Dr.Med., Professor E.A. Turova¹
PhD E.A. Tenyaeva¹
PhD A.V. Golovach¹
PhD I.N. Artikulova^1
1Moscow Scientific and Practical Center for Medical Rehabilitation, Restorative and Sports Medicine, Moscow Department of Health

Objective of the study was to assess the structure and prevalence of diseases of the endocrine system in athletes based on the in-depth medical examination.
Methods and structure of the study. The study involved an analysis of the medical records of the athletes who had undergone an in-depth medical examination on the basis of Branch 1 of the State Autonomous Healthcare Institution of Moscow Centre for Research and Practice in Medical Rehabilitation, Restorative and Sports Medicine of Moscow Healthcare Department. We analyzed the data from a random sample of medical records of 604 athletes engaged in 48 sports, who had undergone the in-depth medical examination in 2016-2018. We considered the data of sports history, anthropometric measurements, thyroid, abdominal, and pelvic ultrasonography, results of the clinical and biochemical surveys of athletes, hormonal blood spectrum rates (TSH, free T4, prolactin, testosterone, cortisol, TPO antibodies), data of the instrumental survey (ECG, impedance monitoring, echocardiography, cycle ergometer test, spirometry).
Study results and conclusions. The study results indicated a high prevalence of thyroid diseases (in 22% of athletes), which significantly exceeds the data of the overall population. We analyzed the structure of thyroid diseases in the athletes: it was asymptomatic hypothyroidism that was diagnosed most often (in 7.8% of cases); iodine deficiency conditions ran second (6.8%); autoimmune thyroiditis, which was found in 4.3% of all subjects, ranked third, and 3% of athletes were diagnosed with thyroid nodules. The statistical analysis revealed an increase in the probability of iodine deficiency conditions and thyroid nodules under increased static physical loads, and autoimmune thyroiditis and hypothyroidism under low-intensity static loads. With an increase in the intensity of dynamic physical loads, the probability of hypothyroidism and thyroid nodules increases. We found a negative correlation between the level of TTG and sports qualification, which testifies to the improvement of the mechanisms of hormonal adaptation with the enhancement of sports skills. Due to the high prevalence of iodine deficiency and associated diseases, athletes need to correct dietary iodine deficiency, which is especially relevant for athletes engaged in sports activities with the high static and dynamic physical loads.

Keywords: athletes, endocrine disorders, thyroid diseases, iodine deficiency, hypothyroidism, autoimmune thyroiditis, thyroid nodule.

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