Clinical and laboratory parameters and quality of life in patients with hypothyroidism

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Abstract


To evaluate the quality of compensation of hypothyroidism, clinical and labora-tory parameters and quality of life of patients with varying degrees of compensa-tion. Two hundred ambulatory patients with primary hypothyroidism receiving levothyroxine (L-T4) for more than one year participated in the study. Patients were examined at baseline and in 6 months. The scores for the Short-Form 36 (SF-36), symptoms of hypothyroidism and lipid profiles were analyzed. Only 58% (84/200) of patients were euthyroid. After 6 months of correction of replacement therapy, hypothyroidism was compensated in 75.5% of patients, decompensated – in 24.5%. We revealed lower level of scale of physical functioning (p = 0.019) among patients with increased level of TSH (>4 mU/l) in comparison with euthyroid patients. As soon as compensation was achieved patients showed better physical functioning (p = 0.01). There were no difference in the quality of life between the patients with decreased TSH and those with compensated hypothyroidism, however, the achievement of compensation was accompanied by improvement in role-emotional functioning (p < 0.016). In the group of patients with TSH > 4 mU/l hypercholesterolemia occurs more frequently than among patients with compensated hypothyroidism (p = 0.041), but the achievement of compensation led to significant reduction of total cholesterol (p = 0.09) and LDL (p = 0.012). Conclusion: In spite of relative simplicity of L-thyroxin replacement therapy many patients with hypothyroidism remain decompensate. Active followup of the patients with decompensated hypothyroidism improves the precision of thyroxine replacement and contribute to better quality of life and lipid profile.

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References

  1. Новик А.А., Ионова Т.И. Исследование качества жизни в медицине: Учеб. пос. / Под ред. Шевченко Ю.Л. М.: ГЭОТАР-МЕД, 2004.
  2. Фадеев В.В., Мельниченко Г.А. Гипотиреоз: Руководство для врачей. М.: РКИ Северопресс, 2002.
  3. Bengel F., Nekolla S., Ibrahim T. et al. Effect of thyroid hormones on cardiac function, geometry, and oxidative metabolism assessed noninvasively by positron emission tomography and magnetic resonance imaging // J. Clin. Endocrinol. Metab. 2000. V. 85. P. 1822–1827.
  4. Bianchi P., Zaccheroni V., Solaroli E. et al. Health-related quality of life in patients with thyroid disorders // Quality of Life Research. 2004. V. 13. N 1. P. 45–54.
  5. Biondi B., Palmieri E., Lombardi G., Fazio S. Effects of subclinical thyroid dysfunction on the heart // Ann. Intern. Med. 2002. V. 137. P. 904–914.
  6. Canaris G., Manowitz N., Mayor G., Ridgway E. The Colorado thyroid disease prevalence study // Arch. Internal. Med. 2000. V. 160. P. 526–534.
  7. Diekman M., Anghelescu N., Endert E., Bakker O. et al. // J. Clin. Endocrinol. Metab. 2000. V. 85 N 5. P. 1857–1862.
  8. Diez J.J. Hypothyroidism in patients older than 55 years: an analysis of the etiology and assessment of the effectiveness of therapy // J. Gerontol. Boil. Sci Med. Sci. 2002. V. 57. N 5. P. 315–320.
  9. Ford E., Mokdad A., Giles W., Mensah G. Serum total cholesterol concentration and awareness, treatment, and control of hypercholesterolemia among US adult // Circulat. 2003. V. 107. P. 2185–2189.
  10. Frey H., Johannesen O., Kapelrud H., Sand T. Appropriate replacement dose of thyroxine in primary hypothyroidism // Acta Med. Scand. 1987. V. 222. P. 163–167.
  11. Helfand M., Redfern C. Screening for thyroid disease // Ann. Intern. Med. 1998. V. 129 (Issue 2). P. 144–158.
  12. Leese G., Jung R., Scott A., Waugh N., Brouning M. Long-term follow-up of treated hyperthyroid and hypothyroid patients // Health Bull (Edinburg). 1993. V. 51. N 3. P. 177–183.
  13. Liewendahl K., Helenius T., Lamberg B.A. et al. Free thyroxine, free triiodothyronine, and thyrotropin concentrations in hypothyroid and thyroid carcinoma patients receiving thyroxine therapy // Acta Endocrinol. 1987. V. 116. N 3. P. 418–424.
  14. Paul T., Kerrigan J., Kelly A. et al. Long-term thyroxine therapy is associated with decreased hip bone density in premenopausal women // JAMA. 1988. V. 259. P. 3137–3141.
  15. Roberts N. Psychological problems in thyroid disease //Brit. Thyroid Found. Newsletter. 1996. V. 18. P. 3.
  16. Saito I., Saruta T. Hypertension in thyroid disorders // Endocrinol. Metab. Clin. N. Am. 1994. V. 23. P. 379–386.
  17. Staub J., Althaus B., Engler H. et al. Spectrum of subclinical and overt hypothyroidism: effect on thyrotropin, prolactin, and thyroid reserve, and metabolic impact on peripheral target tissues // Am. J. Med. 1992. V. 92. P. 631–642.
  18. Wiersinga W. Adult Hypothyroidism (in The Thyroid and its Diseases). 2002. Ch.9.

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