Niedoczynność tarczycy u pacjentów z zespołem metabolicznym

Abstract

Introduction: Metabolic syndrome involves abdominal obesity, arterial hypertension, type 2 diabetes and lipid disorders manifested as atherogenic dyslipidaemia. Abnormal thyroid function affects the severity of MetS components, since regulating metabolism is one of the most important functions of thyroid hormones. In this study, we present the influence of hypothyroidism on lipid and carbohydrate disorders in patients with MetS. Material and methods: The described study was a prospective, two-centre screening study of 24-month duration. The study participants were 441 patients (350 women, 91 men, aged 28-82) with metabolic syndrome diagnosed according to the 2005 IDF. Results: By comparing the study and the control group, statistically significant differences were observed in the mean triglyceride levels (respectively 161,5 vs. 134,8 mg/dL, p = 0.047), mean fasting glycaemia (respectively 111,8 vs. 126,1 mg/dL, p = 0.044) and TG/HDL ratio (4,74 vs. 3,71, p = 0.043). Hypothyroidism shows a positive correlation with the TG levels and TG/HDL-C ratio and a negative correlation with the mean fasting glycaemia in people with MetS. A significantly higher TG/HDL-C ratio and lower mean insulin sensitivity ratio observed in men with hypothyroidism, indicated higher insulin resistance in men. Conclusions: In view of the above, it may be hypothesized that in patients with both MetS and hypothyroidism, especially of male gender, the risk of death of cardiovascular causes is greater due to the severity of MetS components. Moreover, we suggest that in patients recently diagnosed with MetS, active detection of hypothyroidism should be performed by determining the TSH levels, while patients diagnosed with hypothyroidism (apart from replacement therapy) should be monitored for the possible occurrence of MetS in the future.

Hormony tarczycy i otyłość: znana, lecz słabo rozpoznana relacja

“…In this sense, it has been reported that small variations in TSH levels, caused by minimal changes in T4 dosage during replacement therapy in hypothyroid patients, are associated with significant changes in resting energy expenditure. These observations support the clinical evidence that hypothyroidism represents a risk factor for the development of overweight and obesity [51,53].…”

Body Fat Parameters, Glucose and Lipid Profiles, and Thyroid Hormone Levels in Schizophrenia Patients with or without Metabolic Syndrome

“…A previous study showed signs of subclinical hypothyroidism in patients with chronic schizophrenia [ 25 ], which contributes to an increase in cholesterol and blood pressure [ 40 ]. Associations were found between thyroid dysfunction and cardiovascular risk factors, and the development of MetS [ 41 ], as well as between TSH levels and the presence of MetS in patients with schizophrenia [ 42 ], and similarly in the general population [ 43 ]; therefore, it is necessary to monitor the levels of TSH and THs in patients with schizophrenia as possible risk factors for developing MetS.…”

Relationship between Hypothyroidism and Non-Alcoholic Fatty Liver Disease: A Systematic Review and Meta-analysis

“…Second, thyroid hormones can regulate lipid metabolism in the liver via thyroid hormone receptor β, and they can decrease cholesterol and triglyceride levels ( 58 – 60 ). It is worth mentioning that lower levels of thyroid hormones in hypothyroidism can increase the levels of cholesterol, low-density lipoproteins and triglyceride due to the delivery of hepatic fatty acids, but decrease the level of high-density lipoprotein (HDL), and thus can affect lipid metabolism ( 61 ). Therefore, patients with overt hypothyroidism often have fatty infiltration of the liver and thus have a higher risk for NAFLD ( 47 ).…”