الفهرس | Only 14 pages are availabe for public view |
Abstract Background: Subclinical hypothyroidism is characterized by a normal range of free thyroxin concentrations together with increased serum TSH levels. Aim of the Work: study the effect of levothyroxine replacement on cognitive impairment in a sample of patients with subclinical hypothyroidism. Patients and Methods: This was Prospective cohort study conducted on 30 patients with cognitive impairment and subclinical hypothyroidism attending Endocrine outpatient clinic at Ain Shams University Hospital to study the effect of levothyroxine on Cognitive Impairment in patients with Sub-clinical Hypothyroidism. The study conducted on 30 patients. All Participant were subjected to Full history taking and thorough clinical examination. Laboratory investigations: Thyroid profile (FT3, FT4, TSH), Anti TPO, Anti thyroglobulin and Lipid profile. Imaging: Neck us, Echocardiography and Carotid duplex. Addenbrooke’s questionnaire used to diagnose mild cognitive impairment. Results: Our study shows a highly statistically significant difference before, 3 months and 6 months after treatment with levothyroxine regarding all clinical data, TSH, LDL, T. cholesterol, carotid intima-media thickness and Addenbrooke’s questionnaire. Also a statistically significant difference before, 3 months and 6 months after treatment with levothyroxine regarding FT3, FT4 and HDL. Also shows that there is no significant difference regarding triglycerides. our study shows a reverse relation between TSH level and mild cognitive impairment before treatment as when TSH increased, results of Addenbrooke’s questionnaire decreased so cognitive impairment increased. And a reverse relation after 3 and 6 months of levothyroxine treatment as when TSH decreased cognitive impairment improved. Conclusion: This study shows that subclinical hypothyroidism has a great effect of cognitive impairment. As normalization in TSH level results in improvement in cognitive function. also significant reduction in carotid intima media thickness, which may contribute in improvement of cognitive function. also a great improvement on lipid profile which in turn positively affect cardiac and cognitive function. |