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Aim: To compare the frequency of cardiovascular events (CVE), to assess the risk of cardiovascular death using the mSCORE and the development of type 2 diabetes mellitus (DM) using the FINDRISC in patients with rheumatoid arthritis (RA) with and without hypothyroidism., Materials and Methods: The study included 149 patients (125 women, 24 men) with RA (median age - 57 [52; 61] years). In all patients, traditional factors of cardiovascular risk and glucose metabolism disorders (age, smoking status, total blood cholesterol, blood pressure, overweight, abdominal obesity - AO, heredity burdened by diabetes, insufficient physical activity, the lack of the necessary amount of berries, fruits and vegetables in the daily diet, history of hyperglycemia episodes), the 10-year risk of death from cardiovascular causes according to the mSCORE and the risk of developing type 2 DM according to the FINDRISС were assessed, a history of CVE (myocardial infarctions, and its revascularization, stroke) was recorded., Results: Hypothyroidism was diagnosed in 17.4% of RA patients. Patients with hypothyroidism (group 1) were more likely to have AO and less likely to consume unsufficient dietary fiber than patients with euthyroidism (group 2). Moderate, high and very high risk of development according to the mSCORE and FINDRISC was detected in 61.5% of hypothyroid patients and 48.8% euthyroid patients, according to mSCORE alone - in 30.8 and 44.7%, according to FINDRISC - in 0 and 2.4%, respectively (p>0.05 in all cases); 11.5% of patients in group 1 and 6.5% in group 2 suffered from CVE (OR 1.875, 95% CI 0.462-7.607; p =0.63)., Conclusion: It is necessary to evaluate the thyroid gland function, especially in patients with AO due to the high frequency of hypothyroidism in RA. Hypothyroidism did not have an independent effect on the severe CVЕ rates, as well as risk assessment according to the score and FINDRISC in RA patients. Theses, with and without hypothyroidism, were predominantly in the moderate, high, very high risk groups according to both scales.

Searching for aging key points is one of the main problems in geriatrics. More and more research in recent years has been devoted to the study of geroprotective mechanisms, the impact of various conditions and diseases on aging in general. Of particular importance is the determination of age-related involutive processes in the human body, whether they are part of normal aging or a condition that needs to be corrected to improve the functioning of organs and systems. An important mechanism of aging starts is a change in hormonal activity of endocrine glands, in particular in hormonal activity of thyroid. Frequency of hypothyroidism in advanced age explains relevance of the chosen topic. The aim of the review was to find out the role hypothyroidism in aging. The main task was to define, whether thyroid hormones decrease in older age was a protective factor or pathological process. A review of the literature over the past 10 years on subclinical treatment was carried out and we identified the most pressing issues associated with hypothyroidism and aging. We studied data on the relationship between hypothyroidism and major geriatric syndromes, with special attention paid to cognitive diseases and emotional disorders.

Turner syndrome (TS) is a chromosomal disorder affecting female and characterized by complete or partial monosomy of the X chromosome. These genetic changes lead to the abnormalities in growth and development and increase the risk of autoimmune diseases, including those affecting the thyroid. Thyroid pathology in TS may include autoimmune thyroiditis, hypothyroidism, thyrotoxicosis (Graves disease, AIT in the hyperthyroid state).Thyrotoxicosis is the clinical syndrome of excess circulating thyroid hormones. One of the main causes of thyrotoxicosis is Graves' disease (GD), an organ-specific autoimmune disease caused by the production of stimulating thyrotropin receptor antibodies. There are three treatment options for thyrotoxicosis: anti-thyroid drugs, radioactive iodine and thyroidectomy. A personalized approach to disease management is especially important in cases of genetic diseases.We present a clinical case of a patient with TS and GD, who has been referred to a radiologist at the Department of Radionuclide Therapy of Endocrinology Research Center. The patient was diagnosed with congenital hypothyroidism at neonatal screening, but thyroid hormones therapy was initiated aged three. Based on the survey, GD was diagnosed aged twenty one. Anti-thyroid drug therapy was started, which resulted in toxic hepatitis. Taking into account intolerance to anti-thyroid drugs, radioiodine therapy has been recommended, which led to hypothyroidism.

Hypopituitarism is a state of complete or partial deficiency of pituitary hormones, including adrenal insufficiency, hypothyroidism, hypogonadism, growth hormone deficiency, and, rarely, diabetes insipidus.The article describes a clinical case of hypopituitarism due to a pituitary tumor in a postmenopausal woman. Difficulties in diagnosing hypopituitarism were due to a history of primary hypothyroidism. The first identified component of panhypopituitarism in the patient, (central hypothyroidism) had previously been seen as laboratory indications of medication-induced hyperthyroidism.The non-specific nature of the clinical symptoms, as well as a relatively rare combination of endocrine diseases, led to a long examination period and delayed diagnosis of the pituitary tumor.Whether the development of hypopituitarism in a patient with a nonfunctional pituitary tumor is an indication for transsphenoidal pituitary surgery remains a controversial issue. The decision for surgery is made taking into account the characteristics of the course of the disease in a particular patient. In this clinical case, a conservative tactic was chosen with hormone replacement therapy for glucocorticoid and thyroid deficiency.

Tumors of the pituitary gland producing thyrotropin hormone (TSH) are rare and account for about 1-3% of all pituitary adenomas, most frequently occurring in persons of young and working age. This article presents a clinical case of thyrotropinoma in a 44-year-old woman, which was diagnosed 6 years after her initial visit to an endocrinologist. At the debut of the disease, thyrotropinoma manifested as an isolated elevation of TSH, with normal levels of free T4 and free T3. The patient was constantly taking β-blockers due to her disturbing tachycardia. She was diagnosed with subclinical hypothyroidism, for which she was periodically observed, controlling her TSH level and taking levothyroxine drugs in a dose of up to 175 mcg, which was accompanied by elevated TSH levels. After 6 years, there was an increase in free T3 and free T4 in addition to TSH. Magnetic resonance imaging with intravenous contrast enhancement revealed a pituitary microadenoma 4 mm in size, and laboratory examination of all tropic hormones revealed an isolated increase in TSH. Transsphenoidal adenomectomy was performed at the diagnosis of TSH-producing pituitary adenoma. During the three-year postoperative follow-up there was no adenoma recurrence, secondary hypothyroidism developed, the patient currently takes levothyroxine 75 mcg per day continuously.

A rare case of hypothyroid coma developed in a patient with diagnosed primary hypothyroidism, complicated by the development of rhabdomyolysis and prolonged oppression of the respiratory center is presented. The predominance of previous cardiovascular pathology, marked oedema syndrome, and hypercholesterolemia in the clinical picture of the disease initially directed the diagnostics of cardiac pathology, which delayed the diagnosis of hypothyroidism. This publication aims to draw clinicians' attention to hypothyroid coma as a rare complication of hypothyroidism, which in this case was disguised as ischemic heart disease with the development of chronic heart failure.

Aim To study features of coronary damage and incidence of different types of acute coronary syndrome (ACS) in history associated with primary symptomatic hypothyroidism in patients with ischemic heart disease (IHD) and possible associations of replacement hormonal therapy with lipidogram indexes.Material and methods This retrospective study included 344 patients with IHD and functional class I-III stable angina (ССS, 1976). Of them 100 patients had primary symptomatic hypothyroidism and 244 had no hypothyroidism. Coronary angiography was performed for all patients included into this study. Routine laboratory, instrumental and clinical indexes were analyzed. Hypothyroidism was confirmed by levels of thyrotropic hormone, free triiodothyronine, and thyroxine. Comparative analysis was performed for the incidence of ACS types in history, types of coronary injury, and laboratory, instrumental and clinical indexes with assessment of potential interrelations. Statistically significant results were reported. Type of data distribution was evaluated with the Kolmogorov-Smirnov test. Quantitative data with normal (Gaussian) distribution were presented as mean (M) and standard deviation (SD). Data with attributes of non-normal distribution were presented as median (Me) with maximum and minimum values (min; max). Statistical significance of differences between means was assessed with the Mann-Whitney test. Logistic regression analysis was used in parallel for evaluating dependence of a quantitative variable on values of two or more quantitative or qualitative variables (factors). Significance level for testing of statistical hypotheses was р<0.05.Results Incidence of ST segment elevation ACS (STEACS) was significantly higher in IHD patients with hypothyroidism than in the group without hypothyroidism (61.6 and 35.6 %, р=0.03) and also with three-vessel coronary artery disease (60.6 and 30.6 %, р=0.001). In the IHD group with hypothyroidism, levels of total cholesterol, triglycerides, and low- and very low-density lipoproteins were significantly increased compared to the respective values in patients without hypothyroidism (р<0.0001). An inverse correlation was found between lipidogram indexes and L-thyroxine (р<0.0001).Conclusion The incidence of STEACS associated with primary symptomatic hypothyroidism in history was significantly higher in the patient group with IHD on the background of primary symptomatic hypothyroidism compared to the comparison group. Also, the incidence of three-vessel coronary disease was significantly greater than in the IHD patient group without hypothyroidism. A significant association was found between the replacement hormonal therapy and the best lipidogram indexes. The authors suggested that the key factor for prevention of adverse cardiovascular events in IHD with hypothyroidism is achieving control of clinical manifestations of hypothyroidism with replacement hormonal therapy.

Background: The interrelationship of thyroid pathology and ENT organs is one of the least studied aspects of iodine deficiency diseases. Diseases of this localization are distinguished by a variety of their causes, high prevalence, a tendency to prolonged and chronic process, resistance to drug therapy and a negative effect on the quality of life of patients., Aim: To study the state of ENT organs in hypothyroidism in the iodine-deficient region of Eastern Siberia (Irkutsk Region)., Material and Methods: The main group consisted of 302 patients with hypothyroidism, and the control group - 116 people without thyroid pathology. All patients who participated in the study were on replacement therapy (Levothyroxin). An objective study of the ENT organs was performed using an endoscope and a microscope. The SF-36 questionnaire was used to study the indicators of quality of life. A questionnaire was used to assess the symptoms of rhinitis, which provided clarification of the severity of symptoms on a visual analogue scale., Results: Among patients with thyroid dysfunction, various changes characteristic of chronic pathology of the pharynx, larynx, and ear were found with almost the same frequency as among those examined without thyroid pathology. Chronic rhinitis in hypothyroidism is characterized by manifest edematous-hypertrophic changes in the turbinate, intense hyperemia of the nasal mucosa, the presence in the nasal passages of viscous, thick mucous discharge. The most important integral indicators of health components are physical (PH) and psychological (MH) patients with chronic rhinitis were reduced (50.6±1.96 and 53.0±2.08 respectively)., Conclusion: The symptoms of rhinitis are leading in the structure of the pathology of the upper respiratory tract in hypothyroidism and have a significant negative impact on the patient's quality of life indicators.

Thyroid diseases are closely associated with the development of types 1 and 2 diabetes mellitus (DM), and as a consequence, the development of effective approaches for their treatment is one of the urgent problems of endocrinology. Traditionally, thyroid hormones (TH) are used to correct functions of the thyroid system. However, they are characterized by many side effects, such as their negative effect on the cardiovascular system as well as the ability of TH to enhance insulin resistance and to disturb insulin-producing function of pancreas, exacerbating thereby diabetic pathology. Therefore, the analogues of TH, selective for certain types of TH receptors, that do not have these side effects, are being developed. The peptide and low-molecular weight regulators of thyroid-stimulating hormone receptor, which regulate the activity of the thyroid axis at the stage of TH synthesis and secretion in thyrocytes, are being created. Systemic and intranasal administration of insulin, metformin therapy and drugs with antioxidant activity are effective for the treatment of thyroid pathology in types 1 and 2 DM. In the review, the literature data and the results of own investigations on pharmacological approaches for the treatment and prevention of thyroid diseases in patients with types 1 and 2 DM are summarized and analyzed.

Aim: To investigate the association of the polymorphic variants -204A > C (rs 3808607) in the CYP7A1 gene with the development of dyslipidemias in healthy individuals, in patients with non-alcoholic fatty liver disease (NAFLD) and in those with NAFLD concurrent with hypothyroidism., Subjects and Methods: DNA samples and lipidograms were examined in 180 patients, including 60 healthy individuals (Group 1), 60 patients with hypothyroidism concurrent with NAFLD (Group 2), and 60 patients with NAFLD (Group 3). All the patients underwent ultrasound examination of the thyroid gland and abdominal cavity organs; FibroMax scores were calculated., Results: All the study groups most frequently showed a homozygous AA genotype (86.6% of cases in Group 1, 80% in Group 2, and 83.3% in Group 3). The development of NAFLD in CC genotype carriers is characterized by the most pronounced changes in lipid metabolism (atherogenic index (AI), 7.32 in Group 3) compared to the genotypes AA (AI, 4.56 in Group 2 and 1.73 in Group 1) and CC (AI, 6.43 in Group 2 and 2.52 in Group 1) in functional insufficiency of thyroid hormones and relative normal conditions., Conclusion: The analysis of the relationship of polymorphic variants CYP7A1 rs 38088607 to lipid metabolic disturbances in the study groups showed that the significantly higher levels of atherogenic cholesterol fractions were determined in the CC genotype compared to AA genotype carriers and they did not depend on the presence of NAFLD and hypothyroidism. The findings make it possible to consider the AA homozygous genotype of variant mutation CYP7A1 rs 38088607 as protective against dyslipidemia. However, in functional insufficiency of thyroid hormones, the level of triglycerides is significantly higher in both genotypes, which suggests that hypothyroidism plays an essential role in the development of dyslipidemia and NAFLD.

Purpose of the Study: Evaluating the effectiveness of the various options of combination antihypertensive therapy (AHT) in women with arterial hypertension (AH) and metabolic syndrome (MS) and hypothyroidism., Material and Methods: The study included 163 women with hypertension, metabolic syndrome, and hypothyroidism, the median age of 53.5 (48-60) years; in 73 (44.8%) women were diagnosed with subclinical hypothyroidism (SH), 90 (55.2%) - overt hypothyroidism (OH). Patients with both SH and OH, depending on the source of the heart rate (HR) was appointed as one of the following combination of AHT. If heart rate <75 beats/min, patients (n=100) received a combination of the dihydropyridine calcium antagonist (AA) amlodipine 5 mg/day, and angiotensin receptor blockers II (ARB) losartan 50 mg/day, with heart rate >75 beats/min (n=63) - a combination of amlodipine 5 mg/day and imidazoline receptor agonist (IRA) moxonidine 200 micrograms/day. The failure to achieve target blood pressure (BP) after 4 weeks of dose drugs doubled with subsequent evaluation of the effectiveness even after 4 weeks. At baseline and after 6 months of therapy, all patients underwent daily blood pressure monitoring (DBPM)., Results: At 8 weeks, the use of a combination of AA+ARB target BP level was registered in 26 (59%) of 44 women with SH and 34 (60.7%) of the 56 - OH. In the group of women who took the AA+IRA, after 8 weeks of the target blood pressure was observed in 24 (82.8%) of 29 patients with SH and 28 (82.4%) of 34 - to OH. Register the target blood pressure was observed significantly more frequently (p<0,05) when using a combination of AA+IRA compared with AA+ARBs as with SH and OH. As a result of the combination of DBPM AA and ARBs in patients with SH and OG provided a significant reduction in average daily, daytime and nighttime systolic and diastolic blood pressure (SBP and DBP), the time index of SBP and DBP during the day and night hours. The therapy of AA and IRA regardless of the severity of hypothyroidism, there was a significant improvement in all indicators DBPM: average daily, daytime and nighttime SBP and DBP, time index and variability in SBP and DBP during the day and at night. Furthermore, as in the SH and OH significantly more pronounced positive changes most DBPM parameters were recorded using IRA in combination with AA compared with a combination AA+ARB. Significant increase in the number of women with optimal BP daily profile "dipper" observed only when using amlodipine and moxonidine., Conclusion: In women with hypertension, hypothyroidism and MS, regardless of the severity of decline of thyroid function and combination of the dihydropyridine AA IRA had an advantage over the AA combination with ARBs, since most patients provided achieving target blood pressure and clinically significant positive impact on BPM indicators. The results can be used in selecting the optimal AHT in patients with hypertension, MS, and the manifest subclinical hypothyroidism.

Aim: To evaluate the activity of neuron specific enolase (NSE) in patients with primary hypothyroidism (PGT) treated with mexidol., Material and Methods: Patients with PGT (n=110) were examined before and after treatment. Neuropsychological and neurological status of the patients was studied. To assess the status of the peripheral nervous system, electroneuromyography was performed and serum NSE level was determined., Results and Conclusion: The NSE activity depended on gender, age of the patient, duration of endocrinopathy and presence/absence of neurological symptoms. The clear positive dynamics of the majority of the parameters studied was noted during mexidol treatment. The efficacy of antioxidant therapy in these patients was confirmed.

Unlabelled: The aim was to investigate the morphological features of the liver in animals at different periods of post-operative hypothyroidism to reproduce the experimental fatty liver disease., Materials and Methods: thyroidectomy was performed 20 laboratory rats, females breed nonlinear, thyroid was mobilized without thyroid thyroidectomy to 10 individuals. The morphological pattern of the rat's liver was studied in terms of 4 and 8 weeks after surgery at the light optical level., Results: 4 weeks after thyroidectomy was found in rat liver protein and fatty degeneration with focal of inflammatory infiltration, against the backdrop of a serous edema. On the 8th week of the experiment observed the progression of degenerative, necroinflammatory processes expressed hydropic dystrophy, atomizing steatosis and the appearance of periportal fibrosis.

The article presents data on the relationship between thyroid dysfunction and cardiovascular diseases. The role of dyslipidemia, adipokines (adiponectin, leptin, resistin), C-reactive protein, deficiency of vitamin D3 in the development of cardiovascular disease in hypothyroidism is discussed. The article describes characteristics of myocardial remodeling, its dysfunction and their correlation with risk factors of cardiovascular diseases in patients with hypothyroidism.

Subclinical hypothyroidism (SHT) is a clinical-laboratory syndrome characterized by an elevated thyrotropin level and normal levels of T3 and T4. Lipid metabolism disorders in patients with SHT and the influence of substitution therapy with L-thyroxin on the lipid profile are considered in many publications, but the results of these studies are contradictory. This paper was aimed to discuss the relevant literature and search for the most effective treatment strategy.

We measured the levels of osteoprotegerin, resistin, leptin, and adiponectin in patients with hypothyroidism differing in the thyroid status. The levels of osteoprotegerin, resistin, leptin were higher and those of adiponectin lower than normal. The patients suffered atherogenic dyslipidemia associated with enhanced insulin resistance and compensatory hyperinsulinemia. Leptin and adiponectin levels correlated with characteristics of lipid metabolism. It is concluded that leptin and adiponectin play a role in the development of dyslipidemia in hypothyroidism.

The aim of the research was to estimate peripheric blood in patients with iron deficiency anemia and different forms of hypothyreosis. 192 patients with diagnosis of iron deficiency anemia and different forms of hypothyreosis were investigated. Among investigated patients 34 (22.9%) were men and 158 (87.5%) - women. The patients' age varied from 21 to 77 years old. Patients were divided into 3 groups: group I - patients with subclinical hypothyreosis; group I A - patients with isolated subclinical hypothyreosis; group I B - patients with subclinical hypothyreosis in combination with iron deficiency condition. Group II A - patients with isolated primary hypothyreosis; group II B - patients with primary hypothyreosis in combination with iron deficiency. According to the results the different degree of blood formation disturbances were detected in the study groups: tissue iron deficiency; light, moderate and heavy degrees of anemia, and the etiology of risk factors of anemic syndrome in the study groups were determined. It was found that the insufficiency of thyroid hormones determined the insufficiency of the formed elements of blood. The iron deficient anemia with deficit of iron- containing enzymes in tissue led to decreased secretion of thyroid hormone from the thyroid gland and hypothyreosis.

Extracted teeth were studied in patients with hypothyroidism, by applying electron and atomic force microscopy. This method allows one to have extended morphometric characteristics. The patients with hypothyroidism were found to have superficial and internal changes in the enamel, dentin, and cement of intact and carious teeth. The macro- and microelement composition of teeth were investigated. In hypothyroidism, the resistance of dental tissue depends on the homogeneous structure of enamel and dentin.

Objective: To evaluate the efficacy of mexidol and necessity of using it in patients with endocrine polyneuropathies caused by primary hypothyroidism (PPHT). MATERIALS AND METHODS; We have examined 51 patients with confirmed diagnosis of PPHT and assessed their neurological status and indicators of metabolic homeostasis before and after treatment. Electroneuromyography (ENMG) was performed to assess the status of the peripheral nervous system., Results: The results indicate the presence of endocrine disorders of obligate metabolic homeostasis in patients with polyneuropathies. Antioxidants, in particular, mexidol, in a complex with other drugs can be used in the treatment of these disorders. Worsening of ENMG-parameters, demonstrating a trend towards the normalization in response to treatment antioxidants, are characteristics of this pathology., Conclusion: The efficacy of mexidol in patients with PPHT has been confirmed.

Aim: To study a relationship between thyroid function and the stiffness of great arteries in postmenopausal women with arterial hypertension (AH)., Subjects and Methods: The trial enrolled 76 postmenopausal patients with clinical hypothyroidism (CHT) (n = 24) or subclinical hypothyroidism (SCHT) (n = 52) and AH; a control group consisted of 40 postmenopausal women with euthyroidism. Body mass index (BMI), waist and hip circumferences, blood pressure (BP), thyroid-stimulating hormone (TSH), free thyroxine, free triiodothyronine, total cholesterol, triglycerides were determines; volumetric sphygmography was performed. Brachial-ankle pulse wave velocity (baPWV) was measured; cardio-ankle vascular index (CAVI) and ankle-brachial index (ABI) were determined., Results: The patients with CHT or SCHT and the controls were matched for age, BMI, BP, and heart rate. TSH levels in patients with SCHT (6.23 (5.27; 8.22) microU/ml) and in those with CHT (11.8 (9.09; 22.7) microU/ml) were statistically significantly higher than in the control group (2.25 (1.5; 2.72) microU/ml) (p < 0.05). BaPWV in the patients with SCHT (14.35 (12.5; 15.5) m/sec) and in those with CHT (13.75 (13.05; 15.25) m/sec) was also statistically significantly higher than in the control group (12.85 (12; 13.9) m/sec) (p < 0.05). Comparison of ABI and CAVI revealed no significant differences between the groups. Univariate analysis of the findings showed a significant impact on higher arterial stiffness in the SCHT and the CHT groups. Total cholesterol levels were significantly higher in the SCHT group than in the control one., Conclusion: The patients with AH and hypothyroidism versus their peers with AH and without thyroid function had significant rises in blood cholesterol levels and arterial stiffness. The rise in lipid levels was significantly marked only in the patients with SCHT; and baPWV equally increased in both the SCHT and the CHT groups.

The aim of the study was to estimate dynamics of hematological disturbances in autoimmune thyroiditis and subclinical hypothyroidism (SH) during substitution therapy and without it and to elucidate factors promoting successful correction. The control group included 36 women, 60 others had SH. They were matched for age, BMI, free T3 level but differed in TSH (1.8 +/- 0.81 vs 7.0 +/- 3.41 mcunits/ml, p < 0.001) and T4 (p < 0.001) levels. 53 women with SH were followed up for 1 year; 18 of them were not treated (subgroup A) while 35 were given levothyroxin (subgroup B). The following red blood parameters were measured hemoglobin (Hb), ferritin, mean erythrocyte volume, erythrocyte Hb content and concentration, blood iron (Fe) level. SH was characterized by decreased (compared with control) Hb levels (125.8 +/- 13.75 and 133.2 +/- 9.12 g/l, p = 0.005), erythrocyte volume (p = 0.022), Hb content per erythrocyte (p = 0.001), ferritin (24.6 +/- 20.56 vs 36.6 +/- 30.66 mcg/l, p = 0.02), and Fe (p = 0.001). The frequency of anemia (28.3 vs 11.1%, p = 0.039) especially microcytic anemia (p = 0.035) increased A year later women of subgroup A showed further decrease in ferritin level (p = 0.011) and increase in anemia frequency (p = 0.016): microcytic (p = 0.23) and normocytic (p = 0.015). In subgroup B, the frequency of anemia decreased (p = 0.001) while ferritin, Fe and Hb levels slightly increased (p > 0.05). The best effect of therapy and highest rise in ferritin level were documented in younger patients (p = 0.06), in the absence of obesity (p = 0.003) and at the low initial ferritin level (p < 0.001). In regression analysis, ferritin level (094 [0.89; 0.99], p = 0.035) proved the most significant predictor of therapeutic effectiveness. SH was characterized by Fe deficiency, tendency to microcytosis and anemia that progressed in the absence of therapy. Substitution therapy promotes normalization of hematological problems especially in young and non-obese patients. Sideropenic syndrome suggests potential benefits of levothyroxin therapy and may be regarded as an additional indication for its prescription.

We studied morphological structure of the kidneys in chronic endotoxemia modeled against the background of hypothyroidism. The detected changes did not differ from those under conditions of basic endotoxemia model and were characterized by the development of glomerulosclerosis and glomerulohyalinosis. The changes were less severe in rats with hypothyroidism and appeared at the late terms of the experiment. This indicated a moderate protective effect of preexisting thyroid hormone deficiency.

Aim: To study the time course changes in the parameters of endothelial dysfunction in patients with type 2 diabetes mellitus (DM) and subclinical hypothyroidism (SH) in the natural course of SH and during replacement therapy., Subjects and Methods: All the examined patients were divided into 2 groups: 1) 67 patients received replacement therapy with euthyrox in a dose of 25 to 100 microg/day; 2) 60 patients were followed up., Results: At the moment of study inclusion, there was a close direct correlation between the levels of cholesterol and the aggregate intima-media thickness (IMT) (r = 0.7) and between IMT and the levels of sICAM-1 (r = 0.71) and sVCAM-1 (r = 0.8). In the dynamics of the disease (following a year), the above correlations became weaker due to the performed treatment. A weak positive correlation was found between the aggregate IMT and the levels of sICAM-1 (r = 0.2) and sVCAM-1 (r = 0.3)., Conclusion: In patients with type 2 DM, the presence of SH serves as an additional risk factor for endothelial dysfunction. Replacement therapy will be able to considerably retard the progression of the disease and to reduce the incidence of vascular events.

The study included 58 patients with CHD and paroxysmal atrial fibrillation divided into 2 groups depending on thyroid hormone and thyrotropin levels. Group 1 was comprised of 24 patients with subclinical hypothyroidism, group 2 of 18 ones with subclinical hyperthyroidism. Control group consisted of l6 patients with CHD, paroxysmal atrial fibrillation and normal thvroid function. It was shown that patients with CHD, paroxysmal atrial fibrillation and subclinical thyrotoxicosis had T3 and T4 levels 92.6 and 72.5% higher than those with subclinical hypothyroidism. Subclinical thyroid dysfunction was shown to influence hemodynamic isoelectric parameters of the heart. Therapy of paroxysmal atrial fibrillation in CHD patients with subclinical hypothyroidism or hyperthyroidism with simultaneous correction of thyroid function increases the efficacy of anti-arrhythmic therapy up to 50 and 45.9% respectively.

Aim: To study the role of hypothyroidism and concomitant obesity in the development of metabolic syndrome (MS)., Material and Methods: We examined 60 women suffering from obesity and hypothyroidism (TTH 22.24 +/- 4.031). We studied lipid spectrum, carbohydrate metabolism, BP and insulin resistance, fat tissue distribution, exercise tolerance., Results: According to IDF (2005) criteria the women had: metabolic syndrome (83.4%), newly diagnosed hypothyroidism (95%), decompensated hypothyroidism (90%), subclinical hypothyroidism (65%) after six-month replacement therapy with L-T4 MS symptoms declined., Conclusion: Abnormally high level of TSH may be a component of metabolic syndrome.

The aim of this work was to study the role of hypovolemia on pathogenesis of arterial hypertension (AH) in patients with primary hypothyroidism (PH) and specification of indirect signs indicative of increased circulating blood volume. 217patients with PH and AH (mean age 53.3 yr) received substitution therapy with sodium levothyroxin and standard hypotensive therapy with ACE inhibitors. All the patients allocated to 3 groups were examined by 24 hour Holter monitoring and measurement of serum TSH and free T4. Group 1 (n = 74) were patients with compensated PH, group 2 (n = 57) comprised patients with subclinical hypothyroidism, group 3 (n = 86) were patients with decompensated hypothyroidism. The latter group was dominated by non-dippers, the patients showed elevated systolic and diastolic AD, its small reduction and high variability at night time. These clinical and functional signs are supposed to reflect hypovolemia in patients with PH and concomitant AH.

Influence of reduced thyroid gland function upon peripheral blood neutrophil functional activity in Wistar rats with acute mechanical trauma of gingival was studied. Thyroid insufficiency was simulated by daily intraoral Mercazole administration in the doze of 25 mg/kg during 21 days. The parodontal inflammatory process in rats with reduced thyroid gland function was characterized by reduced indicators of spontaneous and induced HCT-tests, by lower activity of posttraumatic inflammatory purulent processes in comparison with animals with euthyroid status.

Dysfunction of thyroid gland plays an important role in the pathogenesis of brain edema and swelling. Toxic brain edema and swelling was modeled under condition of hypo- and hyperfunction of thyroid gland. Mercazolyl and L-thyroxine ambiguously influence the development of toxic brain edema and swelling in rats. L-thyroxin (35.7 microg/kg) favors increase in the water content in brain tissue, which can be considered as synergism with the edematous factor and the formation of brain tissue susceptibility to the development of brain edema and swelling. The administration of mercazolyl (5 mg/kg) and L-thyroxin (35.7 microg/kg) with thymogen (10 microg/kg), thymalin (1.2 mg/kg), cycloferon (0.5 mg/kg) results in decreasing brain tissue density as compared to intact animals. Dysfunction of the thyroid gland leads to changes in pharmacodynamics of immune preparations, which results in a decrease of their antiedematous activity.

On the basis of clinical-EMG analyses, the researches have revealed the criteria characteristic of myasthenia associated with thyroid pathologies. The myasthenia process associated with thyroid pathology is mainly characterized as of generalized average intensity. Alongside with mup-s with reduced duration and amplitude characteristic of myasthenia, EMG exposes potentials with comparatively long duration and high amplitude (mainly when the process is associated with thyreotoxycosis). It should also be noted that spontaneous activity is intensively expressed. Considering all the above mentioned, we can conclude that these changes show disfunctioning of mup-s rather than the character of synapses caused by the process associated with the myasthenia. The results of the research will facilitate the timely revelation of the process associated with myasthenia and will lead to the unfailing adequate pathogenetic treatment.

Aim of this study was to investigate antiarrhythmic and toxic effects of verapamil in mice and rats with thyrotoxicosis and hypothyroidism. We found that changes of thyroid status lead to the increased sensitivity of animals to toxicity of verapamil. At single intraperitoneal introduction of verapamil, LD50 was 118 +/- 7,7 mg/kg for control euthyroid mice, 53 +/- 4,1 mg/kg for hypothyroid mice, and 77 +/- 6,5 mg/kg for thyrotoxic mice. Sensitivity of rat myocardium to arrhythmogenic effects of calcium chloride increased with development of thyrotoxicosis and hypothyroidism. Effective arrhythmogenic dose of CaCl2 was 200 mg/kg for euthyroid rats and 140 mg/kg for rats with thyroid dysfunction. Intravenous introduction of verapamil had antiarrhythmic activity in rats with experimental thyroid dysfunction but at a lower effective dose. Effective preventive dose of verapamil was 3 - 4,5 mg/kg for euthyroid rats and 2 - 2,5 mg/kg for rats with thyrotoxicosis and hypothyroidism. Effective dose of verapamil during rhythm disturbance was 3 mg/kg for control euthyroid rats and 1,5 - 2 mg/kg for rats with abnormal thyroid status. These results provide a basis for the new individual approach for treatment of patients with cardiac arrhythmia combined with thyroid dysfunction.

Fatty acid composition in blood serum and erythrocyte membrane lipids was studied in 38 patients with hypothyroidism treated in the Department of Endocrinology of Chita Regional Clinical Hospital; left ventricular diastolic dysfunction was revealed in 16 patients. The total content of saturated fatty acids (FA) in serum, mostly at the account of myristic and palmitic acids, was found to be increased. The total content of unsaturated FA was decreased. The level of arachidonate in blood serum and erythrocyte membrane lipids was found to be significantly decreased both before the treatment and within the course of replacing hormonal therapy. The content of omega-3 FA in erythrocyte membrane lipids decreased in the course of conventional therapy, which suggests that omega-3 FA preparations should be administered as a part of complex therapy of hypothyroidism.

Experimental studies show depressive behavior in rats caused by hypothyroidism and antidepressant effect of thyroid hormones. The present study analyses changes in the hippocampal and cerebellar cortex local blood flow in the progeny of rats suffering from iodine deficiency before mating and during the whole period of gestation. The diet with very low iodine content results in a decrease of local blood flow in both brain structures, but the greatest changes were observed in hippocampus. Addition of the iodine to the diet eliminates the above blood flow changes.

Fifty five patients with allergic rhinitis and moderate hypothyroidism due to autoimmune thyroiditis have undergone clinical, functional, hormonal, immunological and allergological examinations. Of them, 45 patients received a course of treatment with thyroid hormones and antiallergic drugs while 10 patients received replacement hormonal therapy only. The results of the study demonstrate that treatment of allergic rhinitis associated with hypothyroidism is more effective if antiallergic drugs are added to replacement hormonal therapy.

The aim of the study was to reveal hypothyroidism (HT) in patients with hiatus hernia (HH), treated at Russian Centre of Functional Surgical Gastroenterology. The subjects were 64 women: 18--with HH and diffuse or diffuse nodular goiter, 36--with HH, and 10--without endocrine or somatic disease background. The examination included the evaluation of the thyroid and metabolic status, endoscopy, and 24-hour ph-metry. The results show that one of the early signs of HT is HH and gastroesophageal reflux disease. The latter in HT patients is associated with gastrointestinal motor-evacuatory disturbances rather than with acid exposition in the distal esophagus.

The activity of L-tryptophan was studied on young male rats in depressive state caused by thyreoid hormone dysbalance. The immobilization time in the Porsolt forced swim test in thyreoidectomized rats was significantly increased in comparison to the intact control. The replacement therapy with triiodothyronin (T3) reduced the level of depressed behavior to the initial value. Chronic administration of L-tryptophan significantly decreased the total immobilization time in all the test groups, irrespective of the hormonal state. However, the effect of L-tryptophan was more pronounced in T3-treated rats.

Subclinical hypothyroidism (SH) is the most frequent thyroid disease, but administration of replacement L-thyroxin in it is not obvious. SH may present both with general nonspecific symptoms and disturbance of lipid metabolism, myocardial dysfunction. Many physicians think it valid to restore euthyroid condition, as it may improve general condition of the patients, diastolic and systolic myocardial function, prognosis in ischemic heart disease. However, there are no definite indications to starting L-thyroxin in SH.

Thirty patients with subclinical thyrotoxicosis and 32 with subclinical hypothyroidism with attacks of atrial fibrillation were investigated. At levels of thyroid-stimulating hormone below 0.1 or above 10.0 mIU/l average triiodothyronine and thyroxine levels in patients with subclinical thyrotoxicosis were 89.6 and 73.2%, respectively, higher than in patients with subclinical hypothyroidism. Some relationships were found between levels of thyroid hormones and hemodynamic and electrophysiological parameters of the heart. Differential therapy of attacks of atrial fibrillation was effective in 80 and 62.5% of patients with subclinical thyrotoxicosis or hypothyroidism, respectively.

Bone metabolism markers (bone alkaline phosphatase, ionized calcium, inorganic phosphorus, serum osteocalcin) and urinary excretion of hydroxyproline, Ca2+ and P after overnight fasting and of creatinine were studied in 52 female patients with endemic goiter and hypothyrosis (18 of these with decompensated hypothyrosis, 34 treated with thyroid hormones) and 48 women without thyroid diseases aged 45-60 years with menopause of no longer than 10 years (6.4 +/- 0.43 years). Clinical and x-ray examinations were carried out in all women; hormonal status, basal serum levels of parathyroid hormone and calcitonin were evaluated. A trend to deceleration of bone remodeling was detected in the patients with untreated hypothyrosis in comparison with women without thyroid disease. Signs of increased bone resorption were detected in patients with endemic goiter and hypothyrosis receiving substitute hormone therapy; this gave grounds to refer patients of menopausal age with endemic goiter and hypothyrosis treated with oral thyroxin for a long time to a group at a high risk of osteoporosis and bone fractures and to start preventive osteotropic therapy from the first day of substitute thyroid hormone therapy.

The study aimed at modification of co-herent analysis (CA), as a mathematical method for EEG data processing for objective evaluation of bioelectric brain activity spatial organization in women with epilepsy and secondary amenorrhea of central genesis. One hundred sixty one women (30 with epilepsy, 116 with amenorrhea and 115 controls aged 15 to 41 years) have been examined. Characteristic changes of cortico-cortical inter- and intra-hemisphere relations for patients with catamenial (CTM) and noncatamenial (NCTM) epilepsy in different menstrual cycle terms were found. The most distinct changes were detected in theta-activity analysis. In the beginning of menstrual cycle, the patients with CTM epilepsy exhibited higher CA indices in theta-rhythm range in all right hemisphere pairs studied. On the contrary, patients with NCTM epilepsy exhibited lower CA indices mainly in the right brain hemisphere. alpha-rhythm spatial organization analysis in the same patients showed similar correlations, but they were better expressed in alpha-rhythm generation zone: in the beginning of menstrual cycle CA indices were high in patients with CTM epilepsy and low in those with NCTM epilepsy. Comparing to controls, patients with secondary amenorrhea of central genesis showed most distinct changes in theta-activity towards the CA indices increase in the majority of the leads. In patients with epilepsy and amenorrhea, CA indices of right brain hemisphere and intra-central temporal lead pairs were lower than in patients with amenorrhea without epilepsy by both alpha- and theta-rhythms.

Efficiency of some drugs in the treatment of periodontitis in combination with corrective treatment of thyroid function was evaluated in 70 patients with hypo- and hyperthyrosis with different initial level of nonspecific resistance. The therapeutic complex including drugs commonly used in the treatment of periodontitis and irrigation of the periodontium with lithium chloride and chlorohexidine solutions was highly effective in patients with thyroid dysfunction and relatively favorable status of nonspecific resistance of the organism. In patients with hypo- and hyperthyrosis with poor nonspecific resistance the best effect in the treatment of periodontitis was attained with potassium orotate as an immunomodulator and lithium chloride.

There were examined 27 patients with inflammatory diseases of colon. In cases of the nonspecific ulcerative colitis and Crohn's disease of colon the thyroid gland insufficiency occurs in variant of the thriiodinethyronine low contents syndrome, causing the necessity of the substitution therapy conduction in postoperative period.

Echocardiographic examination of 41 patients has demonstrated that mitral prolapse (MP) of the 1st and 2nd degree is frequently associated with latent or apparent hypothyroidism and occasionally with prolapse of the tricuspid and/or aortic valve. As a rule, MP has a silent course without regurgitation and is diagnosed at ultrasonography. Its correction is made by replacement with thyroid hormones. Beta-adrenoblockers for MP treatment are contraindicated in hypothyroidism. MP complications (sudden death, thromboembolism, infectious endocarditis) are rare in patients with hypothyroidism. Thyroid insufficiency sometimes is accompanied with hydropericardium which is symptomless and is detected only at echocardiography.

The purpose of the investigation is the study and analysis of combined influence of gamma-radiation (137Cs, 1.25 Gy during 20 days) and mercazolyl (20 mg/100 ml drinkable water) in utero on the physical developmental of the rats in the postnatal ontogenesis. It was shown, that antenatal separate influence both of gamma-radiation and mercazolyl induced the decrease of the strength endurance. The combined influence both of these factors induced essential decrease of the strength endurance.