[The incidence of hypothyroidism symptoms and risk factors for cardiovascular events in subclinical hypothyroidism]. / Czestosc wystepowania objawów niedoczynnosci tarczycy oraz czynników ryzyka sercowo-naczyniowego w subklinicznej niedoczynnosci tarczycy.

UNLABELLED: The clinical significance of subclinical hypothyroidism (SH) has not been determined. There are different opinions with regard to symptoms and clinical consequences of SH as well as effectiveness of treatment. Aim of study was the analysis of incidence of hypothyroidism symptoms and selected cardiovascular risk factors in patients with SH in comparison to euthyroid individuals and the evaluation of the effect of treatment of SH on the above parameters. MATERIALS AND METHODS: Fifty patients were included in the study: 25 with SH, 25 in euthyreosis (C). The incidence of hypothyroidism symptoms and metabolic syndrome (MS), as well as total cholesterol (TCH), LDL, HDL triglycerides (TGL), glucose levels, values of systolic (SBP) and diastolic (DBP) blood pressure and the relationship between these factors and laboratory indexes of SH intensity were analyzed. Moreover, the risk of cardiovascular mortality (RCM) with the application of the HeartSCORE Risk Chart was evaluated. After a period of six months a similar analysis in the SH group was conducted; all the patients were administered L-thyroxin (mean dose +/- SD: 67.5 +/- 32.1 microg). RESULTS: The mean number of hypothyroidism symptoms was higher in SH than in C group (SH: 8.4 +/- 3.2 vs. C: 1.7 +/- 1.5, p < 0.0005). Normalization of TSH observed in 17 patients resulted in a decrease in the mean number of symptoms (9.1 +/- 2.8 vs. 5.9 +/- 2.9, p < 0.0001). There were not differences between groups in the incidence of the MS and MS components and also the RCM. However only in SH group a positive correlations between TSH and BMI, TSH and age, age and TCH and LDL levels and SBP DBP values and also between TSH and the RCM were noted. Normalization of TSH level resulted in a decrease in the RCM (p = 0.055). CONCLUSIONS: Treatment of SH might bring potential benefits; it might lessen symptoms and reduce the risk of cardiovascular mortality.

[Effect of subclinical hypothyroidism treatment on selected cardiovascular parameters]. / Wplyw leczenia subklinicznej niedoczynnosci tarczycy na wybrane parametry ukladu sercowo-naczyniowego.

UNLABELLED: The impact of subclinical hypothyroidism (SH) on the cardiovascular system has not been well determined. Due to contradictory views on clinical consequences of SH there is no clear opinion on the indications for treatment of this disorder. The aim of study was to analyse the L-thyroxin therapy effect on normalization of cardiac irregularities in patients with SH observed in physical, electrocardiographic (at rest and 24-hour) and echocardiographic examinations. MATERIALS AND METHODS: 25 patients with SH and 25 in euthyreosis --C were included in the study, mean age +/- SD: SH- 43 +/- 17.4; C--51 +/- 17.2; NS. The frequency of irregularities in the physical, echocardiographic, electrocardiographic (at rest and 24-hour) examinations in both examined groups were compared. The effectiveness of a six-month treatment of SH as well as the impact of normalization of the TSH on results of the above tests were also analyzed. RESULTS: It was observed that SH does not significantly affect results of the physical examination. However, normalization of the TSH decreased differences between the SH and C groups with regard to the frequency of irregularities in rest electrocardiographic examination (SH: 60% vs. C: 24%, p < 0.01). It also reduced the total number of irregularities observed in echocardiographic examination (p < 0.01). The changes included mainly an improvement of systolic and diastolic functions of the left ventricle. Moreover, less intensive supraventricular and ventricular arrhythmia in 24-hour electrocardiographic examination in some patients as well as an average positive correlation (R = 0.420, p < 0.05) between the number of irregularities in this examination and the TSH level were also observed. CONCLUSIONS: Normalization of the TSH level after a six-month treatment period contributes to positive changes with regard to essential cardiac parameters in some patients.