Tng Eng Loon
Singapore Med J. 2016 Oct;57(10):539-545. doi: 10.11622/smedj.2016165.
Subclinical hypothyroidism (SCH) represents a mild or compensated form of primary hypothyroidism. The diagnosis of SCH is controversial, as its symptoms are non-specific and its biochemical diagnosis is arbitrary. The treatment of SCH was examined among non-pregnant adults, pregnant adults and children. In non-pregnant adults, treatment of SCH may prevent its progression to overt hypothyroidism, reduce the occurrence of coronary heart disease, and improve neuropsychiatric and musculoskeletal symptoms associated with hypothyroidism. These benefits are counteracted by cardiovascular, neuropsychiatric and musculoskeletal side effects. SCH is associated with adverse maternal and fetal outcomes that may improve with treatment. Treating SCH in children is safe and may improve growth. Importantly, the evidence in this field is largely from retrospective and prospective studies with design limitations, which precludes a conclusive recommendation for the treatment of SCH.
亚临床甲状腺功能减退（SCH）是原发性甲状腺功能减退的一种轻度或代偿形式。SCH的诊断存在争议，因为其症状不具特异性，且生化诊断具有随意性。对非妊娠成年人、妊娠成年人及儿童的SCH治疗情况进行了研究。在非妊娠成年人中，SCH治疗可能预防其进展为显性甲状腺功能减退，减少冠心病的发生，并改善与甲状腺功能减退相关的神经精神及肌肉骨骼症状。但这些益处被心血管、神经精神及肌肉骨骼方面的副作用所抵消。SCH与不良的母婴结局相关，治疗可能改善这些结局。儿童治疗SCH是安全的，且可能促进生长。重要的是，该领域的证据大多来自存在设计缺陷的回顾性和前瞻性研究，这使得无法对SCH治疗给出确定性推荐。
