vmireavizВестник медицинского института «РЕАВИЗ». Реабилитация, Врач и ЗдоровьеBulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH)2226-762X2782-1579РЕАВИЗ10.20340/vmi-rvz.2020.6.12vmireaviz-108Research ArticleКлиническая медицинаClinical medicineСубклинический гипотиреоз: лечить или наблюдать?Subclinical hypothyroidism: treat or watch?https://orcid.org/0000-0002-2891-3050ЦанаваИ. А.TsanavaI. A.

Цанава Ирина Амирановна, кандидат медицинских наук, доцент кафедры клинической медицины, Медицинкий университет «Реавиз», врач-эндокринолог, детский эндокринолог, ООО «Клиника Пяти Благ»

Самара

Samara 

ira.tsanava@gmail.comhttps://orcid.org/0000-0003-0027-1786БулгаковаC. В.BulgakovaS. V.

Булгакова Светлана Викторовна, доктор медицинских наук, доцент, заведующий кафедрой гериатрии и возрастной эндокринологии, главный гериатр Минздрава Самарской области

Самара

Samara 

osteoporosis63@gmail.comМеликоваА. В.MelikovaA. V.

Меликова Анула Викторовна, врач-акушер-гинеколог, директор

Самара

Samara 

melanabel@mail.ruЧастное учреждение образовательная организация высшего образования «Медицинский университет «Реавиз»РоссияMedical University “Reaviz”Russian FederationФГБОУ ВО «Самарский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииSamara State Medical UniversityООО «Клиника Пяти Благ»Clinic of Five Blagos2020220220210698108Copyright © Цанава И.А., Булгакова C.В., Меликова А.В., 20212021Цанава И.А., Булгакова C.В., Меликова А.В.Tsanava I.A., Bulgakova S.V., Melikova A.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestnik.reaviz.ru/jour/article/view/108

Манифестный гипотиреоз встречается более чем у 5 % населения, а распространенность субклинического гипотиреоза достигает 15 %. В практике эндокринолога в большинстве случаев диагностика и лечение манифестного гипотиреоза не вызывает вопросов, тогда как субклинические изменения гормонов щитовидной железы довольно часто порождают множество дискуссий. Общепринятый референсный диапазон для ТТГ до 4,50 мкМЕ/мл противоречит данным, демонстрирующим, что более 95 % здоровых людей с эутиреозом имеют уровень ТТГ в сыворотке до 2,5 мкМЕ/мл. При этом накоплено множество данных о влиянии даже незначительно измененных уровней тиреоидных гормонов и ТТГ на различные ткани, органы и системы организма, в особенности на сердечно-сосудистую, нервную и репродуктивные системы. В данной обзорной статье проанализированы результаты работ, направленных на изучение взаимосвязи субклинического гипотиреоза с кардиоваскулярными и метаболическими нарушениями, когнитивными расстройствами, патологией беременных.

Manifest hypothyroidism occurs in more than 5 % of the population, while prevalence of subclinical hypothyroidism is much higher and reaches 15 %. In the practice of an endocrinologist, in most cases, the diagnosis and treatment of manifest hypothyroidism does not raise questions, while subclinical changes in thyroid hormones quite often generate a lot of discussions. The generally accepted reference range for TSH up to 4.50 μIU / ml is in conflict with data showing that more than 95 % of healthy people with euthyroidism have serum TSH levels up to 2.5 μIU / ml. At the same time, a lot of data has been accumulated on the effect of even slightly altered levels of thyroid hormones and TSH on various tissues, organs and systems of the body, especially on the cardiovascular, nervous and reproductive systems. This review analyzes the results of studies aimed at studying the relationship of subclinical hypothyroidism with cardiovascular and metabolic disorders, cognitive disorders, pathology of pregnant women.

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The authors declare that there are no conflicts of interest present.