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Background. According to epidemiological studies, the prevalence of subclinical hypothyroidism is about 6 % and it depends on age, gender, region of residence and, at the same time, significantly exceeds the frequency of primary hypothyroidism. Within one year, 5 % of cases of subclinical hypothyroidism turn into the manifested form. Delayed diagnosis of the disease increases the risk of serious complications. It is still controversial whether subclinical hypothyroidism affects blood pressure because of conflicting results in published studies. Thus, the aim of this study was to assess the effects of levothyroxine replacement therapy in patients with subclinical hypothyroidism and hypertension on lipid metabolism, functional state of the endothelium and cognition. Materials and methods. Thirty-one patients with subclinical hypothyroidism and stage 2 hypertension participated in the study, among them 12 (38.71 %) men and 19 (61.29 %) women. The average age of participants was 63.19 ± 1.93 years. The study examined lipid profile, functional state of the endothelium, and cognitive functions based on the results of the Montreal Cognitive Assessment before and after 3 months of additional administration of the levothyroxine replacement therapy at a dose 25–50 µg daily. Results. The lipid analysis revealed a significant decrease in total cholesterol for 10.08 % (5.54 ± 0.17 mmol/L against 6.23 ± 0.25 mmol/L, Р < 0.05), low-density lipoprotein cholesterol for 24.5 % (3.39 ± 0.17 mmol/L against 4.49 ± 0.27 mmol/L, Р < 0.01), triglycerides for 19.42 % (1.66 ± 0.11 mmol/L against 2.06 ± 0.16 mmol/L, Р < 0.05) compared to those at baseline. At the same time, patients with subclinical hypothyroidism and hypertension showed a reliable decrease in atherogenic dyslipidemias, 64.52 against 74.19 %. We also observed a reliable improvement of the functional state of the endothelium: the mean value of the endothelium-dependent vasodilation of the brachial artery increased for 11 % (6.56 ± 0.10 % against 5.91 ± 0.05 %, Р < 0.001). The results of the neuropsychological testing showed a reliable improvement of the cognitive functions among examined patients: the average score on the Montreal Cognitive Assessment raised from 23.77 ± 0.60 at baseline to 26.65 ± 0.47 after three months of taking levothyroxine, Р < 0.001. Conclusions. Levothyroxine replacement therapy in patients with subclinical hypothyroidism and hypertension was followed by a normalization of lipid profile and a decrease in atherogenic dyslipidemias, an improvement of the functional state of the endothelium and state of cognition. [ABSTRACT FROM AUTHOR]

Background. It is well known that chronic kidney disease (CKD) patients develop mineral and bone disturbances which lead to the development of renal osteodystrophy and its complications. Secondary hyperthyroidism is the main reason for the development of mineral and bone disoders in these patients. The purpose of the study was to evaluate the efficacy of combined therapy with Alfacalcidol and Quercetin in the treatment of secondary hyperthyroidism in pre-dialysis CKD patients. Materials and methods. 61 patients with CKD 3 and 4 stages aged 20–78 years were included in the study. Patients were divided into 2 groups: 35 patients received combined treatment with Alfacalcidol and Quercetin granules, and 26 patients received standard treatment with calcium carbonate. Indices of calcium, phosphorus, magnesium, and alkaline phosphatase were analyzed by photocolometry method and parathyroid hormone (PTH) by immune assay method. Statistical analysis was performed in the Statistica 5.0 program (StatSoft Inc., USA). Results. It was shown that intake of Alfacalcidol (0,25–0,5 mcg daily) and Quercetin granules 1.0 g three times per day provided normalization of calcium-phosphorous homeostasis, correction of hyperthyroidism but also has pronounced analgesic effect as compared with patients receiving monotherapy with calcium carbonate. Conclusions. Combined treatment with Alfacalcidol and Quercetin granules in predialysis CKD patients with secondary hyperthyroidism leads to calcium and phosphorus metabolism normalization, correction of secondary hyperthyroidism, and has an analgesic effect. [ABSTRACT FROM AUTHOR]