Hipotireoidismo subclínico - Revisão e atualização
Palavras-chave:
hipotireoidismo, tireotropina, tiroxinaResumo
O hipotireoidismo subclínico, definido como nível sérico elevado de tireotropina (TSH) com níveis normais detiroxina livre (FT4), afeta até 10% da população adulta. O hipotireoidismo subclínico é comum e a maioria dos indivíduos pode ser observada sem, necessariamente, indicação de tratamento. O tratamento pode ser indicado para pacientes com hipotireoidismo subclínico e níveis séricos de tireotropina de 10mU/mL ou mais, mulheres grávidas ou indivíduos jovens e de meia-idade com hipotireoidismo subclínico e sintomas consistentes com hipotireoidismo leve.
Referências
Chaker L, Bianco AC, Jonklaas J, Peeters RP. Hypothyroidism. Lancet. 2017; 390(10101):1550-62.
Urgatz B, Razvi S. Subclinical Hypothyroidism, Outcomes and management Guidelines: a Narrative Review and Update of Recent Literature. Curr Med Res Opin. 2023: 1-15.
Pearce SH, Brabant G, Duntas LH, Monzani F, Peeters RP, Razvi S, Wemeau JL. 2013 ETA Guideline: Management of Subclinical Hypothyroidism. Eur Thyroid J. 2013 Dec;2(4):215-28.
Sgarbi JA, Ward LS. A practical contemporary approach to decision-making on subclinical hypothyroidism. Arch Endocrinol Metab. 2021; 65(1):32-9.
Garber JR, Cobin RH, Gharib H, Hennessey JV, Klein I, Mechanick JI, et al. Clinical Practice Guidelines for Hypothyroidism in Adults: Cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Thyroid. 2012; 22(12):1200-35.
Nygaard B. Hypothyroidism (primary). BMJ Clin Evid. 2014 Feb 21;2014:0605. PMID: 24807886; PMCID: PMC3931439.
Sue LY, Leung AM. Levothyroxine for the Treatment of Subclinical Hypothyroidism and Cardiovascular Disease. Front Endocrinol (Lausanne). 2020 Oct 21;11:591588. doi: 10.3389/fendo.2020.591588. PMID: 33193104; PMCID: PMC7609906.
Yao K, Zhao T, Zeng L, Yang J, Liu Y, He Q, Zou X. Non-invasive markers of cardiovascular risk in patients with subclinical hypothyroidism: A systematic review and meta-analysis of 27 case control studies. Sci Rep. 2018 Mar 15;8(1):4579.
Leng O, Razvi S. Hypothyroidism in the Older Population. Thyroid Res. 2019; 12(2):1-10.
Mazeto GMFS, Sgarbi JA, Ramos HE, Villagelin Neto DGP, Nogueira CR, Vaisman M, et al. Approach to adult patients with primary hypothyroidism in some special situations: a position statement from the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism (SBEM). Arch Endocrinol Metab. 2022; 66(6):871-82.
Rodondi N, den Elzen WP, Bauer DC, Cappola AR, Razvi S, Walsh JP, Asvold BO, Iervasi G, Imaizumi M, Collet TH, Bremner A, Maisonneuve P, Sgarbi JA, Khaw KT, Vanderpump MP, Newman AB, Cornuz J, Franklyn JA, Westendorp RG, Vittinghoff E, Gussekloo J. Thyroid Studies Collaboration. Subclinical hypothyroidism and the risk of coronary heart disease and mortality. JAMA. 2010 Sep 22;304(12):1365-74.
Knudsen N, Laurberg P, Rasmussen LB, Bülow I, Perrild H, Ovesen L, Jørgensen T. Small differences in thyroid function may be important for body mass index and the occurrence of obesity in the population. J Clin Endocrinol Metab. 2005 Jul;90(7):4019-24.
Fox CS, Pencina MJ, D'Agostino RB, Murabito JM, Seely EW, Pearce EN, Vasan RS. Relations of thyroid function to body weight: cross-sectional and longitudinal observations in a community-based sample. Arch Intern Med. 2008 Mar 24;168(6):587-92.
Rao M, Zeng Z, Zhao S, Tang L. Effect of levothyroxine supplementation on pregnancy outcomes in women with subclinical hypothyroidism and thyroid autoimmuneity undergoing in vitro fertilization/intracytoplasmic sperm injection. Reprod Biol Endocrinol. 2018;16(1):92.
Alexander EK, Pearce EN, Brent GA, et al. 2017 Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the postpartum. Thyroid. 2017;27(3):315-389.
Solha ST, Mattar R, Teixeira PF, Chiamolera MI, Maganha CA, Zaconeta AC, et al. FEBRASGO POSITION STATEMENT Rastreio, diagnóstico e manejo do hipotireoidismo na gestação. Femina. 2022; 50(10):607-17.
