The review of literature discusses the problems of diagnostics and therapy of subclinical hypothyroidism and reference ranges for thyroid stimulating hormone. Expediency of change of reference range for TSH and target TSHlevel on L-thyroxine replacement therapy in patients with hypothyroidism is also discussed.

We retrospectively analyzed the results of measurements of serum TSH and free T4 concentrations performed in1014 patients hospitalised in Federal Endocrinological Research Center without known thyroid disorders. According to the present TSH reference ranges (0.4–4.0 mU/l), prevalence of a hypothyroidism in the sample was10% (n = 104). For an estimation of possible consequences of lowering TSH reference interval prevalence of TSH> 2.5 mU/l has been calculated as 24% (n = 250). Тhus, in case of reduction of upper limits for TSH the quantity of persons with a hypothyroidism can increase in 2,5 times.

The aim of the study is to estimate a current state of iodine deficiency problem and necessity group (individual) iodine prophylaxis in adolescent living in iodine deficiency regions. Materials and methods. One-stage epidemiological survey was carried on in two cities: Smolensk and Kazan. There were examined 420 children at the age of 14–16 years. Research methods included: clinical survey, an estimation physical developments estimation (height and weight measurement), ultrasound examination of a thyroid, urinary iodine concentration(UI) measuring, analysis of thyrotropin (TSH) and thyroperoxidase autoantibody. The main results. Prevalence of a diffuse goiter in both regions was approximately equal and corresponded to mild iodine deficiency (10.5% in Smolensk and 8% in Kazan). At the same time, the mean of thyroid volume was significantly higher in a group of teenagers surveyed in Smolensk. Also we revealed that prevalence of nodule goiter is more frequent in Smolensk in than in Kazan. UI in schoolchildren in Smolensk corresponds to mild iodine deficiency (median UI is 61 μg/L). UI indicators in Kazan vice versa correspond to normal level of iodine consumption (median UI is 117.5 μg/L). Essential distinction of iodine sufficiency level has direct relation with iodine prophylactic measures in regions. Data in adolescents in Smolensk reveal insufficient iodine consumption and possible related risk of iodine deficiency disorders development. Conclusion. The obtained results show the necessity of group iodine prophylactic measures in adolescents who livein iodine deficiency regions with any severity level.

AIM: to evaluate global and segmental myocardial diastolic function, vascular wall elasticity, and the relation of arterial compliance to diastolic dysfunction in patients with SH. METHODS. We studied global and regional diastolic function of left and right ventricles (LV and RV) by tissue Doppler imaging (TDI), arterial stiffness by ultrasound assessment of Young`s elastic modulus, as well as biochemical parameters in 50 middle-aged women. 14 of them were euthyroid and had endemic goiter (controls), 11 women were euthyroid but had autoimmune thyroiditis (AT), 25 patients had AT and subclinical hypothyroidism (SH). RESULTS. Patients with SH compared with euthyroid patients and controls exhibited lower Em/Am (p = 0.060) and Et/At (p = 0.034) values, increased prevalence of segmental LV diastolic dysfunction (p = 0.030) and higher Young`s elastic modulus (p = 0.049) indicating impaired global and regional diastolic function as well as increased arterial stiffness. Em/Am and Et/At ratio negatively correlated with age, TSH, LDL cholesterol values and Young`s modulus suggesting that RV and LV diastolic function was more changed in older, hypothyroid patients and by dislipidemia. Young`s elastic modulus values were positively correlated with the number of dysfunctional segments by TDI, cholesterol values and negatively with T4 values. CONCLUSIONS SH is associated with the impairment of global and regional diastolic function of RV and LV, and with increased arterial wall stiffness. There may be a common pathophysiological pathway linking these two entities. Dislipidemia and atherosclerosis acceleration can contribute, at least partly, to the cardiovascular abnormalities.

The purpose of the study was to evaluate haemodynamics and geometrical parameters obtained during echocardiography of patients with various clinical types of autoimmune thyroid disease (ATD). 77 patients with verified diagnosis of ATD were surveyed: 73 (94.8%) female and 4 (5.2%) male. All ATD patients were divided into 3 groups depending on function of the thyroid. Decrease in concentration of thyroid hormones at SCH and CH leads to decrease of contractility of heart. Obtained data shows that SCH and CH increase the rate of development fo eccentric hypertrophies of myocardium (25.9 and 60%, respectively, р <0.04). Patients with SCH and CH are characterised by moderate changes of morphofunctional parameters of heart consisting of increase in size and dilation of cavities of the left auricle and thickness of the left myocardial wall (a relative hypertrophy).

Reproductive function was evaluated in 308 with Graves’ disease (GD): in 250 retrospectively (group 1) and in 58 – prospectively (group 2); the control group included 34 healthy women in reproductive age. The manifestation of Graves’ disease was associated with menstrual abnormalities in 118 women (47.2%) in group 1 and in 37 women (63.8%) in group 2; the most common abnormalities were oligomenorrhea (26 and 21%) and hypomenorrhea (22 and 32%); premature and early menopause were found in 18 and 19%; polymenorrhea in 16% and 11% cases; hypermenorrhea in 11% and 6% cases; amenorrhea in 7% and 11% cases. The prevalence of spontaneous abortion in undertreated hyperthyroidism was 67%, but only 11.8% in case of stable disease (euthyroidism). GD was associated with lower ovarian reserve (high FSH, low Inhibin-B, Antimullerian hormone and ovarian volume). The most favorable results in the view of reproductive outcomes were achieved after radioiodine treatment of GD.