Progress in diagnosis and treatment of subclinical hyperthyroidism

doi:10.3969/j.issn.1004-583X.2016.03.002

Abstract

Abstract: Subclinical hyperthyroidism (SH) is diagnosed in patients having a persistently low or undetectable serum concentration of thyroid-stimulating hormone (TSH) with normal total triiodothyronine, total thyroxine, free triiodothyronine and free thyroxine concentrations, with or without minor symptoms of hyperthyroidism. With the development of the determination method of TSH, the detection rate of SH was increased significantly. Most of the patients with SH can be spontaneous remission without treatment, but there are still some patients to have progress for clinical hyperthyroidism. SH is associated with some serious complications, such as the negative effects on cardiovascular system, osteoporosis, fratures, senile dementia, and so on. It has an important clinical significance to treat SH precisely.

Key words: hyperthyroidism, thyrotropin, therapy

CLC Number:

R581.1

Zhang Lihui, Yuan Lingling. Progress in diagnosis and treatment of subclinical hyperthyroidism[J]. Clinical Focus, 2016, 31(3): 237-240.

Add to citation manager EndNote|Ris|BibTeX

URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2016.03.002

https://huicui.hebmu.edu.cn/EN/Y2016/V31/I3/237

References

[1] Surks MI, Ortiz E, Daniels GH, et al. Subclinical thyroid disease: scientific review and guidelines for diagnosis and management [J]. JAMA, 2004, 291(2): 228-238.
[2] Biondi B, Palmieri EA, Klain M, et al. Subclinical hyperthyroidism: clinical features and treatment options [J]. Eur J Endocrinol, 2005, 152(1): 1-9.
[3] Biondi B, Cooper DS. The clinical significance of subclinical thyroid dysfunction[J]. Endocr Rev, 2008, 29(1): 76-131.
[4] 葛均波, 徐永健. 内科学[M]. 8版. 北京: 人民卫生出版社, 2013:688.
[5] Bahn Chair RS, Burch HB, Cooper DS, et al. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists[J]. Thyroid, 2011, 21(6): 593-642.
[6] Cooper DS, Biondi B. Subclinical thyroid disease[J]. Lancet,2012, 379(9821): 1142-1154.
[7] Mitchell AL, Pearce SH. How should we treat patients with low serum thyrotropin concentrations? [J]. Clin Endocrinol (Oxf), 2010, 72(3): 292-296.
[8] Stagnaro-Green A, Abalovich M, Alexander E, et al. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum [J]. Thyroid, 2011, 21(10): 1081-1125.
[9] 中华医学会内分泌分会, 中华医学会围产医学分会. 妊娠和产后甲状腺疾病诊治指南[J]. 中华内分泌代谢杂志, 2012, 28(5): 354-444.
[10] De Groot L, Abalovich M, Alexander EK, et al. Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society clinical practice guideline [J]. J Clin Endocrinol Metab, 2012, 97(8): 2543-2565.
[11] Nathan N, Sullivan SD. Thyroid disorders during pregnancy [J]. Endocrinol Metab Clin North Am, 2014, 43(2): 573-579.
[12] 李智, 李静, 滕卫平. 115例亚临床甲状腺功能亢进症的流行病学研究[J].中华内分泌代谢杂志, 2003, 19(2):99-100.
[13] Biondi B, Bartalena L, Cooper DS,et al. The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism [J]. Eur Thyroid J, 2015, 4(3): 149-163.
[14] Wirth CD, Blum MR, da Costa BR, et al.Subclinical thyroid dysfunction and the risk for fractures: a systematic review and meta-analysis [J].Ann Intern Med, 2014, 161(3): 189-199.
[15] Moon JH, Park YJ, Kim TH, et al. Lower-butnormal serum TSH level is associated with the development or progression of cognitive impairment including mild cognitive impairment and dementia in elderly: Korean Longitudinal Study on Health and Aging (KLoSHA) [J]. J Clin Endocrinol Metab, 2014,99(2): 424-432.
[16] Wiersinga WM. Guidance in subclinical hyperthyroidism and subclinical hypothyroidism: are we making progress?[J]. Eur Thyroid J, 2015, 4(3):143-148.
[17] 杜馥曼, 杨玉芝, 王嵬民,等. 小剂量甲巯咪唑治疗亚临床甲状腺功能亢进症合并阵发性房颤的临床观察[J]. 中华内分泌代谢杂志, 2011, 27(5): 420-421.
[18] 孙权. 丙基硫氧嘧啶、普萘洛尔联合用药治疗亚临床甲亢合并阵发性房颤的疗效分析[J]. 中国医药指南, 2015, 13(5):181-182.
[19] Mark PD, Andreassen M, Petersen CL, et al. Treatment of subclinical hyperthyroidism: effect on left ventricular mass and function of the heart using magnetic resonance imaging technique[J]. Endocr Connect, 2015, 4(1):37-42.
[20] Azizi F, Amouzegar A, Mehran L,et al. Management of hyperthyroidism during pregnancy in Asia[J]. Endocr J, 2014, 61(8): 751-758.