{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T20:34:24Z","timestamp":1789763664375,"version":"4.0.1"},"reference-count":151,"publisher":"FapUNIFESP (SciELO)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq Bras Endocrinol Metab"],"published-print":{"date-parts":[[2013,4]]},"abstract":"<jats:p>INTRODU\u00c7\u00c3O: O hipotireoidismo subcl\u00ednico (HSC), definido por concentra\u00e7\u00f5es elevadas do TSH em face de n\u00edveis normais dos horm\u00f4nios tireoidianos, tem elevada preval\u00eancia no Brasil, particularmente entre mulheres e idosos. Embora um n\u00famero crescente de estudos venha associando o HSC com maior risco de doen\u00e7a arterial coronariana e de mortalidade, n\u00e3o h\u00e1 ensaio cl\u00ednico randomizado sobre o benef\u00edcio do tratamento com levotiroxina na redu\u00e7\u00e3o dos riscos e o tratamento permanece controverso. OBJETIVO: Este consenso, patrocinado pelo Departamento de Tireoide da Sociedade Brasileira de Endocrinologia e Metabologia e desenvolvido por especialistas brasileiros com vasta experi\u00eancia cl\u00ednica em tireoide, apresenta recomenda\u00e7\u00f5es baseadas em evid\u00eancias para uma abordagem cl\u00ednica do paciente com HSC no Brasil. MATERIAIS E M\u00c9TODOS: Ap\u00f3s estrutura\u00e7\u00e3o das quest\u00f5es cl\u00ednicas, a busca das evid\u00eancias dispon\u00edveis na literatura foi realizada inicialmente na base de dados do MedLine-PubMed e posteriormente nas bases Embase e SciELO - Lilacs. A for\u00e7a da evid\u00eancia, avaliada pelo sistema de classifica\u00e7\u00e3o de Oxford, foi estabelecida a partir do desenho de estudo utilizado, considerando-se a melhor evid\u00eancia dispon\u00edvel para cada quest\u00e3o e a experi\u00eancia brasileira. RESULTADOS: Os temas abordados foram defini\u00e7\u00e3o e diagn\u00f3stico, hist\u00f3ria natural, significado cl\u00ednico, tratamento e gesta\u00e7\u00e3o, que resultaram em 29 recomenda\u00e7\u00f5es para a abordagem cl\u00ednica do paciente adulto com HSC. CONCLUS\u00c3O: O tratamento com levotiroxina foi recomendado para todos os pacientes com HSC persistente com n\u00edveis s\u00e9ricos do TSH &gt; 10 mU\/L e para alguns subgrupos especiais de pacientes.<\/jats:p>","DOI":"10.1590\/s0004-27302013000300003","type":"journal-article","created":{"date-parts":[[2013,5,11]],"date-time":"2013-05-11T13:06:48Z","timestamp":1368277608000},"page":"166-183","source":"Crossref","is-referenced-by-count":38,"title":["Consenso brasileiro para a abordagem cl\u00ednica e tratamento do hipotireoidismo subcl\u00ednico em adultos: recomenda\u00e7\u00f5es do Departamento de Tireoide da Sociedade Brasileira de Endocrinologia e Metabologia"],"prefix":"10.1590","volume":"57","author":[{"given":"Jose A.","family":"Sgarbi","sequence":"first","affiliation":[{"name":"Faculdade de Medicina de Mar\u00edlia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patr\u00edcia F. S.","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio de Janeiro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lea M. Z.","family":"Maciel","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glaucia M. F. S.","family":"Mazeto","sequence":"additional","affiliation":[{"name":"Universidade Estadual Paulista, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Vaisman","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio de Janeiro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renan M.","family":"Montenegro Junior","sequence":"additional","affiliation":[{"name":"Universidade Federal do Cear\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura S.","family":"Ward","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1001\/jama.291.2.228","article-title":"Subclinical thyroid disease: scientific review and guidelines for diagnosis and management","volume":"291","author":"Surks 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