TY - JOUR A2 - Grzmil, Pawel AU - Kalra, Sanjay AU - Aggarwal, Sameer AU - Khandelwal, Deepak PY - 2021 DA - 20121/03/30 TI -甲状腺功能障碍和代谢异常综合征:SP - 9641846 VL - 2021 AB -甲状腺功能障碍(TD)常见于代谢疾病，如糖尿病(DM)、心血管疾病(CVD)、肥胖、血脂异常、高尿酸血症、肝肾功能障碍和多囊卵巢综合征(PCOS)。亚临床甲状腺功能减退(SHypo)会加重糖尿病患者的血糖控制，这些患者，尤其是1型糖尿病患者，TD的患病率更高。TD和DM都会增加心血管疾病的风险。即使是甲状腺激素(TH)水平的微小改变也会改变心血管功能。甲状腺机能亢进使收缩压升高，导致高输出心力衰竭，而甲状腺机能减退则使舒张压升高，导致低输出心力衰竭。慢性亚临床甲亢(SHyper)和SHypo均增加高血压、冠状动脉疾病(CAD)事件、CAD死亡和总死亡的风险。SHyper改变心脏的形态和功能。SHypo引起血脂异常和内皮功能障碍，增加体重增加和肥胖的风险。超重和肥胖患者常出现高瘦素血症，高瘦素血症可增加促甲状腺激素(TSH)的分泌，诱发TD。 Dyslipidemia associated with TD can increase serum uric acid levels. Hyperuricemia promotes inflammation and may increase the risk for dyslipidemia, atherosclerosis, and CVD. TD increases the risk for developing chronic kidney disease. In nephrotic syndrome, proteinuria is associated with urinary loss of TH leading to TD. Some correlation between TD and severity of liver disease is also seen. TD and PCOS have common risk factors and pathophysiological abnormalities. Hypothyroidism must be excluded before diagnosing PCOS. Current guidelines do not strongly recommend thyroid screening in the presence of all metabolic disorders. However, pragmatic thyrovigilance is required. Clinicians must stay alert to signs and symptoms of TD, maintain high clinical suspicion, and investigate thoroughly. Drug-induced TD should be considered when TH levels do not match clinical findings or when patients are on medications that can alter thyroid function. SN - 1687-8337 UR - https://doi.org/10.1155/2021/9641846 DO - 10.1155/2021/9641846 JF - International Journal of Endocrinology PB - Hindawi KW - ER -