of increase) and an increase in ∆RRmin instead of decrease. These reactions indicate autonomic dysfunction. Vasodilatory reserve of the arteries was investigated using ultrasonography of the brachial artery with compressive sample and determination of endothelium-dependent vasodilation. It was found that in boys with neurocirculatory asthenia vagotonic and sympathetic types of vegetative regulation are often determined by disadaptative vegetative provision of cardiac activity, which is accompanied by endothelial dysfunction with reduced vasodilator reserve of the arteries.
The research objectives are lipid spectrum and endothelial function (EF) in women with metabolic syndrome (MS) associated with autoimmune thyroiditis (AIT) against the background of non-compensated with L-thyroxin subclinical hypothyroidism (SH). Groups of women with MS associated with AIT and euthyroidism, women with MS associated with SH and women with MS without any thyroid disorders were observed. Complex «intima media» and endothelial function of brachial artery were evaluated by ultrasound method. It was indicated that dyslipidemia was more significant in women with MS associated with AIT and SH. But there were no abnormalities in complex «intima media» and EF. The cause of it is that the diabetes mellitus occurred two times rarely in this group in comparison with the other groups as well as the high sensitivity to the L-thyroxin. The results of the study demonstrate the necessary prescription of adequate dose of L-thyroxin to compensate SH completely.
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