Role of thyroid gland in metabolic syndrome and in combination with chronic coronary heart disease and type 2 diabetes mellitus
Background. Metabolic syndrome (MS) is a topical issue of 21st century, a criterion for type 2 diabetes mellitus (DM) and coronary heart disease (CHD) severity. Violations of lipid, carbohydrate exchange and hormonal state, in particular the functional state of hypothalamic pituitary and thyroid systems, underlie MS. The functional state of thyroid gland in MS becomes the object of many researches. It is proved that thyroid hormones regulate secretion of insulin. The concept of hypothyroidisminduced MS is wellknown. Subclinical hypothyroidism is an independent risk factor of atherosclerosis and acute coronary syndrome for the elderly women. It is important to pay a considerable attention to the study of thyroid function in comorbid pathology. The purpose of research is to study the thyroid function in MS and in combination with chronic CHD and type 2 DM, both compensated and decompensated. Materials and methods. Three hundred nineteen patients with MS combined with chronic CHD, compensated and decompensated type 2 DM were examined. Depending on a presence or absence of the combined pathology, six groups of patients with MS were formed. The first group was represented by patients with MS without complications, second group — MS and compensated type 2 DM, third group — MS and decompensated type 2 DM, fourth group — MS in combination with chronic CHD, fifth group — MS combined with chronic CHD and compensated type 2 DM, sixth group included patients with MS, chronic CHD and decompensated type 2 DM. The levels of thyroidstimulating hormone (TSH), cortisol, free thyroxine, antithyroglobulin and thyroid peroxidase antibodies were determined to study the thyroid functional state and to confirm of its pathogenic role in this combined pathology. Results. According to the results of research, increase of TSH level was observed in patients with MS without complications, MS with chronic CHD, MS with chronic CHD and compensated type 2 DM. These changes are specific for subclinical hypothyroidism, having regard to the normal levels of free thyroxine. The level of cortisol was increased in MS without complications, with its further decrease. In MS with chronic CHD and decompensated type 2 DM, TSH was at the level in control group that indicates normalization of thyroid function, the cortisol level was increase. Conclusions. Levels of TSH and cortisol are the markers of severity of the combined pathology of MS with CHD and type 2 DM.
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De Santis AS, Diez Roux AV, Hajat A, et al. Associations of Salivary Cortisol Levels with Metabolic Syndrome and Its Components: The Multi-Ethnic Study of Atherosclerosis. J Clin Endocrinol Metab. 2011 Nov;96(11):3483-92. doi: 10.1210/jc.2011-0483.
Gyawali P, Takanche JS, Shrestha RK, et al. Pattern of thyroid dysfunction in patients with metabolic syndrome and its relationship with components of metabolic syndrome. Diabetes Metab J. 2015 Feb;39(1):66-73. doi: 10.4093/dmj.2015.39.1.66.
International Diabetes Federation Epidemiology Task Force Consensus Group. The IDF consensus world wide definition of the metabolic syndrome. (Available from: https://www.idf.org/e-library/consensus-statements/60-idfconsensus-worldwide-definitionof-the-metabolic-syndrome.html.
Libo Y, Xiaohong L, Feng Y, Wei D, Liu W, Zhang T. Subclinical hypothyroidism and the risk of metabolic syndrome: A meta-analysis of observational studies. Endocr Res. 2016 May;41(2):158-65. doi: 10.3109/07435800.2015.1108332.
Mehran L, Amouzegar A, Tohidi M, Moayedi M, Azizi F. Serum free thyroxine concentration is associated with metabolic syndrome in euthyroid subjects. Thyroid. 2014 Nov;24(11):1566-74. doi: 10.1089/thy.2014.0103.
Popovic D, Damjanovic S, Djordjevic T, et al. Stress hormones at rest and following exercise testing predict coronary artery disease severity and outcome. Stress. 2017 Sep;20(5):523-531. doi: 10.1080/10253890.2017.1368488.
Incollingo Rodriguez AC, Epel ES, White ML, Standen EC, Seckl JR, Tomiyama AJ. Hypothalamic-pituitary-adrenal axis dysregulation and cortisol activity in obesity: a systematic review. Psychoneuroendocrinology. 2015 Dec;62:301-18. doi: 10.1016/j.psyneuen.2015.08.014.
Varounis C, Rallidis LS, Franco OH, Lekakis J. Рrevalence of metabolic syndrome and association with burden of atherosclerotic disease in patients with stable coronary artery disease. Current Medical Research and Opinion. 2016;32(6):1678-83. doi: 10.1185/03007995.2016.1163257.
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