内科学
内分泌学
亚临床感染
胆固醇
医学
三碘甲状腺素
胰岛素抵抗
脂蛋白
高密度脂蛋白
疾病
风险因素
动脉粥样硬化性心血管疾病
甲状腺
糖尿病
作者
Leonidas H. Duntas,Léonard Wartofsky
出处
期刊:Thyroid
[Mary Ann Liebert]
日期:2007-11-01
卷期号:17 (11): 1075-1084
被引量:131
标识
DOI:10.1089/thy.2007.0116
摘要
Controversy remains as to the risk of cardiovascular disease (CVD) associated with subclinical hypothyroidism (SCH), defined as an increased serum thyrotropin (TSH) concentration with normal free thyroxine and triiodothyronine levels. Substantial evidence indicates altered cholesterol and lipoprotein metabolism in SCH when serum TSH is above 10 mU/L. Observed abnormalities include elevated plasma levels of total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C); the altered TC/high-density lipoprotein-cholesterol (HDL-C) and LDL-C/HDL-C ratios suggest a potential accelerated risk for CVD. The influence of SCH on lipids is directly proportional to the degree of TSH elevation and becomes more significant with the progression from SCH to overt disease, thereby accelerating any propensity to atherosclerosis. Although many clinicians may tend to ignore SCH with TSH levels <10, it is apparent that an enhanced CV risk could apply to these individuals, perhaps compounded by insulin resistance and amplified by the copresence of other risk factors such as endothelial dysfunction and elevated C-reactive protein.
科研通智能强力驱动
Strongly Powered by AbleSci AI