О.I. Mitchenko, A.O. Logvinenko, V.Yu. Romanov The optimisation of lipid and carbohydrate exchange correction in patients with metabolic syndrome and thyroid dysfunction

According to the Health Ministry of Ukraine, the number of patients suffering from thyroid illnes increased 5 times more during recent 5 yeas. But its prevalence is even much more due to the subclinical disorders. Because of late diagnosis of the subclinical hypothyroidism (SHT) and its consequences, such as dyslipidemia development, atherosclerosis, myocardial infarction, cerebral stroke, sterility, the patients with SHT are often prescribed substitutional hormone therapy. The goal of the treatment is to achieve clinical and laboratory remission in order to prevent this disease at its earliest stage, taking into consideration various clinical signs of hypothyroidism. In accordance with the American Thyroid Association instructions, the TSH screenings had been recommended in all women over 35 years of age and the men over 50 years, with intervals of 5 years, especially when dyslipidemia appears. The mortality risk of cardiovascular pathology decreased up to 9–13 % (17) when the patients were treated by the substitutional hormone therapy (by L-tiroxine). The aim of this study was to examine substitutional hormone therapy influence on lipid and carbohydrate metabolism and to optimize treatment of patients with metabolic syndrome and thyroid dysfunction. We examined 155 women with hypertension II stage and thyroid dysfunction. Such factors as age, antropometric data, the obesity degree, indicators of lipid and carbohydrate profiles, as well as hormones of hypophysial and adrenal axis were tested. The patients examination had been carried out at the beginning and completed in 6 months after examination. Antihypertensive therapy, aspirin, statins have been used during this examinanation. Only endocrinologists prescripted substitutional hormone therapy (L-tiroxine). It was shown that hypolipidemic therapy with statins does not permit to achieve normal lipids levels in patients with different forms of thyroid dysfunction. Yet, the combination of standard hypolipidemic therapy with L-tiroxine improves not only lipid state, but also carbohydrate metabolism.

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