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Ожирение и гипотиреоз

https://doi.org/10.14341/2071-8713-4826

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Аннотация

Связи с широким распространением как ожирения, так и гипотиреоза, врачам необходимо быть особенно внимательным к возможной дисфункции щитовидной железы у пациентов с ожирением. Существует двусторонняя связь между гормонами щитовидной железы и ожирением: как гипотиреоз может влиять на массу тела, так и жировая ткань может изменять уровень гормонов щитовидной железы. Уровень ТТГ и св.Т3 при ожирении часто оказывается повышенным, что опосредовано действием лептина. При лечении гипотиреоза препаратами Л-тироксина небольшое снижение массы тела обусловлено потерей воды, а не жира. Селективные аналоги тиреоидных гормонов, возможно, смогут стать средством для снижения массы тела путем увеличения расхода энергии у пациентов с ожирением при соблюдении гипокалорийной диеты.

Об авторах

S M Zakharova

к.м.н., с.н.с. отделения терапии эндокринопатий лечебно-диагностического отдела


L V Savelieva

к.м.н., зав. отделением терапии эндокринопатий лечебно-диагностического отдела


M I Fadeeva

н.с. отделения терапии эндокринопатий лечебно-диагностического отдела


Список литературы

1. Болезни щитовидной железы. Под редакцией Л.И.Бравермана. М.: Медицина, 2000; 1–3.

2. Фадеев В.В., Мельниченко Г.А. Гипотиреоз. Руководство для врачей. М., 2002; 15–16: 46.

3. Демидова Т.Ю., Галиева О.Р. К вопросу лечения субклинического гипотиреоза у больных ожирением. Клиническая и экспериментальная тиреоидология. 2008; 4(1): 48–52.

4. Нейроэндокринология: клинические очерки. Под редакцией Маровой Е.И. Ярославль: Диа-пресс, 1999: 360–369.

5. аl-Adsani H, Hoffer LJ, Silva JE. Resting energy expenditure is sensitive to small dose changes in patients on chronic thyroid hormone replacement. J Clin Endocrinol Metab. 1997; 82: 1118–1125.

6. Alevizaki M, Saltiki K, Voidonikola P, et al. Free thyroxine is an independent predictor of subcutaneous fat in euthyroid individuals. Eur J Endocrinol. 2009; 16: 459–465.

7. Antonelli A, Fallahi P, Ferrari SM, et al. 3,5-diiodo-L-thyronine increases resting metabolic rate and reduces body weight without undesirable side effects. J Biol Regul Homeost Agents. 2011; 25: 655–660.

8. Asteria С. Central hypothyroidism: consequences in adult. L P. 1297-8.

9. Bastemir M., Akin F., Alkis E. et al. Obesity is associated with increased serum TSH level, independent of thyroid function Swiss. Med. Wkly. 2007; V. 137. Р. 29–30.

10. Baxter JD, Webb P. Thyroid hormone mimetics: potential applications in atherosclerosis, obesity and type 2 diabetes. Nat Rev Drug Discov 2009; 8:308–320.

11. Boeving A, Paz-Filho G, Radominski RB, et al. Low-normal or high-normal thyrotropin target levels during treatment of hypothyroidism: a prospective, comparative study. Thyroid 2011; 21:355–360.

12. Boivin M., Camirand A., Carli F., Hoffer L.J. Silva J.L Uncoupling protein-2 and -3 messenger ribonueclic acids in adipose tissue and skeletal muscle of healthy males: variability, factors affecting expression, and relation to measures of metabolic rate. Journal of Clinical endocrinology and Metabolism. 2000;82:5.

13. Boutcher SH and Dunn SL. Factors that may impede the weight loss response to exercise-based interventions. Obes Rev, November 1. 2009; 10(6): 671-80.

14. Canaris G.J., Manowitz N.R., Mayor G., Ridgway E.C. The Colorado thyroid disease prevalence study. Arch. Internal Med. 2000; V. 160. P. 526–534.

15. Celi FS, Zemskova M, Linderman JD, et al. Metabolic effects of liothyronine therapy in hypothyroidism: a randomized, double-blind, crossover trial of liothyronine versus levothyroxine. J Clin Endocrinol Metab. 2011; 96:3466–3474.

16. Chaffler A., Binart N., Scholmerich J. et al. Hypothesis paper brain talks with fat – evidence for a hypothalamic–pituitary–adipose axis? Neuropeptid. 2005; V. 39. P. 363–367.

17. Davis PJ, Davis FB. Nongenomic actions of thyroid hormone. Thyroid, October 1. 1996; 6(5): 497-504.

18. De Pergola G, Ciampolillo A, Paolotti S, Trerotoli P, Giorgino R. Free triiodothyronine and thyroid stimulating hormone are directly associated with waist circumference, independently of insulin resistance, metabolic parameters and blood pressure in overweight and obese women. Clin Endocrinol (Oxf). 2007;67:265–266.

19. Emerson CH. Anthropomorphic thyroidopathies? Thyroid 2010; 20:1195–1197.

20. 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;168:587–592.

21. Garber J.R., Cobin R.H., Gharib H.,Hennessey J.V., Klein I., Mechanick J.I.,Pessah Pollack R., Singer P.A., Woeber K.A.Clinical Practice Guidelines for Hypothyroidism in Adults: Cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association Endocr. Pract. 2012; 11: 1–207.

22. Gianoukakis A.G.Jennings T.A.King C.S., Hyaluronin accumulation in thyroid tissue: Evidence for contributions from epithelial cells and fibroblasts. Endocrinilogy. 2007; 148 (1), 54-62.

23. Gorglia F, Lanni A, Barth J, Kadenbach B. Interaction of diiodothyronines with isolated cytochrome c oxidase. FEBS Lett 1994. 295-298.Endocrinol. 1995; V. 43(1). P. 55–68.

24. Iacobellis G, Ribaudo MC, Zappaterreno A, Iannucci CV, Leonetti F Relationship of thyroid function with body mass index, leptin, insulin sensitivity and adiponectin in euthyroid obese women. Clin Endocrinol (Oxf). 2005; 62:487–491.

25. Karmisholt J, Andersen S, Laurberg P. Weight loss after therapy of hypothyroidism is mainly caused by excretion of excess body water associated with myxoedema. J Clin Endocrinol Metab. 2011; 96:E99–E103.

26. Kaptein EM, Beale E, Chan LS. Thyroid hormone therapy for obesity and nonthyroidal illnesses: a systematic review. J Clin Endocrinol Metab. 2009; 94:3663–3675.

27. Kok P, Roelfsema F, Langendonk JG, Frolich M, Burggraaf J, Meinders AE, Pijl H. High circulating thyrotropin levels in obese women are reduced after body weight loss induced by caloric restriction. J Clin Endocrinol Metab. 2005; 90:4659–4663.

28. Knudsen N., Laurberg P., Rasmussen L.B. et al. Small differences in thyroid function may be important for body mass index and the occurrence of obesity in the population. J. Clin. Endocr. Met. 2005; V. 90. P. 4019–4024.

29. Ladenson PW, Kristensen JD, Ridgway EC, et al. Use of the thyroid hormone analogue eprotirome in statin-treated dyslipidemia. N Engl J Med. 2010; 362:906–916.

30. Lu S, Guan Q, Liu Y, et al. Role of extrathyroidal TSHR expression in adipocyte differentiation and its association with obesity. Lipids Health Dis. 2012; 11:17.

31. Menendez C, Baldelli R, Camina JP, Escudero B, Peino R, Dieguez C, Casanueva FF. TSH stimulates leptin secretion by a direct effect on adipocytes. J Endocrinol. 2003; 176:7–12.

32. Michalaki M.A., Vagenakis A.G., Leonardou A.S. et al. Thyroid function in humans with morbid obesity. Thyroid. 2006; V. 16.P. 73–78.

33. Montenegro J.Gonzalez O. Saracho R. Aguirre R., Martinez I. Changes in renal function in primary hypothyroidism. American Journal of Kidney desease. 1996; 27 (2), 195-198.

34. Monzani F., Caraccio N., Kozàkowà M., Dardano A., Vittone F., Virdis A. Effect of Levothyroxine Replacement on Lipid Profile and Intima-Media Thickness in Subclinical Hypothyroidism: A Double-Blind, Placebo- Controlled Study. The Journal of Clinical Endocrinology & Metabolism January 1. 1998; vol. 83 no. 1 140-143.

35. Nannipieri M, Cecchetti F, Anselmino M, Camastra S, Niccolini P, Lamacchia M, Rossi M, Iervasi G, Ferrannini E. Expression of thyrotropin and thyroid hormone receptors in adipose tissue of patients with morbid obesity and/or type 2 diabetes: effects of weight loss. Int J Obes (Lond) 2009;33:1001–1006.

36. Ortega FJ, Moreno-Navarrete JM, Ribas V, et al. Subcutaneous fat shows higher thyroid hormone receptor-alpha1 gene expression than omental fat. Obesity (Silver Spring). 2009; 17:2134–2141.

37. Polotsky HN, Brokhin M, Omry G, et al. Iatrogenic hyperthyroidism does not promote weight loss or prevent ageing-related increases in body mass in thyroid cancer survivors. Clin Endocrinol (Oxf). 2012; 76:582–585.

38. Radetti G, Kleon W, Buzi F, Crivellaro C, Pappalardo L, di Iorgi N, Maghnie M. Thyroid function and structure are affected in childhood obesity. J Clin Endocrinol Metab. 2008;93:4749–4754.

39. Reinehr T. Obesity and thyroid function. Mol Cell Endocrinol 2010; 316:165–171.

40. Reinehr T, de Sousa G, Andler W. Hyperthyrotropinemia in obese children is reversible after weight loss and is not related to lipids. J Clin Endocrinol Metab. 2006; 91:3088–3091.

41. Rotondi M., Cappelli C., Leporati P. A hypoechoic pattern of the thyroid at ultrasound does not indicate autoimmune thyroid diseases in patients with morbid obesity, European Journal of Endocrinology.2010; 163: 105–109.

42. Rotondi M, Leporati P, La Manna A, Pirali B, Mondello T, Fonte R, Magri F, Chiovato L. Raised serum TSH levels in patients with morbid obesity: is it enough to diagnose subclinical hypothyroidism? Eur J Endocrinol. 2009; 160:403–408.

43. Scarabottolo L, Trezzi E, Roma P. Experimental hypothyroidism modulates the expression of the low density lipoprotein receptor by the liver. Atherosclerosis, March 1. 1986; 59(3): 329-33.

44. Sorisky A., Bell A. Gagnon A. TSH receptor in adipose cells. Hormon. Met. Res. 2000; V. 32. P. 468–474.

45. Svare A, Nilsen TI, Bjøro T, et al. Serum TSH related to measures of body mass: longitudinal data from the HUNT Study, Norway. Clin Endocrinol (Oxf). 2011; 74:769–775.

46. Tang MH, Chen SP, Ng SW, et al. Case series on a diversity of illicit weightreducing agents: from the well known to the unexpected. Br J Clin Pharmacol 2011; 71:250–253.

47. Vanderpump M., Tunbridge W., French J. et al. The incidence of thyroid disorders in the community: a twenty year follow up of the Whickham survey.Clin. Endocrinol. 1995; V. 43(1). P. 55–68.

48. Weaver JU. Classical endocrine diseases causing obesity. Front Horm Res, January 1. 2008; 36: 212-28.

49. Wieshammer S. Et al. Acute hypothyroidism slows the rate of left ventricular diastolic relaxation. Can.J.Physiol.pharmacol. 1989; Vol.67.P.1007-1010.

50. Yen Paul M. Physiological and Molecular Basis of Thyroid Hormone Action. Physiol Rev. 2001;Vol. 81 no. 3. 1097-114.

51. Zulewski H., Muller B., Exer P. et al. Estimation of tissue hypothyroidism by a new clinical score: evaluation of patients with various grades of hypothyroidism and controls. J. of Clin. Endocrinol. and Metab. 1997; V. 82, N 3. P. 771–776.


Для цитирования:


Zakharova S.M., Savelieva L.V., Fadeeva M.I. Ожирение и гипотиреоз. Ожирение и метаболизм. 2013;10(2):54-58. https://doi.org/10.14341/2071-8713-4826

For citation:


., ., . Obesity and hypothyroidism. Obesity and metabolism. 2013;10(2):54-58. (In Russ.) https://doi.org/10.14341/2071-8713-4826

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ISSN 2071-8713 (Print)
ISSN 2306-5524 (Online)