- Clinical manifestations of reproductive health and life quality in fertile age women with subclinical hypothyroidism in conditions of comorbidity
Clinical manifestations of reproductive health and life quality in fertile age women with subclinical hypothyroidism in conditions of comorbidity
HEALTH OF WOMAN. 2017.5(121):54–56; doi 10.15574/HW.2017.121.54
Varchenko L. M.
Kyiv City Clinical Endocrinology Center
The objective: to evaluate the clinical manifestations of reproductive health and quality of life (QOL) disorders in women of reproductive age with high comorbidity against subclinical hypothyroidism (SHT) and manifest hypothyroidism (MHT).
Materials and methods. 113 cases of SHT (1st group) and 65 cases of MHT (2 nd group) in women of reproductive age were analyzed. The diagnosis of hypothyroidism is established on the basis of data of anamnesis, physical examination, ultrasound of the thyroid gland and determination of thyroid-stimulating hormone levels and free thyroxine in the blood by electroluminescence.
Results. Assessment of QoL using the MOS SF-36 questionnaire was performed in women of reproductive age with SHT, with a high (61.9%) level of menstrual irregularities, gynecological (74.3%) and extragenital (82.3%) diseases, which indicates High comorbidity. It was revealed mainly the average values of QoL on almost all scales, except for emotional functioning.
In women with MHT, with extremely high comorbidity (in 100% of cases), the QL values were reduced and only on the scale of "pain" – within the average.
The conclusion. The data obtained make it possible to recommend the definition of quality of life indicators in women of reproductive age with subclinical hypothyroidism in the practice of a gynecologist as an integral characteristic of health.
Key words: subclinical hypothyroidism, menstrual irregularities, comorbid conditions, quality of life, MOS SF-36 questionnaire, integral health indicators.
1. Bezkorovaina TO. 2016. Otsinka yakosti zhyttia ta emotsiinoho stanu patsiientiv z pervynnym hipotyreozom. Tekst. Nauk. ker. LS Babinets. Aktualni pytannia teoretychnoi ta praktychnoi medytsyny: zbirnyk tez dopovidei IV Mizhnarodnoi naukovo-praktychnoi konferentsii studentiv ta molodykh vchenykh, m. Sumy, 21–22 kvitnia 2016 r. NV Demikhova. Sumy, SumDU. 2:33–34.
2. Babenko OV, Shkapo VL, Nesen AO, Valentynova IA. 2016. Otsinka pokaznykiv yakosti zhyttia u khvorykh z komorbidnoiu patolohiieiu. Tekst. Aktualni pytannia teoretychnoi ta praktychnoi medytsyny: zbirnyk tez dopovidei IV Mizhnarodnoi naukovo-praktychnoi konferentsii studentiv ta molodykh vchenykh, m. Sumy, 21–22 kvitnia 2016 r. NV Demikhova. Sumy, SumDU. 2:33.
3. Pirs S, Razvi S. 2012. Subklinicheskiy gipotireoz: prakticheskie rekomendatsii. Perevod V.V. FadeEva. Thyroid international. 1:3–9.
4. Fadieienko HD, Hridniev OIe, Nesen AO ta in. 2013. Komorbidnist i vysokyi kardiovaskuliarnyi ryzyk-kliuchovi pytannia suchasnoi medytsyny. Ukraynskyi terapevtycheskyi zhurnal 1:102–107.
5. Fadieienko HD, Nesen AO. 2015. Komorbidnist ta intehratyvna rol terapii vnutrishnikh orhaniv. Ukraynskyi terapevtycheskyi zhurnal 2:7–15.
6. Campbell-Scherer D. 2010. Multimorbidity: a challenge for evidence-based medicine. Evid. Based Med. 15(6):165–166. https://doi.org/10.1136/ebm1154; PMid:21106673
7. Caughey GE, Roughead EE. 2011. Multimorbidity research challenges: where to go from here Journal of Comorbidity 1:8–10.8.
8. Garber JR, Cobin RH, Gnarib H et al. 2012. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocr Pract.: 988–1028. https://doi.org/10.4158/EP12280.GL; PMid:23246686
9. Hekimsoy Z, Kafesçiler S, Güçlü F, Özmen B. 2010. The prevalence of hyperprolactinemia in overt and subclinical hypothyroidism. Endocr J. 57(12):1011–5. doi: 10.1507/ endocrj. K10E-215
10. Lazarus J, Brown RS, Daumerie C, Hubalewska-Dydejczyk A, Negro R, Vaidya B. 2014. 2014 European thyroid association guidelines for the management of subclinical hypothyroidism in pregnancy and in children. Eur Thyroid J. 3:76-94. https://doi.org/10.1159/000362597; PMid:25114871 PMCid:PMC4109520
11. Rodondy N, den Elzen WP, Bauer DC et al. 2010. Thyroid Studies Collaboration Subclinical Hypothyroidism an the risk of coronary Heart Disease and Mortality. JAMA. 304:1365–1374. https://doi.org/10.1001/jama.2010.1361; PMid:20858880 PMCid:PMC3923470
12. Stagnaro-Green A, Abalovich M, Alexander E et al. 2011. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid. 21:1081–1125. https://doi.org/10.1089/thy.2011.0087; PMid:21787128 PMCid:PMC3472679
13. Ware JE, Sherbourne CD. 1992. The MOS 36-item short-form health survey (Sf-36): I. conceptual framework and item selection. Medical Care. 30(6):473–483. doi: 10.1097/00005650-199206000-0000214.
14. Warkentin LM, Das D, Majumdar SR, Johnson JA, Padwal RS. 2014. The effect of weight loss on health-related quality of life: systematic review and meta-analysis of randomized trials. Obesity Reviews. 15(3):169–182. https://doi.org/10.1111/obr.12113.