Prevalence of Thyroid Disorders among Adult Women Attending Medical OPD Clinics at 300-bedded Pyin Oo Lwin General Hospital

2019 ◽  
Vol 31 (1) ◽  
pp. 37-43
Keyword(s):  
Thyroid Hormone ◽  
General Hospital ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Age Groups ◽  
Thyroid Disorders ◽  
Adult Women ◽  
Subclinical Hyperthyroidism ◽  
Hormone Levels ◽  
Thyroid Hormone Levels

Thyroid gland disorders are the most common endocrine conditions. A hospital-based, cross-sectional descriptive study was carried out to identify thyroid hormone levels, different types of thyroid dysfunction and to find out the prevalence of thyroid disorders in adult women. It was done at 300-bedded Pyin Oo Lwin General Hospital during September 2016 through February 2017. A total of 115 adult women in the age 18-85 years (mean of 47.37±15.7 year) who were attending medical clinics OutPatient Department of study hospital were enrolled. Serum thyroxine (T4), triiodothyronine (T3) and thyroid stimulating hormone (TSH) were determined by using Mini-vidas, fully automated Immunology analyzer at Pathology Research Division, Department of Medical Research (Pyin Oo Lwin Branch). Data entry and analysis were done by SPSS software 20.0 version. Among different age groups, highest number of subject lies between age group of 46-60 years. Thyroid function status was considered according to American Thyroid Association (ATA, 2000) and abnormalities in thyroid hormone levels were detected in 36/115 cases (31.7%) of participants. Hyperthyroidism was observed in 10 cases (8.7%) and hypothyroidism in 8 cases (7.0%). Subclinical hyperthyroidism was found in 12 cases (10.4%) and subclinical hypothyroidism was also seen in 6 cases (5.2%). High number of total subclinical hyperthyroidism was observed in 31-60 age groups. In age 18-30 years, no cases of hypothyroidism and subclinical hypothyroidism were observed, both hyperthyroidism and hypothyroidism were more prevalent in above 60 years and subclinical hypothyroidism was prevalent in 31-45 years. Serum free T3, T4 and TSH were significantly different in various groups of thyroid dysfunction (p<0.001). This study highlights that thyroid dysfunction remains a common health problem among adult women and is useful for screening programs and clinical management of consequences of thyroid disorders in this area.

Which quantitative method in determination of the thyroid hormone levels is more consistent with the clinical symptoms of the thyroid disorders?

2015 ◽  
Vol 25 (1) ◽  
pp. 101-106 ◽  
Author(s):  
Ali Akbar Shamsian ◽  
Kiarash Ghazvini ◽  
Mohammad Sokhtanloo ◽  
Masoud Saleh Moghaddam ◽  
Rosita Vakili
Keyword(s):  
Thyroid Hormone ◽  
Quantitative Method ◽  
Clinical Symptoms ◽  
Thyroid Disorders ◽  
Hormone Levels ◽  
Thyroid Hormone Levels

scholarly journals SAT-LB80 Elevated Pre-Op Thyrotropin Levels Are Associated With Increased 30-Day Mortality in Patients Undergoing Cardiac Surgery With Cardiopulmonary Bypass

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Shariq Rashid Masoodi ◽  
Rameesa Batul ◽  
Khurram Maqbool ◽  
Amir Zahoor ◽  
Mona Sood ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Thyroid Hormone ◽  
Thyroid Hormones ◽  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Hormone Levels ◽  
Icu Stay ◽  
Thyroid Hormone Levels ◽  
Serum Thyroid Hormones

Abstract BACKGROUND: The association between thyroid dysfunction and postoperative mortality is contentious. Thyroid function is frequently depressed during and after cardiopulmonary bypass surgical procedures, and this may adversely affect myocardial performance and postop outcome.OBJECTIVES: To study i) the changes and clinical significance of serum thyroid hormones during cardiopulmonary bypass (CPB), and ii) the association between biochemically assessed peri-op thyroid function and 30-day mortality after CBPSTUDY DESIGN: Prospective Cohort StudySUBJECTS: 279 patients undergoing various cardiac surgeries under cardiopulmonary bypass.METHODS: All consenting patients undergoing open heart surgery in last five years at a tertiary care centre in North-India were studied. The thyroid hormone levels (Total T3, T4 and TSH) were measured before admission, and postoperatively on Day 1 & 7, and 3 months following surgery. The patients’ gender, age, weight, body mass index, heart disease details, previous cardiac surgeries, and cardiac surgery-related data such as pump time, aortic clamping time, hypothermia duration, postoperative hemodynamic status and postoperative use of inotropic drugs were recorded and analysed. Patients were classified as having biochemically overt or subclinical hyperthyroidism or hypothyroidism, normal thyroid function, or non-classifiable state based on preoperative thyroid-stimulating hormone and total T4 values. Outcome data were collected from hospital records. Biochemical thyroid dysfunction was not systematically treated. Outcomes measured were length of ICU stay, postoperative complications and 30-day mortality.RESULTS: There was significant changes in thyroid function in patients undergoing cardiopulmonary bypass surgery (Fig 1). All patients showed a decrease in T3, T4 and TSH after surgery. Post-op complications were observed in 137 patients (49%) most common being atrial fibrillation (34%) followed by acute kidney injury (23%), infections (18%), dyselectrolytemia (7%), bleeding (1.4%) and ARDS (1.4%). Of 263 patients followed, eventually 26 patients expired with a mortality rate of 8.89% (95% CI, 0.4 - 19.4). Perioperatively, there was a significant correlation between 30-day with type of surgery (r, 0.26), aortic clamp time (r, 0.45), CBP time (r, 0.48), number of inotropes used (r, 0.57), hours of mechanical ventilation (r, 0.4), ICU stay (r, 0.13) and post-op complications (r, 0.24), as well as with the reduction in the thyroid hormone levels; 17 (7%), 3 (20%) and 6 (46%) patients of those with pre-op TSH level of &lt;6.5, &gt;6.5 and &gt;10.5 mIU/L expired (p &lt;0.001).CONCLUSION: Pre-op thyroid dysfunction is associated with increased mortality in patients undergoing cardiac surgery with CBP. Excess mortality with elevated serum TSH levels suggests the importance of timely detection and intervention in individuals with thyroid dysfunction undergoing cardiac surgery.Table of Contents oTable 1. Characteristics of patients who expired versus those who survived cardiac surgery with cardiopulmonary bypass (CPB) oFig 1. Changes in serum thyroid hormones during CPB surgery oTable 1. Characteristics of patients who expired versus those who survived cardiac surgery with cardiopulmonary bypass (CPB) oFigures in parenthesis indicate ±Standard Deviation, unless indicated otherwise oFig 1. Changes in serum thyroid hormones during CPB surgery

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

Circulation ◽  
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.

TO STUDY THE PREVALENCE OF THYROID DYSFUNCTION AND IT'S EFFECTS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS IN TERTIARY CARE HOSPITAL

2021 ◽  
pp. 25-27
Author(s):  
Fouzia Sultana Shaik ◽  
G. Vijaya Kumar
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
General Hospital ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Thyroid Disorders ◽  
High Incidence

Background: The relationship between normal thyroid function and type 2 diabetes has been a particular focus of concern. Type 2 Diabetes being the most common endocrine, metabolic disorder, there lies a curiosity to understand and learn the association of this disease with another common endocrine gland that is the thyroid gland. This study is aimed to describe the association of poorly controlled diabetes and thyroid dysfunction. OBJECTIVES: Ÿ To study the thyroid functions in patients with type 2 diabetes mellitus. Ÿ To study the spectrum of thyroid dysfunction in patients with type 2 diabetes mellitus. Materials And Methods: A hospital-based observational prospective study was conducted in the Santhiram Medical College and General Hospital for six months. Patients with type 2 diabetes mellitus of age more than 30 years, from OPD and IPD of all the departments in Santhiram General Hospital irrespective of glucose control and treatment, with informed written consent were studied. Thyroid prole tests, target organ evaluation for type 2 diabetes mellitus were performed for all patients in this study group. Thyroid USG was done. Results: 100 cases of type 2 diabetes mellitus without proven thyroid disease were included in the study . Thyroid disorders were diagnosed in 29 % cases . Hypothyroidism in 1 , hyperthyroidism in 13 and subclinical hypothyroidism in 15 cases. In this study 50 patients were male, 50 were females. Females ( 36%) had high incidence of thyroid disorder than males ( 22%). Subclinical hypothyroidism was more common (31.25%) in elderly age group. Elderly females had high incidence of subclinical hypothyroidism (18.2%). Clinical features of hyperthyroidism are seen in 8 patients. In the patients with hyperthyroidism( 55.5%) there was poor glycemic control . Duration of diabetes has no relation with incidence of thyroid disorders. Majority of patients with subclinical hypothyroidism had uncontrolled sugars with microvascular complications. Conclusion: Prevalence of thyroid disorders in diabetes mellitus is 29%. Incidence is higher in elderly population . Duration of diabetes mellitus has no impact on thyroid dysfunction. Severe diabetic complications are noted in patients with subclinical hypothyroidism. Subclinical hypothyroidism is seen commonly among females. Diabetes with hyperthyroidism has poor glycemic control

scholarly journals Thyroid testing paradigm switch from thyrotropin to thyroid hormones—Future directions and opportunities in clinical medicine and research

Endocrine ◽  
2021 ◽  
Vol 74 (2) ◽  
pp. 285-289
Author(s):  
Stephen P. Fitzgerald ◽  
Nigel G. Bean ◽  
James V. Hennessey ◽  
Henrik Falhammar
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Dysfunction ◽  
Clinical Medicine ◽  
Older Individuals ◽  
Free Triiodothyronine ◽  
Thyroid State ◽  
Peripheral Tissues ◽  
Hormone Levels ◽  
Thyroid Hormone Levels ◽  
Tsh Levels

Abstract Purpose Recently published papers have demonstrated that particularly in untreated individuals, clinical parameters more often associate with thyroid hormone, particularly free thyroxine (FT4), levels than with thyrotropin (TSH) levels. Clinical and research assessments of the thyroid state of peripheral tissues would therefore be more precise if they were based on FT4 levels rather than on TSH levels. In this paper we describe implications of, and opportunities provided by, this discovery. Conclusions The FT4 level may be the best single test of thyroid function. The addition of free triiodothyronine (FT3) and TSH levels would further enhance test sensitivity and distinguish primary from secondary thyroid dysfunction respectively. There are opportunities to reconsider testing algorithms. Additional potential thyroidology research subjects include the peripheral differences between circulating FT4 and FT3 action, and outcomes in patients on thyroid replacement therapy in terms of thyroid hormone levels. Previously performed negative studies of therapy for subclinical thyroid dysfunction could be repeated using thyroid hormone levels rather than TSH levels for subject selection and the monitoring of treatment. Studies of outcomes in older individuals with treatment of high normal FT4 levels, and pregnant women with borderline high or low FT4 levels would appear to be the most likely to show positive results. There are fresh indications to critically re-analyse the physiological rationale for the current preference for TSH levels in the assessment of the thyroid state of the peripheral tissues. There may be opportunities to apply these research principles to analogous parameters in other endocrine systems.

scholarly journals Characterization of Fetal Thyroid Levels at Delivery among Appalachian Infants

2020 ◽  
Vol 9 (9) ◽  
pp. 3056
Author(s):  
Madison N. Crank ◽  
Jesse N. Cottrell ◽  
Brenda L. Mitchell ◽  
Monica A. Valentovic
Keyword(s):  
Thyroid Hormone ◽  
Demographic Characteristics ◽  
Maternal Body Mass Index ◽  
Thyroid Disorders ◽  
Free T4 ◽  
Hormone Levels ◽  
Free T3 ◽  
Significant Difference ◽  
Fetal Thyroid ◽  
Thyroid Hormone Levels

Thyroid disorders are a frequently encountered issue during pregnancy and a cause of maternal and fetal morbidity. In regions like Appalachia that are particularly susceptible to health disparities, descriptive studies are needed to assist in identifying pathologic derangements. We sought to characterize fetal thyroid hormone levels at delivery and investigate whether or not maternal demographic characteristics affect the prevalence of neonatal thyroid disease. A cross-sectional analysis was conducted on 130 pregnant women recruited from the Tri-State region, incorporating areas of Kentucky, Ohio, and West Virginia. Total triiodothyronine (T3) (p = 0.4799), free T3 (p = 0.6323), T3 uptake (p = 0.0926), total thyroxine (T4) (p = 0.8316), free T4 (p = 0.0566), and Thyroid stimulating hormone (TSH) (p = 0.8745) levels were comparable between urban and rural newborns. We found no effect of hypertension status or nicotine levels on fetal umbilical cord thyroid hormone levels. Maternal diabetic status was associated with lower T4 (p = 0.0099) and free T4 (p = 0.0025) levels. Cotinine affected levels of T4 (p = 0.0339). In regard to maternal Body Mass Index (BMI), there was an increase in total T3 as BMI increased (p = 0.0367) and no significant difference in free T3, T3 uptake, T4, free T4, or TSH. There was a negative correlation between TSH and 1 min Apgar scores (p = 0.0058). Lead and cadmium have been implicated to alter TSH levels, but no correlation was found in our study (r2 = 0.0277). There were no differences in cord blood between urban (37.3 ± 10.3 fmol/ug DNA) and rural (70.5 ± 26.8 fmol/ug DNA) benzo(a)pyrene DNA adducts (p = 0.174). Thyroid disorders present a unique opportunity for the prevention of perinatal morbidity and mortality, since maternal treatment, as well as maternal demographic characteristics, can have direct fetal effects.

scholarly journals Maternal hypothyroxinaemia in pregnancy is associated with obesity and adverse maternal metabolic parameters

2016 ◽  
Vol 174 (1) ◽  
pp. 51-57 ◽  
Author(s):  
Bridget A Knight ◽  
Beverley M Shields ◽  
Andrew T Hattersley ◽  
Bijay Vaidya
Keyword(s):  
Thyroid Hormone ◽  
Plasma Glucose ◽  
Subclinical Hypothyroidism ◽  
Hdl Cholesterol ◽  
Metabolic Parameters ◽  
Metabolic Phenotype ◽  
Hormone Levels ◽  
Cholesterol Ratio ◽  
Thyroid Hormone Levels ◽  
In Pregnancy

ObjectiveSubclinical hypothyroidism and isolated hypothyroxinaemia in pregnancy have been associated with an increased risk of gestational diabetes. We aimed to ascertain if these women have a worse metabolic phenotype than euthyroid pregnant women.Design, subjects and methodsWe recruited 956 healthy Caucasian women with singleton, non-diabetic pregnancies from routine antenatal clinics. Detailed anthropometric measurements (including BMI and skinfold thickness) and fasting blood samples (for TSH, free thyroxine (FT4), free triiodothyronine (FT3), HbA1c, lipid profile, plasma glucose and insulin resistance (HOMA-IR) analysis) were obtained at 28 weeks gestation.ResultsIn comparison to euthyroid women (n=741), women with isolated hypothyroxinaemia (n=82) had significantly increased BMI (29.5 vs 27.5 kg/m2, P<0.001), sum of skinfolds (57.5 vs 51.3 mm, P=0.002), fasting plasma glucose (4.5 vs 4.3 mmol/l, P=0.01), triglycerides (2.3 vs 2.0 mmol/l, P<0.001) and HOMA-IR (2.0 vs 1.3, P=0.001). Metabolic parameters in women with subclinical hypothyroidism (n=133) were similar to those in euthyroid women. Maternal FT4 was negatively associated with BMI (r=−0.22), HbA1c (r=−0.14), triglycerides (r=−0.17), HOMA-IR (r=−0.15) but not total/HDL cholesterol ratio (r=−0.03). Maternal FT3:FT4 ratio was positively associated with BMI (r=0.4), HbA1c (r=0.21), triglycerides (r=0.2), HOMA–IR (r=0.33) and total/HDL cholesterol ratio (r=0.07). TSH was not associated with the metabolic parameters assessed.ConclusionsIsolated hypothyroxinaemia, but not subclinical hypothyroidism, is associated with adverse metabolic phenotype in pregnancy, as is decreasing maternal FT4 and increasing FT3:FT4 ratio. These associations may be a reflection of changes in the thyroid hormone levels secondary to increase in BMI rather than changes in thyroid hormone levels affecting body weight and related metabolic parameters.

scholarly journals Small for Gestational Age is a Risk Factor for Thyroid Dysfunction in Preterm Newborns

2020 ◽  
Author(s):  
Chunhua Liu ◽  
Kaiyan Wang ◽  
Jizhong Guo ◽  
Jiru Chen ◽  
Mei Chen ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Thyroid Dysfunction ◽  
Z Score ◽  
Normal Range ◽  
Free Triiodothyronine ◽  
Hormone Levels ◽  
Thyroid Hormone Levels ◽  
Altered Thyroid

Abstract Background Thyroid hormones play an important role in the normal growth and maturation of the central nervous system. However, few publications addressed the altered thyroid hormone levels in preterm small for gestational age (SGA) newborns. We hypothesized preterm SGA infants have higher thyroid-stimulating hormone (TSH) concentrations than appropriate for gestational age (AGA) ones within the normal range and an increased incidence of thyroid dysfunction. Methods The study was designed to compare thyroid hormone levels within the normal range and the incidence of thyroid dysfunction in the SGA and AGA groups to test the hypothesis. Blood samples were collected between 72 and 96 hours of life and analyzed with TSH, free thyroxine (FT4) and free triiodothyronine (FT3) assays. Thyroid function test (TFT) results, and neonatal demographic and clinical factors were analyzed to identify the associations between SGA birth and altered thyroid concentrations and thyroid dysfunction. Results TSH and FT4 concentrations were significantly higher in the SGA group than the AGA group ((4.89(interquartile range (IQR): 2.62~7.59) vs. 3.15(IQR: 1.86~5.42) mU/L, p=0.015), and (18.64±4.39 vs. 17.40±3.70 pmol/L, p=0.037), respectively). The higher TSH levels were associated with being SGA or Z-score of birth weight (BW) for GA after adjusting for potential confounders (( β SGA =1.28 (95% confidence interval (CI) 0.45~2.12), p=0.003) or ( β Z-score =-0.25 (95%CI -0.48~-0.03), p=0.028), respectively). However, we did not find a significant association between SGA birth and altered FT4 concentrations. Furthermore, compared with the AGA group, the SGA group presented an increased incidence of transient hypothyroxinemia with delayed TSH elevation (dTSHe) (odds ratio (OR) =8.75(95%CI 0.71~78.02)), a higher percentage receiving levothyroxine (L-T4) therapy (OR=1.80 (95%CI 0.98~3.21)), and a higher rate of follow-up within the first 6 months of life (OR=1.82 (95%CI 0.93~3.39)). Conclusions Preterm SGA newborns had significantly higher TSH concentrations within the normal range and an increased incidence of thyroid dysfunction. The SGA newborns with these features should be closely followed up with periodical TFTs and endocrinologic evaluation.

scholarly journals Correlation of Cognitive Performance and Thyroid Hormone Levels in Adolescents with Subclinical Hypothyroidism

2014 ◽  
Vol 04 (02) ◽  
pp. 169-175 ◽  
Author(s):  
A. R. Somashekar ◽  
Vishnu Girish ◽  
Chandrika Rao ◽  
Nandigudi Srinivas Murthy
Keyword(s):  
Thyroid Hormone ◽  
Cognitive Performance ◽  
Subclinical Hypothyroidism ◽  
Hormone Levels ◽  
Thyroid Hormone Levels
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