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CNAA / Theses / 2009 / June /

Metabolic aspects of pathogenesis of autoimmune thyroiditis


Author: Protopop Svetlana
Degree:doctor of medicine
Speciality: 03.00.04 - Biochemistry
Year:2009
Scientific adviser: Leonid Lîsîi
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Scientific consultant: Larisa Zota
doctor, associate professor (docent)
Institution:
Scientific council:

Status

The thesis was presented on the 10 June, 2009
Approved by NCAA on the 1 October, 2009

Abstract

Adobe PDF document0.35 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.