[甲状腺功能减退症对类风湿性关节炎患者心血管事件和 2 型糖尿病的影响]。

IF 0.3 4区医学 Q3 MEDICINE, GENERAL & INTERNAL Terapevticheskii Arkhiv Pub Date : 2024-06-03 DOI:10.26442/00403660.2024.05.202700

L V Kondratyeva, T V Popkova, E L Nasonov

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引用次数: 0

摘要

目的：比较伴有和不伴有甲状腺功能减退症的类风湿性关节炎（RA）患者发生心血管事件（CVE）的频率，使用mSCORE评估心血管死亡风险，以及使用FINDRISC评估2型糖尿病（DM）的发病情况：研究包括 149 名 RA 患者（125 名女性，24 名男性）（中位年龄 - 57 [52; 61] 岁）。所有患者均存在心血管风险和糖代谢紊乱的传统因素（年龄、吸烟状况、血总胆固醇、血压、超重、腹部肥胖--AO、糖尿病遗传、体力活动不足、日常饮食中缺乏必要的浆果、水果和蔬菜）、根据 mSCORE 和 FINDRISС，评估了 10 年因心血管原因死亡的风险和罹患 2 型糖尿病的风险，并记录了 CVE（心肌梗塞及其血管重建、中风）病史。结果显示17.4%的RA患者被诊断出患有甲状腺功能减退症。与甲状腺功能正常的患者（第2组）相比，甲状腺功能减退的患者（第1组）更有可能患有AO，而摄入膳食纤维不足的可能性较低。根据 mSCORE 和 FINDRISC，61.5% 的甲状腺功能减退症患者和 48.8% 的甲状腺功能亢进症患者有中度、高度和极高度的发病风险，仅根据 mSCORE，30.8% 的甲状腺功能减退症患者和 44.7% 的甲状腺功能亢进症患者有中度、高度和极高度的发病风险。第1组11.5%的患者和第2组6.5%的患者患有CVE（OR 1.875，95% CI 0.462-7.607；P=0.63）：由于甲状腺功能减退症在RA中的高发率，因此有必要对甲状腺功能进行评估，尤其是AO患者。甲状腺功能减退对严重CVЕ的发生率以及根据评分和FINDRISC对RA患者进行的风险评估没有独立影响。根据这两个量表，患有或未患有甲状腺功能减退症的患者主要属于中度、高度和极高度风险组。

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[The effect of hypothyroidism on cardiovascular events and type 2 diabetes mellitus developing in rheumatoid arthritis].

Aim: To compare the frequency of cardiovascular events (CVE), to assess the risk of cardiovascular death using the mSCORE and the development of type 2 diabetes mellitus (DM) using the FINDRISC in patients with rheumatoid arthritis (RA) with and without hypothyroidism.

Materials and methods: The study included 149 patients (125 women, 24 men) with RA (median age - 57 [52; 61] years). In all patients, traditional factors of cardiovascular risk and glucose metabolism disorders (age, smoking status, total blood cholesterol, blood pressure, overweight, abdominal obesity - AO, heredity burdened by diabetes, insufficient physical activity, the lack of the necessary amount of berries, fruits and vegetables in the daily diet, history of hyperglycemia episodes), the 10-year risk of death from cardiovascular causes according to the mSCORE and the risk of developing type 2 DM according to the FINDRISС were assessed, a history of CVE (myocardial infarctions, and its revascularization, stroke) was recorded.

Results: Hypothyroidism was diagnosed in 17.4% of RA patients. Patients with hypothyroidism (group 1) were more likely to have AO and less likely to consume unsufficient dietary fiber than patients with euthyroidism (group 2). Moderate, high and very high risk of development according to the mSCORE and FINDRISC was detected in 61.5% of hypothyroid patients and 48.8% euthyroid patients, according to mSCORE alone - in 30.8 and 44.7%, according to FINDRISC - in 0 and 2.4%, respectively (p>0.05 in all cases); 11.5% of patients in group 1 and 6.5% in group 2 suffered from CVE (OR 1.875, 95% CI 0.462-7.607; p=0.63).

Conclusion: It is necessary to evaluate the thyroid gland function, especially in patients with AO due to the high frequency of hypothyroidism in RA. Hypothyroidism did not have an independent effect on the severe CVЕ rates, as well as risk assessment according to the score and FINDRISC in RA patients. Theses, with and without hypothyroidism, were predominantly in the moderate, high, very high risk groups according to both scales.

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来源期刊

Terapevticheskii Arkhiv 医学-医学：内科

CiteScore

1.40

自引率

33.30%

发文量

171

审稿时长

3-8 weeks

期刊介绍： Терапевтический архив The journal was founded by the prominent Russian therapists M.P. Konchalovsky and G.F. Lang in 1923. Then its editors-in-chief were Professors V.N. Vinogradov and A.G. Gukasyan. Since 1972, E.I. Chazov, Academician of the Russian Academy of Sciences, has been heading the editorial board of the journal. Over 90 years, there have been more than 1000 issues where the authors and editorial staff have done their best for readers to keep abreast of current advances in medical science and practice and for physicians to master the advanced principles of recognition and treatment of a wide spectrum of visceral diseases. The papers published in the journal (editorials, original articles, lectures, reviews, etc.) cover both current scientific achievements and practical experience in diagnosing, treating, and preventing visceral diseases. The authors of publications are not only Russian, but also foreign scientists and physicians. All papers are peer-reviewed by highly qualified Russian specialists. The journal is published monthly. Traditionally, each issue has predominantly certain thematic areas covering individual therapy specializations. Every year, one of the issues is devoted to related problems in practical medicine (allergology and immunology, neurology and psychiatry, obstetrics, oncology, etc.). This all draws the attention of the reading public to the journal. The journal is indexed in RSCI (Russian Science Citation Index), PubMed/Medline, Index Medicus, Scopus/EMBASE, Web of Science Core Collection (Science Citation Index Expanded), Web of Science (Russian Science Citation Index - RSCI, Current Contents Connect, BIOSIS Previews), Google Scholar, Ulrich''s Periodicals Directory. The journal is included in the list of periodicals recommended by the Higher Attestation Committee for publishing the papers containing the basic materials of doctoral and candidate dissertations. By the decision of the Presidium of the Russian Academy of Medical Sciences, the “Therapevticheskiy Arkhiv” was awarded the Botkin medal. It was admitted to the European Association of Sciences Editors (EASE). The journal was honored with the Golden Press Fund decoration at the 13th International Press Professional Exhibition.