The 2015 European Thyroid Association Guidelines on diagnosis and treatment of endogenous subclinical hyperthyroidism
Endogenous subclinical hyperthyroidism (SHyper) is caused by Graves' disease, autonomously functioning thyroid nodules and multinodular goitre. Its diagnosis is based on a persistently subnormal serum thyroid-stimulating hormone (TSH) level with free thyroid hormone levels within their respective reference intervals. In 2014 the European Thyroid Association Executive Committee, given the controversies regarding the treatment of Endo SHyper, formed a task force to develop clinical practice guidelines based on the principles of evidence-based medicine. The task force recognized that recent meta-analyses, including those based on large prospective cohort studies, indicate that SHyper is associ…
Heart in Hyperthyroidism
Hyperthyroidism is a common endocrine disorder that produces important clinical consequences on the cardiovascular system. In overt hyperthyroidism the increase in left ventricular performance is predominantly sustained by an increased preload with enhanced left ventricular diastolic function and reduced systemic vascular resistance. The pattern of cardiovascular abnormalities is similar in subclinical and overt hypothyroidism, suggesting that a lesser degree of thyroid hormone deficiency may also affect the cardiovascular system. Untreated overt and subclinical hypothyroidism can lead to an increased risk of coronary heart disease (CHD), heart failure (HF), and cardiovascular mortality.
Thyroid Dysfunction and Diabetes Mellitus: Two Closely Associated Disorders
Thyroid dysfunction and diabetes mellitus are closely linked. Several studies have documented the increased prevalence of thyroid disorders in patients with diabetes mellitus and vice versa. This review critically discusses the different underlying mechanisms linking type 1 and 2 diabetes and thyroid dysfunction to demonstrate that the association of these two common disorders is unlikely a simple coincidence. We assess the current state of knowledge on the central and peripheral control of thyroid hormone on food intake and glucose and lipid metabolism in target tissues (such as liver, white and brown adipose tissue, pancreatic b cells, and skeletal muscle) to explain the mechanism linking…
Heart in Hypothyroidism
The transition from the fetal to the adult phenotype heart depends on the increase in thyroid hormone (TH) in perinatal period (Liu and Gerdes, J Mol Cell Cardiol 22:1339–1348, 1990; Gerdes and Iervasi, Circulation 122:385–393, 2010). Moreover, T3 action is essential for preserving both cardiac morphology and performance in adult life because thyroid hormone controls the inotropic and lusitropic properties of the myocardium, cardiac growth, myocardial contractility, and vascular function (Liu and Gerdes, J Mol Cell Cardiol 22:1339–1348, 1990; Gerdes and Iervasi, Circulation 122:385–393, 2010; Fazio et al., Recent Prog Horm Res 59:31–50, 2002; Kahaly and Dillmann, Endocr Rev 26:704–728, 2005…