Division of Endocrinology and Metabolism, Department of Internal Medicine, Dong-A Medical Center, Dong-A University College of Medicine, Busan, Korea.
Endocrinol Metab (Seoul). 2015 Sep;30(3):246-51. doi: 10.3803/EnM.2015.30.3.246. Epub 2015 Aug 4.
Subclinical hypothyroidism (SCH) is a common disorder that is characterized by elevated thyroid-stimulating hormone levels in conjunction with free thyroxine concentrations within the normal reference range. Thyroid hormones are known to affect the heart and vasculature and, as a result, the impact of SCH on the cardiovascular (CV) system has recently become an important topic of research. Strong evidence points to a link between SCH and CV risk factors such as alterations in blood pressure, lipid levels, and atherosclerosis. Additionally, accumulating evidence indicates that SCH is associated with metabolic syndrome and heart failure. The present review proposes that SCH may be a potentially modifiable risk factor of CV disease and mortality. However, large-scale clinical trials with appropriate power investigating the risks and benefits of SCH treatment are required to determine whether these benefits can be achieved with levothyroxine therapy.
亚临床甲状腺功能减退症(SCH)是一种常见的疾病,其特征是促甲状腺激素水平升高,同时游离甲状腺素浓度在正常参考范围内。甲状腺激素已知会影响心脏和血管,因此,SCH 对心血管(CV)系统的影响最近已成为一个重要的研究课题。强有力的证据表明,SCH 与 CV 危险因素之间存在关联,如血压、血脂水平和动脉粥样硬化的改变。此外,越来越多的证据表明,SCH 与代谢综合征和心力衰竭有关。本综述提出,SCH 可能是 CV 疾病和死亡率的一个潜在可改变的危险因素。然而,需要进行大规模、有足够效力的临床试验,以调查 SCH 治疗的风险和益处,从而确定使用左甲状腺素治疗是否可以实现这些益处。