Синдром гипотиреоза как фактор риска возникновения нарушений парасимпатической иннервации

Abstract

The objective: to study the significance of the presence of hypothyroidism syndrome as a risk factor for the development of autonomic neuropathy (AN). Materials and methods. The study involved 77 women, of whom 31 had hypothyroidism syndrome, and 46 had euthyroid thyroid pathology. The age of patients with hypothyroidism syndrome ranged from 24 to 57 years and averaged 42.4±9.20 years, mean age patients of the euthyroid pathology group of the thyroid gland was equal to 40.0±12.22 years (age interval 20–63 years). Patients underwent an ultrasound examination of the thyroid gland, fasting glycemia levels, A1c, TSH, T4s, T3s, blood creatinine levels, and GFR were calculated using CKD-EPI on line equations. In addition, antithyroglobulin and antithyroperoxidase levels were determined. To diagnose autonomic neuropathy, a Valsalva test and a deep breathing test were used. Statistical analysis was performed using the standard computer program Microsoft Excel. Results. The state of autonomous innervation was normal in 71.0% of the examined hypothyroidism group and in 97.8% of the euthyroidism group. AN was absent both in hypothyroidism syndrome (0.0%) and in euthyroid thyroid pathology (0.0%). Moreover, the “borderline state” of autonomic innervation was observed in 29.0% of the examined groups of hypothyroidism syndrome and only 2.2% of the examined groups of thyroid euthyroid pathology (p=0.0019). The chance of finding parasympathetic disorders in the hypothyroidism group was 0.409, and in the group of euthyroid thyroid pathology was 0.022. Conclusions. Thus, in the presence of hypothyroidism, the chances of finding autonomic disorders were 18.409 times higher than those for euthyroid thyroid pathology, which requires appropriate correction when planning comprehensive treatment tactics. Key words: autonomic neuropathy, hypothyroidism syndrome, euthyroid pathology of the thyroid gland.