Metabolic aspects of pathogenesis of autoimmune thyroiditis
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StatusThe thesis was presented on the 10 June, 2009Approved by NCAA on the 1 October, 2009 Abstract – 0.35 Mb / in romanian |
Keywords
autoimmune thyroiditis; euthyroidism; subclinical hypothyroidism; clinical hypothyroidism; insulin sensitivity; insulin resistance; plasma lipoproteins; atherosclerotic risk; blood pressure; obesity; metabolic risk; metabolic syndrome.Summary
The aim of this study was to investigate the role of thyroid dysfunction and insulin resistance to evolution of the metabolic syndrome in the patients with different degree of thyroid insufficiency. 70 women with autoimmune thyroiditis (31 – euthyroid, 20 – with subclinical hypothyroidism, 19 – with clinical hypothyroidism) were compared with 27 healthy women. The examination outcome relived that increase of TSH concentration, decrease of free thyroxine levels and elevation of fT3/fT4 ratio in early stages of thyroid insufficiency represent markers of evolution to clinical hypothyroidism.
The survey highlighted that insulin sensitivity is diminished in all studied groups, compared with healthy controls. This finding confirms that thyroid insufficiency contributes to establishment of insulin resistance.
The atherogenic dyslipidemia was found in the patients with subclinical and clinical hypothyroidism. The reviled correlations indicate that alterations of cholesterol metabolism are caused by thyroid insufficiency, but alterations of triglyceride metabolism – by insulin resistance associated with hypothyroidism.
It was shown that a trend to elevation of blood pressure is specific to the patients with subclinical and clinical hypothyroidism. Thyroid insufficiency augments preferentially diastolic blood pressure, but insulin resistance – both systolic and diastolic blood pressure. Obesity induced by thyroid insufficiency substantially contributes to exacerbation of insulin resistance, arterial hypertension and atherogenic dyslipidemia.
A high risk for majority of clinical components of the metabolic syndrome was found in the patients with subclinical and clinical hypothyroidism, except decrease of HDL-cholesterol concentration.
The finding data allow summarize that in the patients with autoimmune thyroiditis the
metabolic syndrome is initiated by thyroid insufficiency, but is intensified by insulin resistance
associated with hypothyroidism.
Oficial Reviewers
- Valentin Gudumac
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova - Alexandru Dascaliuc
doctor habilitat, professor, Institute of Genetics, Physiology and Plant Protection of the ASM
Theses
