Features of a lipid metabolism and thickness of an intima-media complex in young patients with subclinical hypothyroidism
Keywords:subclinical hypothyroidism, dyslipidemia, intima-media complex, general practitioner - family doctor
Background. The article presents the analysis of literature data and the results of the author’s retrospective studies on the presence of dyslipidemia and changes in the thickness of the intima-media complex in young people with a subclinical hypothyroidism in the practice of a family doctor. The purpose of the study was evaluate and analyze the presence of a dyslipidemia and an intima-media complex thickening in young patients with a subclinical hypothyroidism. Materials and methods. A total of 134 individuals were surveyed. All patients were divided into two groups. The first (I) group - 114 patients with an autoimmune thyroiditis (AIT) and the second (II) group - 20 patients without signs of thyroid pathology. Depending on the thyroid dysfunction, group I was divided into two subgroups: І а subgroup - 94 patients with laboratory confirmed subclinical hypothyroidism, and І b subgroup - 20 patients in the stage of euthyroidism. This distribution of patients made it possible to reliably identify and evaluate the presence of a dyslipidemia, the thickness of the intima-media complex (IMC) and to analyze them according to thyroid status. The research methodology was based on a systematic approach and analysis using the methods of semantic evaluation of scientific documents and comparison. Results. Increased levels of total cholesterol were found: in the I a subgroup - 49 (34.04 %) patients (5.39±0.24 mmol/l), in the I b subgroup - 2 (10,0 %) patients (5.05±0.07 mmol/l). A Low Density Lipoprotein (LDL) level of ˃2.6 mmol / l was detected in 80.85 % of patients in the I a subgroup and in 35,0 % of patients in the I b subgroup. It should be noted that the greatest changes in the lipid spectrum occurred in patients of I a subgroups, which outweighed the similar indices in persons from group II - without signs of thyroid dysfunction. When analyzing the I a subgroup indicators, a strong correlation was found between the Thyroid Stimulating Hormone (TSH) level and the thickness of the intima-media complex on both sides (r = 0.77). In addition, a correlation was established between the level of a total cholesterol, LDL and the thickness of the intima-media complex (r = 0.67 and r = 0.62) on both sides. Conclusions. Characteristic signs of early development of a subclinical Common Carotid Artery (CCA) atherosclerosis that were dependent on a thyroid dysfunction were identified. Changes in a lipid profile and of the intima-media complex thickness of CCA were significantly different from those of patients without a thyroid pathology.
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