Krytsky T. Correlation Between Androgen Deficiency, Vitamin D Insufficiency and Structural-functional State of Bone Tissue in Hypothyroidism Male Patients

The dissertation presents a new solution of the urgent problem of Internal Medicine – establishing the correlation between androgen deficiency, vitamin D insufficiency and structural-functional state of bone tissue in hypothyroidism male patients and developing a new concept of integrated prevention of vitamin D deficiency, androgen deficiency and risk reduction of bone mineral density disorders. At the initial stage, 45 male patients with primary hypothyroidism aged 35 to 60, as well as 25 almost healthy male patients who formed a control groupwere monitored. The functional state of the pituitary-gonadal system was assessed for thedescription of androgenic status in patients.The concentration of follicle-stimulating hormone, luteinizing hormone, prolactin, thyroid-stimulating hormone was determined in blood by immune enzyme method.Hormone levels were also determined: total testosterone, sex hormone-binding globulin. To study the correlation between hypothyroidism and androgen deficiency in men at different stages of adulthood, 60 primary hypothyroidism male patients aged 21 to 60 were observed.The surveyed men were divided into two groups according to the age periodization of human ontogenesis – the group of the first period of adulthood (aged 21 to 35) and the group of the second period of adulthood (aged 36 to 60).Control groups of almost healthy individuals were formed by men of appropriate age (in-by 25 individuals aged 21 to 35 and 36 to 60). Analysis of erectile function in 60 hypothyroidism male patientswas performed using the questionnaire "International Index of Erectile Function – 15" (ICEF-15). Оn the basis of complete examination of hypothyroidism male patients, frequency of androgen deficiency was determined for the first time; correlation of androgen deficiency, vitamin D deficiency and structural-functional state of bone tissue were also established. For the first time in Ukraine, it was found that erectile dysfunction is significantly more common in hypothyroidism patients (72.0 %) than in men of the control group.For the first time, the assessment of integrative indicators of ICEF-15 in hypothyroidism patients was performed.Calculations of integrative indicators of the condition of sexual functionin examined patients with hypothyroidism, androgen deficiency and obesity or normal body weight are the priority data. It is established that the duration of the disease has the most pronounced negative effect on bone mineral density in hypothyroidism patients.Osteoporosis in patients with a longer duration of the disease is 2.5 times more common than in patients with a disease period of 5-15 years.The obtained results correlate with the duration of replacement therapy by thyroid hormone drugs. It is established that increased body weight in hypothyroidism male patients significantly reduces the risk of osteoporosis and osteopenia in such patients. For the first time, effectiveness of testosterone undecaonate administration for androgen deficiency correction in hypothyroidism male patientshas been demonstrated.