The effect of stress on the thyroid morphofunctional status (literature review)

Abstract

The article is a literature review on the effect of stress on the thyroid morphofunctional status. The article provides the results of research regarding the effect of various stressors on the thyroid functional state. It also discusses the mechanisms of immune system dysfunction under the influence of stressors that cause autoimmune disorders. The pathophysiological connection between the action of stress hormones and thyroid hormones is described, which consists in changes in the functional state of the thyroid gland depending on the stage of stress. The article also analyzes recent multifactorial population studies on the association of elevated cortisol levels, hyperinsulinemia, hyperleptinemia, and increased neoplastic proliferative activity. The dyshormonal etiology of insulin resistance is based on hypersensitivity due to various factors, which is based on catecholaminergic and serotonergic dysregulatory pathology. As a result, hypercortisolemia occurs. Also, in response to a chronic increase in cortisol level, the expression of leptin increases. Hyperinsulinemia and hyperleptinemia develop under the influence of hypercortisolemia. Patients with obesity, dyslipidemia, hyperleptinemia, hyperinsulinemia have increased level of insulin-like growth factor-1 and other growth factors that participate in the vascular wall remodeling and in the mechanisms of stimulation of the division of various types of cells. There are isolated studies indicating an increased incidence of nodular goiter in people with a negative metabolic phenotype. The presence of hyperinsulinemia and hyperleptinemia can be a crucial marker of the boundary between physiological cell division and neoplastic proliferative activity. Insulin-like growth factor-1 plays a significant role in the regulation of cell proliferation and apoptosis in terms of energy metabolism and depends on the type of eating behavior. Chronic stress changes eating behavior. Therefore, in this difficult historical period for Ukraine, it is important to study both clinical and pathogenetic aspects of hormonal, immunological, metabolic changes that occur in the body under the influence of chronic stress and contribute to the development of thyroid pathology.