Glueck Charles J, Streicher Patricia
Cholesterol Center Jewish Hospital, 3200 Burnet Avenue, Cincinnati, OH 45229, USA.
Curr Atheroscler Rep. 2003 Jan;5(1):73-7. doi: 10.1007/s11883-003-0071-5.
Subclinical hypothyroidism can be diagnosed in 1% to 10% of the adult population, is more common in women, and increases with age. In many patients, treatment with L-thyroxine reduces low-density lipoprotein cholesterol, improves cardiac function, reduces symptoms of hypothyroidism, and diminishes neuropsychiatric symptoms. Treatment also reduces the likelihood of statin-induced myopathy. However, in double-blind, placebo-controlled trials of L-thyroxine therapy in subclinical hypothyroidism, cardiovascular and symptomatic benefits have been neither uniform nor definitive. In the absence of a large-scale, multicenter, randomized trial, physicians have to individualize therapy for each patient. Benefits of therapy are most likely to be realized in patients with thyroid-stimulating hormone levels greater than 10 mU/L on repeated measures, those with hypothyroid symptoms, those who are pregnant, those with a documented family history of hypothyroidism, and those with severe hyperlipidemia.
亚临床甲状腺功能减退在1%至10%的成年人群中可被诊断出来，在女性中更为常见，且随年龄增长而增加。在许多患者中，左甲状腺素治疗可降低低密度脂蛋白胆固醇、改善心脏功能、减轻甲状腺功能减退症状并减少神经精神症状。治疗还可降低他汀类药物引起的肌病的可能性。然而，在亚临床甲状腺功能减退患者中进行的左甲状腺素治疗的双盲、安慰剂对照试验中，心血管益处和症状改善既不统一也不明确。在缺乏大规模、多中心、随机试验的情况下，医生必须为每位患者制定个体化治疗方案。对于多次测量促甲状腺激素水平大于10 mU/L的患者、有甲状腺功能减退症状的患者、孕妇、有甲状腺功能减退家族病史记录的患者以及患有严重高脂血症的患者，治疗最有可能带来益处。
