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Clinical and experimental thyroidology

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Vol 6, No 2 (2010)

Articles

40-45 629
Abstract
Primary congenital hypothyroidism (CH) is the most common neonatal metabolic disorder and before the introduction of neonatal screening programs it was one of the most frequent causes of mental retardation. CH has the incidence of about 1:3000 newborns in different populations. In Belarus the population neonatal screening for CH has been performing since 1991. By the beginning of 2010 1320580 newborns were screened, and 201 cases of CH were diagnosed. The frequency of CH was estimated as 1:6570. The most common cause of CH in Belarus is thyroid hypoplasia. Neonatal thyroid stimulating hormone (TSH) level is a sensitive marker of iodine deficiency, so the neonatal screening results can be used for monitoring the population iodine prophylaxes programs. In 90-th, the primary positive rate in neonatal screening for CH was 0.65–5.2% for different regions of Belarus with cut-off level of 25 mIU/L. TSH level >5 mIU/L was noticed in 50% of screened newborns. In the 21-th century the number of primary positives diminished to 0.01–0.02% with cut-off level of 15 mIU/L. TSH level >5 mIU/L is noticed in 8.9% of screened newborns. The results of population neonatal screening for CH reflect the effectiveness of iodine prophylaxes programs run in Belarus in the 21-th century.
46-50 348
Abstract
Gly389Arg polymorphism β1-adrenoreceptors can influence the cardio-vascular prognosis. Human heart β1-adrenoreceptors perform a crucial role in mediating the cardiostimulant effects of norepinephrine. Understanding the significance of Gly389Arg polymorphism in the human heart is beginning to emerge, but not in adult patients with thyrotoxicosis. We've studied the Gly389Arg polymorphism of β1-adrenoreceptors gene in relation to Echo-cardiography parameters in 136 normotensive patients with a thyrotoxicosis without any CVD. Echo-CG was performed according to standard protocol before and during the thyreostatic treatment. The genotype distribution was as following: Gly/Gly – 25% (1 group (1 gr.)), Arg/Gly – 75% (2 group (2 gr.), Arg/Arg – 0%. There was significant difference between 1 and 2 gr. by relative left ventricle wall thickness, left ventricular mass index, isovolumic relaxation time, Е/А ratio. The frequency of diastolic dysfunction (DD) was in gr. 1–10%, in gr. 2–30%, р <0.001. After treatment during a year this damages were saved. These data demonstrate, that Gly/Gly genotype of β1-adrenoreceptors gene can have cardioprotective effect leading to less of LV hypertrophy and diastolic dysfunction in patients with thyrotoxicosis.
51-56 571
Abstract
To lean the condition of thyroid gland and thyroid function in patients with chronic renal failure on a hemodialysis. A total of 234 patients (105 males and 129 females) with chronic renal failure who are being treated by a long-term hemodialysis from 1 to 167 months, living in different city of Eastern Siberia were examined. All patients included in the study have ultrasonografic scan of thyroid. Free thyroid hormones, thyrotropin and thyroid peroxidase antibodies blood levels were determined. Among the examined cases in 60 (25.4%) was diagnosed thyroid disease (autoimmune thyroiditis without dysfunction, subclinical hypothyroidism, nontoxic diffuse or nodular goiter) for the first time. In 102 (43.6%) of cases the thyroid disease has not revealed, in 39 (16.7%) euthyroid sick syndrome type 1 or 2 was determined.
57-61 514
Abstract
The estimate the functional state of the female adolescent thyroid with menstrual cycle disorder, living in the iodine deficiency regions, 130 female adolescents with irregular menstrual cycle were examined. Hypothyroidism incidence (in them) was 16.9%. In addition we considered TSH range 2.5–4.0 mU/l (highly normal TSH level) the extent of which was 12.3%. High extent of antibody carriage to the thyroid (31.3%) in girls with irregular menses, having high blood TSH level. There were no statistical differences between the structure of menstrual dysfunction and menstrual duration depending on thyroid function (p = 0.2383, respectively), as well as the average values of estradiol levels depending on TSH level (p = 0.3213). Thus, the influence of highly normal TSH on menstrual function development in female adolescents.
62-67 636
Abstract
To assess the quality of life of patients with hypothyroidism and to compare with the QoL of patients with nodular goiter and people without thyroid disease. Thirty patients with compensated primary hypothyroidism (aged from 25 to 55 years), 28 patients with nodular (multinodular) euthyroid goiter of the same age not receiving levothyroxine, and 30 healthy people. The scores for the Short-Form 36 (SF-36) and Beck Depression Inventory Scale were analyzed. Almost all scales of the questionnaire SF-36 (except for general health and role emotional functioning) in patients with compensated hypothyroidism were significantly lower (p < 0.05), than in healthy people. While comparing QoL in patients with hypothyroidism with QoL in patients with nodular goiter the rates of role physical functioning (p = 0.042), vitality (p = 0.015), social functioning (p = 0.0) and psychological health (p = 0.021) of patients with hypothyroidism were significantly less compared with patients with euthyroid goiter. In assessing the severity of depression revealed that the value on a scale of depression in patients with compensated hypothyroidism was significantly higher compared with the results of patients with nodular goiter and healthy individuals (p = 0.014). Conclusion: In patients with compensated hypothyroidism in almost all parameters the quality of life worse than in people without thyroid disease, and on many scales (role physical functioning, vitality, social functioning and psychological health) is worse than in patients with euthy-roid goiter. Severity of depression in patients with compensated hypothyroidism is higher compared to patients with nodular goiter and healthy people, which may be one of the reasons for the decrease of quality of life of these patients.


ISSN 1995-5472 (Print)
ISSN 2310-3787 (Online)