Thyroid and menopause
Thyroid and menopause
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DOI：
10.3109/13697137.2013.838554
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发表时间：
2014-06-01
期刊：
影响因子：
2.8
通讯作者：
Vitti, P.
中科院分区：
文献类型：
--
作者：
del Ghianda, S.;Tonacchera, M.;Vitti, P.
甲状腺功能障碍在普通人群中很常见，尤其是在女性中。事实上，所有甲状腺疾病在女性中都比男性更常见，可能会干扰生殖系统。在女性的整个生育期，甲状腺功能和性腺轴是相关的。这两个腺体之间的关系是相互的。特别是，甲状腺激素通过几种作用直接或间接地影响生殖功能。关于更年期和甲状腺功能之间的关系的研究很少，而且不允许澄清更年期是否会对甲状腺产生影响，而不考虑年龄的变化。随着年龄的增长，甲状腺生理和功能的变化主要是：甲状腺吸碘减少，游离甲状腺激素和游离三碘甲状腺原氨酸的合成和分解代谢，而反三碘甲状腺原氨酸增加；促甲状腺激素水平保持正常，有时有升高的趋势。这些变化在两性中都存在，没有男女之分。这些关系的复杂性可以概括为三个方面：甲状腺状况对更年期综合征影响不大；更年期可能改变某些甲状腺疾病的临床表现，特别是自身免疫性疾病；甲状腺功能不直接参与更年期并发症的发病机制。然而，甲状腺功能亢进或甲状腺功能减退可加重冠状动脉粥样硬化和骨质疏松症。应考虑绝经后雌激素替代治疗对甲状腺功能减退症妇女甲状腺激素需求的影响。
Thyroid dysfunction is common in the general population especially in women. All thyroid diseases are in fact more common in women than in men and may interfere with the reproductive system. Thyroid function and the gonadal axes are related throughout the woman's fertile period. The relationship between the two glands is mutual. In particular, thyroid hormones affect the reproductive function both directly and indirectly through several actions. Studies on the relationship between menopause and thyroid function are few and do not allow to clarify whether menopause has an effect on the thyroid regardless of aging. With aging, the main changes regarding thyroid physiology and function are: a reduction of thyroid iodine uptake, free thyroxine and free triiodothyronine synthesis and catabolism of free thyroxine while reverse triiodothyronine increases; the level of thyroid stimulating hormone remains normal with sometimes a tendency to higher limits. These changes are present in both sexes without distinction between males and females. The complexity of the relationships can be summarized in three aspects: thyroid status does not influence significantly the climacteric syndrome; menopause may modify the clinical expression of some thyroid diseases, particularly the autoimmune ones; thyroid function is not directly involved in the pathogenesis of the complications of menopause. However, coronary atherosclerosis and osteoporosis may be aggravated in the presence of hyperthyroidism or hypothyroidism. The effects of postmenopausal estrogen replacement on thyroxine requirements in women with hypothyroidism should be considered.