Clinical Manifestation, Course and Results of the Treatment of Patients with Osteoarthritis and Hypothyroidism: Age and Gender Aspects

L.O. Voloshyna, N.V. Pashkovska

Abstract


The objective is to investigate the prevalence of subclinical and clinical hypothyroidism in a cohort of patients with osteoarthrosis (OA) and its impact on clinical features, course and results of treatment of OA. Material and methods. The study involved 312 patients with OA aged 37–76 years old. According to serum thyroid-stimulating hormone (TSH) levels the patients were divided into groups: those with subclinical symptoms (43 persons), with clinical hypothyroidism (14 patients), and with high-normal TSH levels (114 patients) and low-normal TSH levels (141 patients). Methods: anthropometric, biochemical, measuring of thyroid hormones (thyroid), thyroid peroxidase antibodies, the glomerular filtration rate (GFR), electrocardiography, office blood pressure measurement, thyroid ultrasound. Results. A noticeable upward trend of high-normal levels of TSH, polyosteoarthrosis occurrence, prevalence and severity of age-related comorbidities is revealed with age. Patients with OA against the background of subclinical hypothyroidism inherent higher levels of comorbidity, particularly components of the metabolic syndrome, torpid course of OA with signs of accelerating progression, higher stages of joint damage, more profound impairment of lipid metabolism, a moderate decrease in GFR, worse treatment results for OA and comorbidities. The most pronounced features are marked in patients with clinical hypothyroidism. Correction of hypothyroidism contributed to improving treatment outcomes for OA and comorbidities. Conclusions. In patients with OA aged over 50 years old with systematic destruction of the joints, torpid or progressive course, the emergence of low results of the treatment of OA and comorbidities the ultrasound examination of thyroid, measuring TSH levels, free T4, antibodies to thyroid peroxidase are recommended for early diagnosis of subclinical forms of hypothyroidism and timely medical correction of thyroid function. This will improve the overall results of the treatment of OA and comorbidities.

Keywords


osteoarthrosis; hypothyroidism; comorbid processes; treatment

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DOI: https://doi.org/10.22141/2224-0721.6.78.2016.81854

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