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首页> 外文期刊>Therapeutic advances in endocrinology and metabolism. >Levothyroxine treatment of mild subclinical hypothyroidism: a review of potential risks and benefits
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Levothyroxine treatment of mild subclinical hypothyroidism: a review of potential risks and benefits

机译：左甲状腺素治疗轻度亚临床甲状腺功能减退症：潜在风险和益处的综述

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Subclinical hypothyroidism (SCH) is defined as elevated thyroid stimulating hormone (TSH) with normal levels of free triiodothyronine (FT3) and free thyroxine (FT4). SCH is further classified into a milder condition with TSH levels between 4.0 and 10.0 milli-international units (mIU)/l (mild-SCH) and a severe form with TSH 10.0 mIU/l (severe-SCH). SCH is a common problem (prevalence is greater in women than men), which increases further with increasing age and TSH levels. Even though the risk of progression to overt hypothyroidism is higher in patients with severe-SCH, the risk is also significant in patients having mild-SCH; it has been suggested that every twofold rise in serum TSH would increase the risk from 1 to 4%, which further increases to 38% if thyroid antibodies are positive. Current data have shown increased cardiovascular risk in patients with mild-SCH and have demonstrated some benefits of levothyroxine treatment in reducing these events. However, evidence on the association of mild-SCH and musculoskeletal system, cognitive dysfunction, mood disorders, dyslipidaemia, diabetes and goitre is conflicting. Similarly, the discussion regarding the exact upper limit of normal for serum TSH remains controversial. The data have also shown increased risk of adverse pregnancy outcomes in patient with mild-SCH, with some benefits of thyroxine treatment. The recent available guidelines related to management of patients with serum TSH.
机译：亚临床甲状腺功能减退症（SCH）定义为甲状腺刺激激素（TSH）升高，游离三碘甲状腺素（FT3）和游离甲状腺素（FT4）处于正常水平。 SCH进一步分为TSH水平在4.0-10.0毫国际单位（mIU）/ l（轻度SCH）和TSH> 10.0mIU / l的严重形式（重度SCH）的轻度病状。 SCH是一个常见问题（女性患病率高于男性），并且随着年龄和TSH水平的升高而进一步增加。即使重度SCH患者发展为明显的甲状腺功能减退的风险较高，轻度SCH患者的风险也很明显。有人提出，血清TSH的每增加2倍会使患病风险从1％增加到4％，如果甲状腺抗体呈阳性，则患病风险会进一步增加到38％。当前数据显示轻度SCH患者的心血管风险增加，并已证明左甲状腺素治疗可减少这些事件。但是，关于轻度SCH与肌肉骨骼系统，认知功能障碍，情绪障碍，血脂异常，糖尿病和甲状腺肿相关的证据相互矛盾。同样，关于血清TSH正常值的确切上限的讨论仍然存在争议。数据还显示，轻度SCH患者的不良妊娠结局风险增加，并且甲状腺素治疗有一定益处。最近可用的指南涉及血清TSH患者的治疗。

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