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甲状腺疾病与心血管疾病。

Thyroid and cardiovascular diseases.

作者信息

Tan Öksüz Sinem Başak, Şahin Mustafa

机构信息

Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Ankara University, Ankara, Turkiye.

出版信息

Turk J Med Sci. 2024 Oct 1;54(7):1420-1427. doi: 10.55730/1300-0144.5927. eCollection 2024.

Abstract

The thyroid gland is one of the major regulator organs of hemostasis in the human body, controlling the functioning of numerous systems. Thyroid hormones exert a modulating effect on the cardiovascular system in particular, ensuring optimal functioning within the normal range. Triiodothyronine (T3), as an active form of thyroid hormone, is mainly responsible for this effect via both genomic and nongenomic mechanisms. It has been reported that overt thyroid disorders are associated with a number of cardiovascular diseases and cardiac mortality. While hyperthyroidism appears to be related to atrial fibrillation and heart failure, the most pronounced cardiovascular complication of hypothyroidism seems to be atherosclerosis. Achieving euthyroidism is of great importance for restoring cardiovascular function. However, depending on the underlying health conditions, this may not be possible for all patients. Furthermore, there has been a growing focus on the role of subclinical thyroid dysfunctions and their impacts on the cardiovascular system in recent years. The pattern of cardiovascular abnormalities in subclinical thyroid disorders appears to parallel that of overt hypothyroidism, suggesting that even mild alterations in thyroid hormone levels may also have effects on the cardiovascular system. The management of subclinical thyroid disease remains controversial. Current evidence suggests that patient age and underlying cardiovascular diseases are major factors in clinical decision-making.

摘要

甲状腺是人体止血的主要调节器官之一,控制着众多系统的功能。甲状腺激素尤其对心血管系统发挥调节作用,确保其在正常范围内最佳运作。三碘甲状腺原氨酸(T3)作为甲状腺激素的一种活性形式,主要通过基因组和非基因组机制产生这种作用。据报道,明显的甲状腺疾病与多种心血管疾病及心脏死亡率相关。虽然甲状腺功能亢进似乎与心房颤动和心力衰竭有关,但甲状腺功能减退最显著的心血管并发症似乎是动脉粥样硬化。实现甲状腺功能正常对于恢复心血管功能至关重要。然而,根据潜在的健康状况,并非所有患者都能做到这一点。此外,近年来,亚临床甲状腺功能障碍的作用及其对心血管系统的影响受到越来越多的关注。亚临床甲状腺疾病中的心血管异常模式似乎与明显的甲状腺功能减退相似,这表明即使甲状腺激素水平的轻微变化也可能对心血管系统产生影响。亚临床甲状腺疾病的管理仍存在争议。目前的证据表明,患者年龄和潜在的心血管疾病是临床决策的主要因素。

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