Results of Long-Term Monitoring of Women with Primary Hypothyroidism

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Aim. To perform the long-term monitoring of patients with compensated primary hypothyroidism. Design. One center prospective long-term observation study. Materials and methods. A prospective study including 112 women in age 62.5 [56.0; 68.0] years with compensated primary hypothyroidism treated by levothyroxine sodium. A control group consists of 30 women aged 62.0 [56.0; 66.0] years without thyroid diseases, cancer and severe heart, renal and respiratory failure. All patients were examined initially and 93 patients of main and 29 women from control groups were assessed within 4–19 years after study entering. Echocardiography was performed in 104 women of the main group at the beginning of the study and in 50 patients at the end. Results. It was revealed that in patients with compensated hypothyroidism over time coronary artery disease and diabetes mellitus type 2 were developed more frequently (relative risk (RR) = 2.23, 95% confidence interval (CI): 1.06; 4.7, and RR = 8.73, 95% CI: 1.2; 61.4; p < 0,05, respectively), and there was a tendency to development of atrial fibrillation (RR = 1.4, 95% CI: 0.3; 6.1; p > 0.05) and cancer (RR = 1.87, 95% CI: 0.44; 7.8; p > 0.05), as well, and lipid disorders were persisted, over time statistically the decrease of injection fraction (p < 0.001), end diastolic volume (p = 0.011), left ventricle (LV) myocardium mass index (p = 0.015) and the increase of end systolic LV index (p = 0.015) were detected. Among them the number of women with diastolic LV dysfunction with impaired relaxation (type 1) was increased from 82.7% (86 from 104) to 96% (48 from 50). Patients with hypothyroidism initially had the decrease of quality-of-life parameters by Short Form-36, except general health status and physical functioning has been significantly worsen over time (p = 0.002). Conclusion. Thus, during dispensary monitoring of women with primary hypothyroidism it is important to be alert on cancer, to regularly assess hormone and lipid, glucose parameters, to yearn the target thyroid tests and blood pressure values, to prescribe an adequate antihypertensive and hypolipidemic therapy to increase the quality of life and prevent cardiovascular disorders. Keywords: primary hypothyroidism, compensation, long-term monitoring, lipid spectrum, quality of life

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