CORRECTION OF THYROID DYSFUNCTION AND METABOLIC DISORDERS IN PERIMENAPAUSAL WOMEN WITH HYPOTHYROIDISM
DOI:
https://doi.org/10.11603/1811-2471.2023.v.i4.14310Keywords:
non-alcoholic fatty liver disease, intestinal lesions, COVID-19, zonulin, calprotectin, α1-antitrypsin, dysbiosisAbstract
SUMMARY. Women who reach the perimenopausal age often have multiple metabolic disorders, especially in the presence of concomitant thyroid pathology. Perimenopausal age is considered as an independent predictor of the occurrence of components of the metabolic syndrome in women. Estrogen deficiency causes symptoms of menopause, which often manifests itself in the pathology of the thyroid gland.
The aim – to assess the effectiveness of complex therapy with levothyroxine, metformin and rosuvastatin on the severity of metabolic syndrome in perimenopausal women with hypothyroidism.
Material and Methods. In the study participated 98 women with primary hypothyroidism who were treated in the endocrinology department of the Ternopil Regional Clinical Hospital. The average age of the examined was (44.6±0.9) years. The patients underwent a general clinical examination (anthropometric assessment of body height and weight, body mass index was calculated, waist circumference and hip circumference were measured), and the levels of thyroid-stimulating hormone and thyroid hormones in blood serum were determined. The level of basal glucose in the blood serum and the level of basal insulin, the level of glycosylated hemoglobin, total cholesterol, high-density lipoprotein cholesterol, triglycerides were determined. According to the obtained lipidogram indicators, the following were determined: low-density lipoprotein cholesterol and the atherogenicity factor.
Results. Patients were divided into 2 clinical groups. The first group consisted of 48 patients with a TSH range from 0.4 to 2.5 mIU/ml, which characterized the low-normal level of the TSH interval. The II group included 50 women with a TSH level in the range of 2.5–4.0 mIU/ml, which indicated a high-normal interval of reference values. Metabolic syndrome was diagnosed in 42 (42.85 %) women. Prescribing metformin had a positive effect on insulin resistance indicators (the HOMA-IR index decreased in 17.2 % of women), and 76.3 % of patients achieved normoglycemia after 6 months of taking the drug. The use of rosuvastatin in the complex treatment of women with HT normalized indicators of dyslipidemia (the level of TG decreased by 24.3 %, LDL-C by 27.3 %, HDL-C increased by 19.3 %). For perimenopausal women with hypothyroidism, replacement therapy with levothyroxine is recommended to achieve a low-normal target range of thyroid-stimulating hormone (0.4 to 2.5 mIU/ml).
Conclusions. Individually selected dosage of levothyroxine in combination with metformin and statins had reliably positive effects on the normalization of thyroid dysfunction and improvement of metabolic syndrome indicators in perimenopausal women.
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