Metabolische Relevanz der autonomen Schilddrüsenfunktion

Zusammenfassung

Die Funktionslage von Patienten mit thyreoidaler Autonomie ist entweder euthyreot, subklinisch hyperthyreot oder manifest hyperthyreot. Während sowohl die fehlende metabolische Relevanz bei Euthyreose als auch die deutlichen Wirkungen der manifesten Hyperthyreose unumstritten sind, hat sich die Einschätzung der subklinisch hyperthyreoten Funktionslage in den letzten Jahren deutlich geändert: Aufgrund der negativen Auswirkungen der subklinischen Hyperthyreose auf 1. die kardiorespiratorische und zirkulatorische Funktionen mit signifikanter Erhöhung des Mortalitätsrisiko und 2. den Knochenmetabolismus mit signifikanter Anhebung des Frakturrisikos an Wirbelsäule und Femurhals sollte auch bei diesen Patienten unbedingt eine ablative Therapie angestrebt werden.

Abstract

Patients with thyroid autonomy exhibit either euthyroid or subclinical hyperthyroid or overt hyperthyroid function. The metabolic relevance of euthyroidism and overt hyperthyroidism are well defined, whereas the consequences of subclinical hyperthyroidism were revisited in the last 5-10 years. Due to the negative effects of slightly enhanced concentrations of the thyroid hormones on cardiorespiratoric and circulatoric functions in subclinical hyperthyroidism the mortality rate is significantly increased especially in the elderly, as well as the risk of hip and spine fractures. It is recommended, that all patients with thyroid autonomy and subclinical hyperthyroidism should undergo an ablative therapy.

Schilddrüsenautonomie - subklinische Hyperthyreose - latente Hyperthyreose - kardiovaskuläre Komplikationen - Frakturrate

Thyroid autonomy - subclinical hyperthyroidism - cardiovascular disease - increased fracture risk

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