Subclinical thyroid disorders: significance and clinical impact

Razvi, Salman; Weaver, Jolanta U.; Pearce, Simon H. S.

doi:10.1136/jcp.2008.057414

Cited by 44 publications

(39 citation statements)

References 91 publications

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“…Essa relação, entre níveis de TSH e disfunção cognitiva, foi recentemente avaliada em uma coorte com 178 recém-nascidos, em que níveis de TSH no cordão umbilical apresentaram uma correlação positiva com disfunções executivas futuras (15). Alternativamente, níveis de TSH podem exercer feed-back negativo em vias neuroendócrinas associadas ao desempenho cognitivo, ainda não totalmente elucidadas (1)(2)(3)5,11,16).…”

Section: Discussionunclassified

“…O hipotireoidismo subclínico (HS) é uma condição endócrina relativamente comum, acometendo, aproximadamente, entre 1% e 15% da população (1)(2)(3). Enquanto alguns pesquisadores relatam que os pacientes podem evoluir para hipotireoidismo clínico com progressão diretamente proporcional aos níveis de TSH, outra parcela dos pacientes não apresentará evolução do quadro, requerendo apenas observação clínica.…”

unclassified

“…Apesar de não haver consenso em quais momentos o tratamento farmacológico com a levotiroxina deve ser iniciado, sugere-se seu uso na presença de sintomas clí-nicos de hipotireoidismo, na presença de dislipidemias e níveis constantes e elevados de anticorpos, principalmente os anticorpos antiperoxidase (1)(2)(3)(4).…”

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“…Esses sintomas decorrem da importante ação da triiodotironi-na no metabolismo celular, principalmente no sistema nervoso central (3).…”

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Disfunções cognitivas em pacientes com hipotireoidismo subclínico

Fernandes¹,

Alvarenga

Silva³

et al. 2011

Arq Bras Endocrinol Metab

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OBJETIVO: Avaliar a presença de disfunções cognitivas em pacientes com hipotireoidismo subclínico (HS). SUJEITOS E MÉTODOS: Estudo seccional comparando os achados neuropsicológicos de 89 pacientes com HS e 178 indivíduos eutireoidianos. Para avaliação neuropsicológica, foram utilizados: Teste de Performance Contínua (CPT-II), Iowa Gambling Task, Teste de Stroop, Teste de Wisconsin (WCST), Teste da Figura Complexa de Rey-Osterreich, Teste de Fluência Verbal (categorias semântica e fonológica) e Teste de Aprendizagem Auditivo Verbal de Rey. RESULTADOS: Os pacientes mostraram pior desempenho na flexibilidade cognitiva (WCST) e na capacidade de manter atenção sustentada (erros por omissão no CPT-II). CONCLUSÕES: Esses déficits podem causar prejuízos na vida diária do paciente, constituindo possíveis indicações de tratamento.

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Section: Discussionunclassified

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“…Esses sintomas decorrem da importante ação da triiodotironi-na no metabolismo celular, principalmente no sistema nervoso central (3).…”

unclassified

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Disfunções cognitivas em pacientes com hipotireoidismo subclínico

Fernandes¹,

Alvarenga

Silva³

et al. 2011

Arq Bras Endocrinol Metab

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“…Subclinical hypothyroidism is defined as a biochemical perturbation of TSH values with normal free T4 levels [8] , irrespective of the presence or absence of symptoms [9] . The prevalence of subclinical hypothyroidism increases with age up to 20% in subjects older than 65 years of age [10] .…”

Section: Introductionmentioning

confidence: 99%

Comorbidity Assessment and Thyroid Hormones in Independently-Living Elderly

Abdelhai

salem

Gawish

2016

Zagazig University Medical Journal

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Background: the study was undertaken with an objective to study the spectrum of thyroid dysfunction in elderly and to correlate comorbidity with abnormal thyroid function. Methods: a total of 246 subjects aged more than 60 years, admitted to General Medicine or attended the outpatient clinic who were presented with vague symptoms like easy fatigability and lethargy, were subjected to detailed clinical examination and thyroid function testing by biochemical means. Results: a total of 246 patients were included in the study. Thyroid disorders were present in 51.2%. Clinical hypothyroidism in 8.13%, subclinical hypothyroidism in 4.88% cases, hyperthyroidism in 3.3% and Low triiodothyronine (T3) syndrome in about one third of our patients were noted. There were no correlation between the thyroid hormones and most of clinical and laboratory parametes. The prevalence of abnormal thyroid patterns were significantly high in patients with comorbidities in comparison to those without. Conclusions: Elderly patients especially those with comorbidity have high prevalence of thyroid dysfunction. Clinical diagnosis is difficult to make because of vague symptomology and comorbid diseases. So, high clinical suspicion and thyroid function tests always helps in diagnosing the disease.

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Subclinical hypothyroidism is an independent predictor of adverse cardiovascular outcomes in patients with acute decompensated heart failure

et al. 2016

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AimsAltered thyroid hormone metabolism characterized by a low triiodothyronine (T3), so‐called low‐T3 syndrome, is a common finding in patients with severe systemic diseases. Additionally, subclinical thyroid dysfunction, defined as abnormal thyroid stimulating hormone (TSH) and normal thyroxine (T4), causes left ventricular dysfunction. Our objective was to identify the prevalence and prognostic impact of low‐T3 syndrome and subclinical thyroid dysfunction in patients with acute decompensated heart failure (ADHF).Methods and resultsWe examined 274 ADHF patients who were not receiving thyroid medication or amiodarone on admission (70 ± 15 years, 156 male), who underwent thyroid function tests. Euthyroidism was defined as TSH of 0.45 to 4.49 mIU/L; subclinical hypothyroidism as TSH of 4.5 to 19.9 mIU/L; and subclinical hyperthyroidism as TSH < 0.45 mIU/L, with normal free T4 level for the last two. Additionally, low‐T3 syndrome was defined as free T3 < 4.0 pmol/L among euthyroidism subjects. On admission, 188 patients (69%) showed euthyroidism, 58 (21%) subclinical hypothyroidism, 5 (2%) subclinical hyperthyroidism, and 95 (35%) low‐T3 syndrome. Cox proportional hazards models revealed that higher TSH, but not free T3 and free T4, was independently associated with composite cardiovascular events, including cardiac death and re‐hospitalization for heart failure. Indeed, subclinical hypothyroidism was an independent predictor (hazard ratio: 2.31; 95% confidence interval: 1.44 to 3.67; P < 0.001), whereas low‐T3 syndrome and subclinical hyperthyroidism were not.ConclusionsSubclinical hypothyroidism on admission was an independent predictor of adverse cardiovascular outcomes in ADHF patients, suggesting a possible interaction between thyroid dysfunction and the pathophysiology of ADHF.

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Subclinical thyroid disorders: significance and clinical impact

Cited by 44 publications

References 91 publications

Disfunções cognitivas em pacientes com hipotireoidismo subclínico

Disfunções cognitivas em pacientes com hipotireoidismo subclínico

Comorbidity Assessment and Thyroid Hormones in Independently-Living Elderly

Subclinical hypothyroidism is an independent predictor of adverse cardiovascular outcomes in patients with acute decompensated heart failure

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