THE INTEGRAL ASSESMENT OF THYROID FUNCTION IN PATIENTS WITH METABOLIC SYNDROME

Abstract

Introduction. Thyroid dysfunction is one of the most common endocrine disorders that can significantly affect various aspects of metabolic health. In recent years, numerous studies have shown that the presence of thyroid dysfunction, particularly subclinical hypothyroidism, is closely associated with components of metabolic syndrome (MS). The Aim of the Study. The aim of this study is to assess the prevalence of thyroid dysfunction in patients with metabolic syndrome. Research Methods. Serum levels of thyroid hormones were analyzed using laboratory methods compliant with quality standards. The results were compared with the clinical data of the patients, and statistical analysis was performed using ROC-analysis. Results and Discussion. Patients with metabolic syndromedemonstrated a 56% higher TSH level compared to the control group, indicating potential thyroid regulatory dysfunction. In 88% of patients with metabolic syndrome, TSH levels remained within reference ranges, while 12% had elevated TSH with normal FT3 and FT4 values, suggesting possible subclinical hypothyroidism. The FT3/FT4 ratio (0.36±0.1) was at the upper limit of normal, TSHI was significantly decreased and TFI elevated. ROC analysis showed that the TFI index has the highest diagnostic efficiency for detecting metabolic syndrome, with an AUC of 0.79, sensitivity of 77%, and specificity of 75% at a threshold of 7.68. The TSHI index has moderate discriminatory ability (AUC 0.67), while the FT3/FT4 index demonstrated limited diagnostic value (AUC 0.58), indicating its low effectiveness for metabolic syndrome screening. Conclusions. Patients with MS showed normal TSH, FT3, and FT4 levels but elevated TSH Index, indicating potential peripheral resistance to thyroid hormones. Elevated TSH Index requires further diagnostics and monitoring to prevent hypothyroidism. TFI is the most promising index for use in the diagnostic algorithm for detection of endocrine disturbances and for personalizing management strategies in metabolic syndromepatients.