Prevalence and Risk Factors of Thyroid Dysfunction in Older Adults in the Community

Abstract Prevalence estimates and evidence informing treatment targets for thyroid dysfunction largely come from studies of middle-aged adults. We conducted a cross-sectional analysis to determine the prevalence of thyroid dysfunction and risk factors for abnormal thyroid tests in participants aged ≥65 in the Atherosclerosis Risk in Communities (ARIC) study (N = 5,392). We measured serum concentrations of triiodothyronine (T3), free thyroxine (FT4), thyroid peroxidase antibody (Anti-TPO), and thyroid stimulating hormone (TSH). In this population (58% women, 22% black), 17% reported medication use for thyroid dysfunction. Among those not on treatment, the prevalence of overt and subclinical hypothyroidism was 0.82% and 6.06%, respectively. Overt and subclinical hyperthyroidism affected 0.26% and 0.78%, respectively. Multivariable adjusted TSH, FT4 and T3 levels were 25%, 1.3% and 3.9% lower in blacks compared to whites, respectively. Men were less likely to be anti-TPO positive compared to women (p < 0.001). Former and never smoking were associated with lower T3 and FT4 levels compared to current smoking. The prevalence of thyroid dysfunction in older adults is nearly 25%. Multiple illnesses can interact to contribute to declines in health. Additional attention to thyroid dysfunction and screening in this age group is recommended.

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Abstract P266: Prevalence and Risk Factors of Thyroid Dysfunction in Older Adults in the Community

Circulation ◽

10.1161/circ.137.suppl_1.p266 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Nermin Diab ◽

Natalie Daya ◽

Stephen P Juraschek ◽

Seth Martin ◽

John W McEvoy ◽

...

Keyword(s):

Risk Factors ◽

Older Adults ◽

Cardiovascular Risk ◽

Thyroid Hormone ◽

Thyroid Dysfunction ◽

Thyroid Peroxidase ◽

Age Group ◽

Cross Sectional ◽

Hormone Levels ◽

Thyroid Hormone Levels

Context: Prevalence estimates and evidence informing treatment targets for thyroid dysfunction largely come from studies of middle-aged adults. There are limited data on the prevalence of thyroid dysfunction in older populations. Objective: To determine the prevalence of thyroid dysfunction and risk factors for abnormal thyroid tests in older adults. Methods: We conducted a cross-sectional analysis of data from participants aged 65 or older in the Atherosclerosis Risk in Communities (ARIC) study who attended visit 5 in 2011-2013. We measured serum concentrations of triiodothyronine (T3), free thyroxine (FT4), thyroid peroxidase antibody (Anti-TPO), and thyroid stimulating hormone (TSH) in 5,392 participants. We used multivariable linear and logistic regression to assess associations of demographic and clinical risk factors with thyroid hormone levels. Results: In this population of older adults (mean age 76; 56% women and 22% black), the prevalence of thyroid dysfunction was up to 25% when accounting for treated and untreated thyroid dysfunction categories. 15.6% reported use of medication for thyroid dysfunction. Among those not being treated, the prevalence of overt chemical hypothyroidism was 6.0% and subclinical hypothyroidism was 0.82%. Overt chemical hyperthyroidism and subclinical hyperthyroidism affected 0.26% and 0.78% of the population, respectively. Multivariable adjusted cardiovascular risk factor associations for TSH, FT4 and T3 levels are presented in Table . Men were less likely to be anti-TPO positive compared to women (OR=0.59, CI: 0.47,0.75, P<0.001). Conclusions: There is a high prevalence of thyroid dysfunction in this older, community-based population. Prevalence of thyroid dysfunction and thyroid hormone levels vary with sex, race, age group and multiple cardiovascular risk factors. Accounting for these associations in the clinical setting might prove useful in improving thyroid function assessment in this age group.

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Prevalence of thyroid dysfunction and anti-thyroid peroxidase antibodies in vitiligo patients

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20170803 ◽

2017 ◽

Vol 3 (1) ◽

pp. 140 ◽

Cited By ~ 1

Author(s):

Jishna P. ◽

M. P. Binitha ◽

Abdul Latheef E. N. ◽

V. P. Anilakumari

Keyword(s):

Autoimmune Diseases ◽

Thyroid Dysfunction ◽

Thyroid Stimulating Hormone ◽

Thyroid Peroxidase ◽

Cross Sectional ◽

Autoimmune Thyroid ◽

Thyroid Peroxidase Antibodies ◽

Thyroid Peroxidase Antibody ◽

Antibody Positivity ◽

Antibody Levels

Background: Vitiligo is associated with various autoimmune diseases, including autoimmune thyroid disease. The objectives of the present study was to determine the prevalence of thyroid dysfunction and anti-thyroid peroxidase antibodies in patients with vitiligo, and to compare the clinical profile of anti-thyroid peroxidase positive and anti-thyroid peroxidase negative patients.Methods: A cross-sectional comparative study was conducted in 100 patients with vitiligo and 100 controls. After dermatologic and systemic evaluation, serum thyroid hormones and anti-thyroid peroxidase antibody levels were measured in all the subjects.Results: Thyroid dysfunction was more common in the vitiligo group (27%) than in the controls. Serum thyroid stimulating hormone abnormalities were more common in the vitiligo group (27%) than in the controls (6%). The most common thyroid dysfunction was subclinical hypothyroidism. Anti-thyroid peroxidase antibody positivity was higher in the vitiligo group (36%) when compared to the controls (24%), and the most common type of vitiligo was vitiligo vulgaris (18%) in this group. Thyroid dysfunction and anti-thyroid peroxidase positivity were more common in women (58%) when compared to men (42%). There was a significantly higher prevalence of other autoimmune diseases in the vitiligo group (20%) compared to the controls (6%). Conclusions: This study shows a significant association between vitiligo and thyroid dysfunction, anti-thyroid peroxidase antibodies and other autoimmune diseases. We recommend that thyroid evaluation and regular follow-up should be done in patients with vitiligo for prompt detection of thyroid dysfunction.

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Abstract 061: Long-chain monounsaturated fatty acids and congestive heart failure incidence: the Atherosclerosis Risk in Communities Study

Circulation ◽

10.1161/circ.125.suppl_10.a061 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Fumiaki Imamura ◽

Rozenn N Lemaitre ◽

Lyn M Steffen ◽

Aaron R Folsom ◽

David S Siscovick ◽

...

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Older Adults ◽

Fatty Acids ◽

Congestive Heart Failure ◽

Plasma Phospholipid ◽

Atherosclerosis Risk In Communities ◽

Atherosclerosis Risk ◽

Middle Aged Adults ◽

Long Chain

Background: Animal experiments in 1970s demonstrated direct cardiotoxicity of long-chain monounsaturated fatty acid (LCMUFA, 22:1 and 24:1 fatty acids) consumption. We recently found plasma phospholipid 22:1 and 24:1 to be associated with 34% and 75% higher risk (quintiles 5 vs. 1), respectively, of congestive heart failure (CHF) among older adults in the Cardiovascular Health Study. We wished to validate these results in a second independent cohort of middle-aged adults. Methods: We evaluated 3,577 adults free of CHF at baseline (age=54.1±5.8) in the Minnesota subcohort of the Atherosclerosis Risk in Communities Study (ARIC) in whom plasma phospholipid LCMUFA were measured. Incident CHF was ascertained from 1988 to 2008 by annual phone contacts, hospitalization discharge codes, and death certificates. Using multivariate Cox models, we evaluated prospective association of each LCMUFA with incident CHF, and potential mediation via CHF risk factors, including ECG left ventricular hypertrophy, and incident coronary heart disease (CHD). As a negative control, we also evaluated incident stroke, given its many shared risk factors for CHF but no link to potentially direct cardiotoxicity. Results: Mean±SD plasma phospholipid levels (% of total fatty acids) of 22:1 and 24:1 were 0.01±0.03 and 0.58±0.17. Over the 64,438 person-years of follow-up, 330 CHF events occurred. After multivariable adjustment, higher levels of 22:1 and 24:1 were associated with higher risk of CHF (Figure). Hazard ratios (95%CI) for quintiles 5 vs. 1 of 22:1 and 24:1 levels were 1.57 (1.11–2.23) and 1.92 (1.22–3.03) (p trend=0.03 and 0.002), respectively. These associations were only partly attenuated by potential mediators, including incident CHD. Neither LCMUFA was associated with incident stroke (not shown). Conclusions: Higher 22:1 and 24:1 LCMUFA levels were associated with CHF risk in middle-aged adults, consistent with our prior findings in older adults. These findings support the possibility of clinical cardiotoxicity of LCMUFA in humans.

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Abstract P275: Growth Differentiation Factor (gdf)-15 and Metabolic Outcomes: The ARIC Study

Circulation ◽

10.1161/circ.141.suppl_1.p275 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Justin B Echouffo Tcheugui ◽

Natalie R Daya ◽

Kunihiro Matsushita ◽

Chiadi E Ndumele ◽

Ron C Hoogeveen ◽

...

Keyword(s):

Older Adults ◽

Metabolic Syndrome ◽

Cross Sectional ◽

Atherosclerosis Risk In Communities ◽

Differentiation Factor ◽

Metabolic States ◽

Unit Increase ◽

Sectional Analysis ◽

Roche Diagnostics ◽

Aric Study

Introduction: Mechanistic studies suggest an involvement of growth differentiation factor 15 (GDF-15) in metabolic dysregulation. However, the potential utility of GDF-15 as a marker of diabetes or metabolic syndrome (MetS) risk remains unclear, especially in older adults. Hypothesis: GDF-15 is positively associated with biomarkers of hyperglycemia, diabetes, and MetS. Methods: We conducted a cross-sectional analysis of older adults who attended visit 6 (2016-2017) of the Atherosclerosis Risk in Communities (ARIC) Study. GDF-15 was measured using electrochemiluminescence immunoassay (Elecsys, Roche Diagnostics). Linear regression was used to assess continuous outcomes after appropriate transformations, and multivariable-adjusted odds of diabetes or MetS by quartiles of GDF-15 were derived using logistic regression. Results: Among 3,792 participants (mean age 80 years, 59% women, 23% blacks and 77% whites), higher GDF-15 concentrations (per 1-unit increase in ln[GDF-15]) were associated with higher levels of fasting plasma glucose (mg/dL) (adjusted β coefficient : 10.98, 95% CI:8.86 - 13.09) and HbA 1C (%)(0.41, 95% CI: 0.35 - 0.48). Higher GDF-15 was associated with greater odds of diabetes (adjusted odds ratio [OR]: 5.81 for highest vs. lowest GDF-15 quartile, 95% CI 4.43-7.61) and of MetS syndrome (adjusted OR: 2.57, 95% CI 2.01-3.20) among individuals without diabetes (Figure). Conclusions: In this sample of older adults, elevated GDF-15 was strongly associated with diabetes and metabolic syndrome. These data strongly suggest that GDF-15 could be a robust biomarker of adverse metabolic states.

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Prediction of post partum thyroid dysfunction: can it be improved?

Acta Endocrinologica ◽

10.1530/eje.0.1390036 ◽

1998 ◽

Vol 139 (1) ◽

pp. 36-43 ◽

Cited By ~ 55

Author(s):

JL Kuijpens ◽

VJ Pop ◽

HL Vader ◽

HA Drexhage ◽

WM Wiersinga

Keyword(s):

Risk Factors ◽

At Risk ◽

Thyroid Dysfunction ◽

Post Partum ◽

First Trimester ◽

Thyroid Stimulating Hormone ◽

Bottle Feeding ◽

Smoking Habits ◽

Thyroid Peroxidase ◽

Independent Risk Factors

BACKGROUND: Screening pregnant women for thyroid peroxidase antibodies (TPOAb) to identify those at risk for post partum thyroid dysfunction (PPTD) is controversial, mainly because of the low positive predictive value (ppv) of TPOAb. OBJECTIVES: To evaluate if the ppv of TPOAb can be enhanced, either by taking into account the time of TPOAb testing, or by combining this parameter with other putative determinants of PPTD such as smoking, family history or other autoimmune diseases. METHODS: A prospective study was performed in the Kempenland region (southeastern Netherlands). Three hundred and ten unselected women were visited at 12 and 32 weeks gestation and 4, 12, 20, 28 and 36 weeks post partum. Serial thyroid stimulating hormone (TSH), free thyroxine (fT4) and TPOAb testing was performed. Thyroid dysfunction (TD) was defined as abnormal TSH either in combination with abnormal fT4 (overt TD) or without abnormal fT4 (subclinical TD). PPTD was defined as overt TD post partum. Multivariate regression analysis was performed for determining independent risk factors for PPTD. The sensitivity and specificity of TPOAb at different time points and at different concentrations were calculated and presented in receiver operating characteristic (ROC) curves. Women who had experienced PPTD were followed for 2.5-3 years. RESULTS: Data from 291 women were available for analysis. Serum fT4 declined during pregnancy and returned to baseline values post partum. TD in gestation was present in 23 women (7.9%): serum TSH was transiently decreased in 13 (6 had overt gestational thyrotoxicosis (2.1%)) and increased in 10 (2 had TPOAb). Both point prevalence and concentration of TPOAb decreased during gestation and returned to baseline levels within 12 weeks post partum. TD in post partum was present in 36 women (12.4%): 21 had subclinical and 15 overt TD. Out of the 15 women with overt TD (incidence of PPTD: 5.2%) 10 were positive for TPOAb (TPOAb+): 9 had thyrotoxicosis (4 TPOAb+), 5 hypothyroidism (5 TPOAb+) and 1 thyrotoxicosis followed by hypothyroidism (TPOAb+). Independent risk factors for PPTD were TPOAb (relative risk (RR) = 2 7.2), bottle feeding (RR = 11.1) and smoking habits (ever smoked: RR = 3.1; women with PPTD had smoked more cigarettes for a longer period of time). The sensitivity of TPOAb testing was highest at 12 weeks gestation (0.67). The ppv of TPOAb was 0.31-0.75 (depending on time of testing and concentration), increasing slightly to 0.38-0.80 when combined with bottle feeding or smoking habits. There appeared to be an autoimmune form of PPTD in 2/3 of cases and a non-autoimmune form; women with the autoimmune form were at risk for developing permanent hypothyroidism. CONCLUSIONS: A maximum of 2/3 of PPTD cases can be predicted from the presence of TPOAb because 1/3 remained negative for TPOAb. The most appropriate time for TPOAb testing is in the first trimester of pregnancy. The combination of TPOAb testing with anamnestic determinants of PPTD does not increase ppv substantially.

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Circulating Betatrophin Is Increased in Patients with Overt and Subclinical Hypothyroidism

BioMed Research International ◽

10.1155/2016/5090852 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 8

Author(s):

Cheng Han ◽

Xinghai Xia ◽

Aihua Liu ◽

Xiaowen Zhang ◽

Mi Zhou ◽

...

Keyword(s):

Subclinical Hypothyroidism ◽

Thyroid Dysfunction ◽

Metabolic Diseases ◽

Thyroid Autoimmunity ◽

Thyroid Stimulating Hormone ◽

Overt Hypothyroidism ◽

Thyroid Peroxidase ◽

Thyroid Peroxidase Antibody ◽

Antibody Positivity ◽

Healthy Control

Thyroid hormone (TH) affects many metabolic processes such as promoting oxidation of sugar, fat, and protein in many tissues. Thyroid dysfunction is associated with metabolic disorders. The newly discovered adipocyte- and hepatocyte-derived cytokine, betatrophin, has been reported to be involved in metabolic diseases, but its influence on thyroid dysfunction is uncertain. Therefore, the present study aims to evaluate circulating betatrophin levels in subjects with different thyroid function status and to predict the factors associated with betatrophin levels, especially whether thyroid stimulating hormone (TSH), TH, or thyroid autoantibodies are associated with betatrophin levels. In the study, serum betatrophin was measured in the subjects grouped as overt hypothyroidism (OH), subclinical hypothyroidism (SCH), euthyroid with isolated thyroid peroxidase antibody positivity (isolated Ab), and healthy control (HC), according to their thyroid functions. From our results, we found that betatrophin may be associated with thyroid insufficiency but not thyroid autoimmunity. Thus, when interpreting the results of betatrophin, thyroid functions should also be taken into consideration.

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Assessment of subclinical hypothyroidism for a clinical score and thyroid peroxidase antibody: a comparison with euthyroidism grouped by different thyroid-stimulating hormone levels

Asian Biomedicine ◽

10.1515/abm-2019-0045 ◽

2019 ◽

Vol 13 (3) ◽

pp. 85-93 ◽

Cited By ~ 1

Author(s):

Darya S. Abdulateef ◽

Taha O. Mahwi

Keyword(s):

Subclinical Hypothyroidism ◽

Pearson Correlation ◽

Clinical Score ◽

Cross Sectional Study ◽

Thyroid Stimulating Hormone ◽

Clinical Feature ◽

Thyroid Peroxidase ◽

Cross Sectional ◽

Thyroid Peroxidase Antibody ◽

Stimulating Hormone

Abstract Background Subclinical hypothyroidism (SCH) might have many symptoms of hypothyroidism. The controversy appears to lower the level of thyroid-stimulating hormone (TSH) and group subjects with TSH of more than 3 or even 2.5 mIU/L as SCH subjects. Objectives To assess SCH subjects both clinically using Zulewski clinical score and biochemically and to evaluate whether the euthyroid subjects with high-normal TSH (HNT) have any clinical symptom or subnormal biochemical finding. Methods A prospective cross-sectional study of 233 subjects, 67 with SCH and 166 euthyroidism, was conducted. Euthyroid subjects were divided according to the level of TSH as HNT (>2.5 mIU/L) and low-normal TSH (0.5–2.5 mIU/L). The subjects were examined for clinical feature including Zulewski clinical score and biochemical evaluations including thyroid peroxidase antibody (TPO-Ab) titer. The comparisons between groups were assessed using independent sample t test, and correlations between variables were evaluated using Pearson correlation. Results A significantly higher clinical score and higher frequencies of symptoms were found in the SCH group compared to the euthyroid group. The most frequent symptom was fatigue. Euthyroid subjects with HNT were found to have higher TPO-Ab titers than those with low-normal TSH, P < 0.05. The Zulewski clinical score was positively correlated with TSH and TPO-Ab titer but negatively correlated with the FT4 level, P < 0.05. Conclusions Zulewski clinical score is higher in SCH subjects compared to euthyroid subjects and can aid in assessing SCH subjects. A significant correlation exists between Zulewski clinical score and each of the TSH, FT4, and TPO-Ab titer levels. The frequency of TPO-Ab positivity is high in SCH. Additionally, euthyroid with higher TSH levels has higher level of TPO-Ab titer but not higher clinical score.

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Thyroid Peroxidase Antibody (TPO) as a Predictor of Radiation Induced Thyroid Dysfunction Among Nurses and Technicians Working in Mansoura Specialized Medical Hospital: Cross Sectional Study

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530319666190626143301 ◽

2020 ◽

Vol 20 (2) ◽

pp. 288-294

Author(s):

Ahmed Albehairy ◽

Sherif Fathy ◽

Rania Bahriz

Keyword(s):

Sensitivity And Specificity ◽

Thyroid Dysfunction ◽

Cross Sectional Study ◽

Radiology Department ◽

P Value ◽

Thyroid Peroxidase ◽

High Dose ◽

Cross Sectional ◽

Thyroid Peroxidase Antibody ◽

Group 2

Background:: Thyroid gland is a probable goal tissue for radiation-related injury. Occupational exposure to ionizing radiation leads to thyroid dysfunction and exposure to high dose may lead to thyroid carcinoma. Objective:: Evaluation of the role of Thyroid peroxidase antibody as a predictor for thyroid dysfunction among nurses and technicians in the radiology department in Mansoura Specialized Medical hospital (MSMH). Subjects and Methods:: Subjects were Nurses and technicians who are working in (MSMH) with persistent daily duty in the last 3 years and fulfilling the inclusion and exclusion criteria. All subjects included in the study were recruited in one month and divided into two groups; Group 1: 50 subjects who were working in radiology, coronary angiography and ERCP unit, Radiation -exposed group. Group 2: 33 subjects who were working in In-patient departments and in out- patient clinics and not exposed to any type of radiation. Non fasting blood sample was taken from all enrolled subjects for measurement of TSH and Anti-TPO. Results:: TPO was positively and significantly correlated to age, TSH, duration of radiology/ y (r=0.388, 0.364, 0.342respectively) p value <0.05. Roc curve was done to detect the sensitivity and specificity of TSH in relation to TPO that revealed the cutoff value of TSH > 1.69 with Sensitivity and Specificity. PPV, NPV and accuracy at cutoff >1.69 were 70.6%, 51.5%, 42.8%, 77.3% and 58%. Conclusion:: Working personnel with positive anti TPO and their TSH levels are more than 1.69 associated with symptoms of hypothyroidism, a trial of treatment is mandatory to relieve symptoms.

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Metabolic Syndrome, Thyroid Function and Autoimmunity - The PORMETS Study

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530318666180801125258 ◽

2019 ◽

Vol 19 (1) ◽

pp. 75-83 ◽

Cited By ~ 8

Author(s):

Luís Raposo ◽

Sandra Martins ◽

Daniela Ferreira ◽

João Tiago Guimarães ◽

Ana Cristina Santos

Keyword(s):

Metabolic Syndrome ◽

Thyroid Dysfunction ◽

Positive Association ◽

National Sample ◽

Thyroid Stimulating Hormone ◽

Thyroid Peroxidase ◽

Free Triiodothyronine ◽

Cross Sectional ◽

Thyroid Peroxidase Antibodies ◽

The Metabolic Syndrome

Background:The prevalence of thyroid dysfunction and autoimmunity in the Portuguese population has not yet been estimated. However, the national prevalence of the metabolic syndrome remains high. The association of thyroid pathology with cardiovascular risk has been addressed but is still unclear. Our study aimed to evaluate the prevalence of thyroid dysfunction and autoimmunity and to assess the associations of thyroid-stimulating hormone and thyroid hormones and antibodies with metabolic syndrome, its components, and other possible determinants in a national sample.Material and Methods:The present study included a subsample of 486 randomly selected participants from a nationwide cross-sectional study sample of 4095 adults. A structured questionnaire was administered on past medical history and socio-demographic and behavioural characteristics. Blood pressure and anthropometric measurements were collected, and the serum lipid profile, glucose, insulin, hs- CRP, TSH, FT4, FT3 and thyroid antibodies were measured.Results:In our sample, the prevalence of hypothyroidism, hyperthyroidism and undiagnosed dysfunction was 4.9%, 2.5% and 72.2%, respectively. Overall, the prevalence of positivity for the thyroid peroxidase and thyroglobulin antibodies was 11.9% and 15.0%, respectively. A positive association was found between free triiodothyronine and metabolic syndrome (OR: 2.019; 95% CI: 1.196, 3.410). Additionally, thyroid peroxidase antibodies had a negative association with metabolic syndrome (OR: 0.465; 95% CI: 0.236, 0.917) and its triglyceride component (OR: 0.321; 95% CI: 0.124, 0.836).Conclusion:The prevalence of undiagnosed thyroid dysfunction and autoimmunity was high. Thyroid peroxidase antibodies were negatively associated with metabolic syndrome and its triglyceride component, whereas the free triiodothyronine level was positively associated with metabolic syndrome.

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Assessment of the Thyroid Function During the Three Trimesters of Pregnancy Among the Egyptian Population

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.1734 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A849-A850

Author(s):

Mohamed Fahmy Amara

Keyword(s):

Thyroid Function ◽

Thyroid Dysfunction ◽

Thyroid Stimulating Hormone ◽

Human Thyroid ◽

Thyroid Peroxidase ◽

Sample Population ◽

Fetal Outcomes ◽

Cross Sectional ◽

Significant Difference ◽

In Pregnancy

Abstract Background: Pregnancy is associated with significant but reversible changes in the thyroid function that might cause maternal and fetal complications. Undetected and untreated thyroid disorders are associated with adverse maternal and fetal outcomes, thus screening is important. There are limited data on the prevalence of newly diagnosed thyroid disease during pregnancy from Egypt. Therefore, this study was designed to evaluate the prevalence of thyroid dysfunction during the three trimesters of pregnancy. Subjects and Methods: This was a cross-sectional study conducted at the antenatal clinic of El-Shatby Maternity Hospital at Alexandria University. The total sample population comprised of 90 pregnant women divided into 30 women for each trimester compared with 30 non- pregnant healthy women regarding thyroid function parameters and thyroid peroxidase antibody (anti - TPO) by using COBAS analyzer measured by the electrochemiluminescence immunoassay “WCLIA” employs monoclonal antibodies specifically directed against human thyroid-stimulating hormone (TSH), free thyroxine (FT4), FT3 and anti TPO. Results: 120 ladies were enrolled for this study aged between 20-45 years excluding subjects with previously diagnosed endocrinal anomalies. There were significant differences between pregnant and non-pregnant females regarding TSH and FT4, but no significant difference regarding FT3 and anti TPO in all trimesters. Conclusion: There is a discrepancy between FT4 & TSH in pregnancy due to the presence of other stimulatory and inhibitory factors in pregnancy, thyroid anomalies increased with the advance in pregnancy, thus screening of TSH and anti TPO is important. Considering the immense impact that maternal thyroid dysfunction has on maternal and fetal outcomes, prompt identification of thyroid dysfunction and its timely treatment is essential.

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