Potenciais riscos metabólicos em adultos com hipotireoidismo subclínico: uma revisão de escopo

Abstract

Subclinical hypothyroidism (SCH) is an endocrine disorder characterized by elevated TSH levels with normal free T3 and T4. Although often asymptomatic, SCH has been associated with significant metabolic and cardiovascular changes and is considered a risk factor for the development of chronic diseases. This study aims to discuss the main metabolic risks related to SCH in adults. It is a scoping review conducted according to PRISMA-ScR guidelines, including original articles (2019–2025) published in Portuguese or English. The search strategy was based on the Population, Concept, and Context (PCC) framework, where the population was adults, the concept was metabolic risks, and the context referred to SCH. The article search was conducted in the LILACS, SciELO, MEDLINE/PubMed, and Science Direct databases using the following descriptors: “hypothyroidism,” “subclinical hypothyroidism,” “metabolism,” “non-communicable diseases,” “diabetes mellitus,” “cardiovascular diseases,” and “adults.” Studies were excluded if they did not address the research question, were duplicates, non-original, experimental, published in languages other than Portuguese or English, or involved children, adolescents, the elderly, women with polycystic ovary syndrome, individuals with cancer, or those infected with COVID-19. After manual screening, the data were extracted and analyzed qualitatively. Of the 9,314 records identified, 8,748 were excluded based on the exclusion criteria, and 39 articles were selected for full-text reading. Thirty-four publications were excluded for not addressing the research question, resulting in five studies included in the review. Findings reveal that individuals with SCH show a higher propensity for dyslipidemia, insulin resistance, liver fibrosis, progression of non-alcoholic fatty liver disease (NAFLD), and the development of type 2 diabetes mellitus(T2DM). The studies indicated the presence of one or more risks related to non-communicable chronic diseases in SCH groups. Therefore, the reviewed literature highlights that SCH may have systemic implications and reinforces the importance of appropriate monitoring and management of this condition in various clinical and population contexts.