Endocrine Abstracts

Objective: A subclinical hypothyroidism (SH) is the independent factor of the risk of cardiovascular diseases. The aim is to learn the possibility of optimization of the standard treatment of lipid and carbohydrate disoders, antihypertensive treatment of the levothyroxine replacement therapy (LRT) for women with metabolic syndrome (MS) and SH.

Methods: 137 women: 1gr.-68pts with MS, SH and with the LRT use; 2gr.-69pts with MS and without LRT use. Body mass index, echocardiography, fast levels of TSH, freeT4, freeT3, glucose, insulin, lipids, ambulatory blood pressure monitoring were determined. The insulin resistance was diagnosed at increase of the Homa-index. All of the patients got 10 mg of atorvastatin, 10 mg of lisinopril (ACE Inhibitors), metformin 1500 mg per day and patients of 1 gr. got additionally LRT in the dose of 50 mg per day. Patients were observed at the beginning and in 6 months of treatment.

Results: In 6 months the authentically large serum levels of total cholesterol (TC5.4±0.5 mmol/l) and low-density lipoprotein (LDL3.0±0.2 mmol/l) cholesterol in 2 gr. remained as at the beginning of the research. This pattern of lipid abnormalities for women with MS, SH is important because it is a risk factor for atherosclerotic cardiovascular disease. The Homa-index 3.0±0.2, blood pressure monitoring 143/85 mm Hg remained elevated. In 6 months the women with MS, SH and LRT use of the 1 gr. demonstrated the reliable decline, the best decline of all indicators: TC4.5±0.4 mmol/l, LDL2.0±0.3 mmol/l, glucose, Homa-index 2.2±0.3, ambulatory blood pressure monitoring 130/80 mm Hg.

Conclusions: The therapy of atorvastatin, lisinopril, metformin for women with MS, SH during 6 months is insufficient for the achievement of the target levels of TC, LDL, glucose, Homa-index, ambulatory blood pressure monitoring while setting of the combined therapy of LRT use, optimizes efficiency of lipid lowering therapy allowing to attain the normal levels of lipids without the increase of dose of statin and to decrease displays of insulin resistance and to improve antihypertensive treatment.