Estudo dos fatores de risco cardiometabólicos em mulheres com Tireoidite Crônica Autoimune

• Ano de defesa: 2017
• Autor(a) principal: MOREIRA, Jaqueline Nascimento
• Orientador(a): BORGES, Maria de Fátima
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal do Triângulo Mineiro
• Programa de Pós-Graduação: Programa de Pós-Graduação Stricto Sensu em Atenção à Saúde
• Departamento: Instituto de Ciências da Saúde - ICS::Curso de Graduação em Enfermagem
• País: Brasil
• Palavras-chave em Português: Tireoidite crônica autoimune.; Síndrome metabólica.; Escore de risco global.; Resistência insulínica.
• Palavras-chave em Inglês: Chronic autoimmune thyroiditis.; Metabolic syndrome.; Overall risk score.; Insulin resistence.
• Palavras-chave em Espanhol: Autoinmune tiroiditis crónica.; Síndrome metabólico.; Valoración global del riesgo.
• Área do conhecimento CNPq: Saúde Pública
• Link de acesso: http://bdtd.uftm.edu.br/handle/tede/490

Chronic autoimmune thyroiditis (CAT) is the most common cause of hypothyroidism in adults, especially in women. The main clinical manifestations are the signs and symptoms of hypothyroidism. Metabolic Syndrome (MS) is a complex interrelated set of risk factors for cardiovascular disease and diabetes. These factors include hyperglycemia, hypertension, elevated triglyceride levels, low HDL-c, and accumulation of abdominal fat. Estimating the risk of atherosclerotic disease results from the sum of the risk associated with each of the risk factors plus the potentiation caused by synergisms between some of these factors. The thyroid and SM binomials are highlighted, since dysfunction of the thyroid gland alters important metabolic pathways resulting in the establishment of the constituent elements of MS. The main objective of this study was to study the main cardiometabolic risk factors, clinical and laboratorial, present in women with CAT treated with levothyroxine and therefore euthyroid. This is a cross-sectional, analytical study with a quantitative approach. Data were collected at the UFTM Endocrinology outpatient clinic using an instrument that included socioeconomic, anthropometric, clinical and laboratory data. Twenty women with CAT and 20 women without thyroid disease aged between 20 and 45 years participated in the study. Categorical variables were analyzed using absolute and relative frequency distributions. A comparative analysis of cardiometabolic risk factors between the affected group and the control group was performed. Also comparative analysis of frequencies of occurrences of cardiometabolic risk factors between the CAT and normal groups; Besides correlations between numerical clinical and laboratory variables. The level of significance of the inferential procedures was 5%. It was observed that the women with CAT presented values of BMI compatible with overweight or obesity in 70% of the cases and abdominal circumference above 80 cm in 70%, being statistically higher in relation to the control group. Regarding the metabolic profile, it was observed that the means of fasting glycemia concentrations were significantly higher in the group with CAT than in the control group, and the same was observed in relation to the HOMA index. Regarding the lipid profile, it was verified that there was no significant difference between the groups, although more people in the CAT group presented borderline values, demonstrating the effectiveness of hormone replacement therapy. Overall risk scorewas significantly higher in patients with CAT than in the control group, presenting an intermediate risk for cardiovascular disease, while the control group presented low risk. By definition and conventional criteria adopted, 20% of patients with CAT versus 7% of the control group had 3 or more cardiometabolic risk factors. It was concluded from these results that patients with CAT had significantly higher fasting glycemia and HOMA-IR levels than in the control group; Although the basal insulin concentrations did not present difference between the two groups, these data suggest the presence of insulin resistance. Whether it is due to CAT or overweight / obesity, the design of the present study did not allow the conclusion. To do so, a future study should necessarily select patients with CAT and normal controls with normal BMI.