甲状腺功能障碍伪装在正常范围内

G. Canali, Vittoria Garella, Silvia Taranto, Sara L'Assainato, V. Calcaterra, G. Zuccotti
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摘要

甲状腺功能在代谢稳态、调节血压、能量消耗和糖脂代谢中起着至关重要的作用。众所周知,甲状腺改变模式,特别是甲状腺功能减退,与代谢综合征有关。然而,最近,不同的甲状腺激素释放模式显示不符合甲状腺功能减退或甲状腺功能亢进的经典定义,在这些模式中,激素水平可能经常在正常范围内。甲状腺激素抵抗综合征被定义为一种状态,其特征是甲状腺激素在正常范围的上限内,但TSH水平从正常到高。事实上,许多研究表明,这种情况与肥胖、代谢综合征、糖尿病和NAFLD等疾病之间存在关联。最近的研究假设,甲状腺激素抵抗可能存在于残疾患者中,因此他们也调查了所有这些情况是否以及如何相互影响。此外,鉴于TSH和甲状腺激素在各种疾病的发展中所起的重要作用,及其对卫生系统的影响,因此,在临床环境中建立支持甲状腺稳态解释的可靠算法是至关重要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Disfunzioni tiroidee mascherate all’interno dei range di normalità
Thyroid function plays a crucial role in metabolic homeostasis, in the regulation of blood pressure, energy expenditure and in glucose and lipid metabolism. Thyroid alteration patterns, particularly hypothyroidism, are widely known to be associated with metabolic syndrome. However, more recently, different thyroid hormone release patterns have shown not to fit within the classic definitions of hypothyroidism or hyperthyroidism, patterns in which hormone levels may often be within the normal range. A condition defined as thyroid hormone resistance syndrome has been identified as a state characterized by thyroid hormones within the upper limits of the normal range but with normal to high TSH levels. In fact, many studies have shown an association between this condition and pathologies such as obesity, metabolic syndrome, diabetes and NAFLD. Recent studies have hypothesized that thyroid hormone resistance might be present in patients with disabilities, therefore they also investigated whether and how all those conditions may influence one another. Furthermore, given the important role that TSH and thyroid hormones play in the development of various diseases, and the consequent implications for the health system, the creation of reliable algorithms that support the interpretation of thyroid homeostasis in the clinical setting is therefore pivotal.
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