Abstract | Hipotireoza je stanje smanjene funkcije štitnjače koje dovodi do niskih razina hormona štitnjače u stanicama.
Prevalencija varira od 0,1% do 2,0%, dok je subklinička hipotireoza prisutna u 4-10% odraslih, posebno starijih žena.
Bolest se češće javlja kod žena, i to 5 do 20 puta više nego kod muškaraca. Najčešći uzrok je Hashimotov tireoiditis,
autoimuna bolest koja uzrokuje oštećenje štitnjače. Simptomi uključuju umor, porast tjelesne mase, hladnu kožu i
poremećaje pamćenja. Dijagnoza se postavlja laboratorijskim analizama, a liječenje se provodi nadomjesnom
terapijom, najčešće levotiroksinom. Cilj ovog diplomskog rada bio je procijeniti kvalitetu života osoba oboljelih od
hipotireoze. Istraživanje se provodilo u ZU Ljekarna Nives Miloš od kolovoza do studenog 2023. Ispitano je 237
punoljetnih pacijenata, s dijagnozom hipotireoze minimalno šest mjeseci od kojih je većina bila ženskog spola i
prosječne dobi 40,5 godina. Ispitanici su ispunili anonimni upitnik ThyPro 39, koji je korišten za procjenu njihove
kvalitete života, uz dodatna pitanja o komorbiditetima, lijekovima, prehrambenim dodacima i sociodemografskim
podacima. Upitnik mjeri fizičke, psihološke i socijalne simptome te pokazuje utjecaj bolesti na pacijentov svakodnevni
život.. Najčešći komorbiditeti uključuju inzulinsku rezistenciju, hipertenziju i sindrom policističnih jajnika (PCOS).
Liječenje se većinom provodi monoterpaijom levotiroksinom, a 80% ispitanika koristi dodatke prehrani. Istraživanje je
također pokazalo visoku adherenciju (90%) u uzimanju terapije, bez pada adherencije s duljim trajanjem bolesti.
Istraživanje je pokazalo značajne probleme sa umorom, anksioznošću, emocionalnom osjetljivošću te ukupnom
kvalitetom života koja je narušena. Terapija levotiroksinom dobro kontrolira tjelesne simptome, dok psihički simptomi
ostaju izazov. Ovo istraživanje među prvima je koji koriste ThyPro-39 upitnik u Hrvatskoj te onima koji se bave
kvalitetom života osoba oboljelih od hipotireoze, a prvo je koje je u ispitivanje uključilo i utjecaj drugih komorbiditeta
i utjecaj korištenja dodataka prehrani. Rezultati ukazuju na činjenicu da unatoč dobroj kontroli bolesti, pacijenti
prijavljuju poteškoće vezane uz umor, anksioznost, emocionalnu osjetljivost i seksualni život, što ukazuje na značajan
utjecaj bolesti na kvalitetu života koja je znatno narušena u odnosu na zdravu populaciju. |
Abstract (english) | Hypothyroidism is a condition characterized by reduced thyroid function, leading to low levels of thyroid hormones in
cells. Its prevalence ranges from 0.1% to 2.0%, while subclinical hypothyroidism affects 4-10% of adults, particularly
older women. The disease is more common in women, occurring 5 to 20 times more frequently than in men. The most
common cause is Hashimoto's thyroiditis, an autoimmune disorder that damages the thyroid gland. Symptoms include
fatigue, weight gain, cold skin, and memory disturbances. Diagnosis is made through laboratory tests, and treatment is
typically administered through hormone replacement therapy, most commonly with levothyroxine. The aim of this
thesis was to assess the quality of life of individuals with hypothyroidism. The study was conducted at ZU Ljekarna
Nives Miloš from August to November 2023. It examined 237 adult patients with a diagnosis of hypothyroidism for at
least six months, most of whom were female with an average age of 40.5 years. Participants completed an anonymous
ThyPRO-39 questionnaire, used to evaluate their quality of life, along with additional questions about comorbidities,
medications, dietary supplements, and sociodemographic data. The questionnaire measures physical, psychological,
and social symptoms and assesses the impact of the disease on the patient’s daily life. The most common
comorbidities include insulin resistance, hypertension, and polycystic ovary syndrome (PCOS). Treatment is
predominantly through monotherapy with levothyroxine, and 80% of participants use dietary supplements. The study
also found high adherence (90%) to therapy, with no decrease in adherence with the duration of the disease.
Significant issues with fatigue, anxiety, emotional sensitivity, and overall diminished quality of life were reported.
While levothyroxine therapy effectively manages physical symptoms, psychological symptoms remain challenging.
This study is among the first in Croatia to use the ThyPRO-39 questionnaire for assessing the quality of life in
individuals with hypothyroidism and is the first to include the impact of other comorbidities and the use of dietary
supplements. The results indicate that despite good disease control, patients report difficulties related to fatigue,
anxiety, emotional sensitivity, and sexual life, which suggests a significant impact of the disease on quality of life,
substantially diminished compared to the healthy population. |