Prevalence of Clinical and Subclinical Thyroid Disease in a Peritoneal Dialysis Population

AimsWe investigated dialysis duration, dose of erythropoietin (EPO), and clinical manifestations in peritoneal dialysis (PD) patients with subclinical hypothyroidism.MethodsThis cross-sectional study, performed in 3 centers, assessed 122 adult patients on PD for more than 6 months with regard to demographic data, dialysis duration, thyroid function, biochemical data, EPO dose, and clinical manifestations. Thyroid dysfunction was determined by serum thyroid-stimulating hormone, free thyroxine, total thyroxine, total triiodothyronine, antithyroid peroxidase antibodies, and auto-antibodies against thyroglobulin.ResultsOf the 122 study patients, 98 (80.3%) were assessed as having euthyroidism; 19 (15.6%), subclinical hypothyroidism; and 5 (4.1%), subclinical hyperthyroidism. The proportion of women (74.2% vs. 57.1%, p = 0.038), the mean duration of PD (58.1 months vs. 37.9 months, p = 0.032), and the weighted mean monthly EPO dose (1.22 μg/kg vs. 1.64 μg/kg, p = 0.009) were significantly higher in the subclinical hypothyroidism group than in the euthyroidism group, but the prevalences of coronary artery disease and cerebrovascular disease were not. From the multivariate model, PD duration was more significant than sex as a risk factor for subclinical hypothyroidism ( p = 0.0132).ConclusionsSubclinical hypothyroidism is frequent in PD patients, especially female patients and patients with a longer PD duration. Compared with euthyroid patients, patients with subclinical hyperthyroidism need a higher dose of EPO to maintain a stable hemoglobin level.

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ASSOCIATION OF SUBCLINICAL HYPOTHYROIDISM WITH METABOLIC SYNDROME: A CROSS-SECTIONAL STUDY

10.36106/ijsr/8624190 ◽

2020 ◽

pp. 1-4

Author(s):

Rajesh Kumar Jha ◽

Sanjay Nath Jha ◽

Vinayanand Jha ◽

Krishna Kumar Jha ◽

Debarshi Jana

Keyword(s):

Metabolic Syndrome ◽

Subclinical Hypothyroidism ◽

Demographic Data ◽

Low Density Lipoprotein ◽

Strong Association ◽

Density Lipoprotein ◽

Cross Sectional Study ◽

Thyroid Stimulating Hormone ◽

Sectional Study ◽

Cross Sectional

Objective: Metabolic syndrome (MetS) and subclinical hypothyroidism (SCH) both are known to have adverse cardiovascular outcomes. Available studies have shown variable results on the association of SCH with MetS as well as individual components of MetS. We aimed to study the association of SCH with MetS and its individual components of MetS. Material and Methods: This cross-sectional study was carried out in individuals volunteered for health checkup at Department of Medicine, Darbhanga Medical College and Hospital, Laheriasarai, Bihar. About 60 cases with MetS and 120 controls without having MetS were recruited. Demographic data such as history of diabetes mellitus, hypertension, dyslipidemia, blood pressure (BP), waist circumference and serum T3, serum T4, thyroid stimulating hormone, fasting blood sugar, fasting lipid profile, and hemoglobin A1c were collected and statistically analyzed. Statistical analysis was done by using SPSS sav software packages. Chi-square test was used for the comparison of qualitative data. Results: SCH was present in 52 (28.9%) among 180 study participants. SCH was present in 35 (58.33%) participants having MetS and in 17 (14.16%) of controls. There was a strong association between SCH and MetS (p<0.001). Significant association of SCH with diastolic BP (p=0.017) and with central obesity (p=0.004) was observed but not with high-density lipoprotein, triglyceride, hyperglycemia, systolic BP, total cholesterol, and low-density lipoprotein. Conclusion: We observed a strong association of SCH with MetS. We also observed significant association of SCH with diastolic BP and with obesity. The finding of this study indicates the need to screen individuals with MetS for SCH.

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Effect of the Cut-Off Level for Thyroid-Stimulating Hormone on the Prevalence of Subclinical Hypothyroidism among Infertile Mexican Women

Diagnostics ◽

10.3390/diagnostics11030417 ◽

2021 ◽

Vol 11 (3) ◽

pp. 417

Author(s):

Lidia Arce-Sánchez ◽

Salvatore Giovanni Vitale ◽

Claudia Montserrat Flores-Robles ◽

Myrna Souraye Godines-Enriquez ◽

Marco Noventa ◽

...

Keyword(s):

Insulin Resistance ◽

Subclinical Hypothyroidism ◽

Thyroid Autoimmunity ◽

Cross Sectional Study ◽

Thyroid Stimulating Hormone ◽

Mexican Women ◽

Cross Sectional ◽

Group 3 ◽

Group 2 ◽

Group 1

The primary aim of this study was to compare the prevalence of subclinical hypothyroidism (SCH) using two different cut-off levels for TSH values (≥2.5 mIU/L versus ≥4.1 mIU/L). The secondary objective was to analyze the clinical-biochemical characteristics in women with and without SCH. This was a retrospective cross-sectional study. In total, 1496 Mexican women with infertility were included: Group 1, women with TSH levels ranging between 0.3 and 2.49 mIU/L, n = 886; Group 2, women with TSH between 2.5 and 4.09 mIU/L, n = 390; and Group 3, women with TSH ≥4.1 mIU/L n = 220. SCH prevalence was 40.7% (CI 95%: 38.3–43.3%) with TSH cut-off ≥ 2.5 mIU/L, and 14.7% (CI 95%: 12.7–16.5%) with TSH cut-off ≥ 4.1 mIU/L, (p = 0.0001). The prevalence of overweight was higher in Group 2 than in Groups 1 and 3. Thyroid autoimmunity, obesity and insulin resistance were higher in Group 3 than in Group 1 (p < 0.05). No other differences were observed between groups. Conclusions: The prevalence of SCH in our selected patients increased almost three times using a TSH cut-off ≥ 2.5 mIU/L compared with a TSH cut-off ≥ 4.1 mIU/L. Women with TSH ≥4.1 mIU/L compared with TSH cut-off ≤ 2.5 mIU/L more often presented with obesity, thyroid autoimmunity and insulin resistance.

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Association of serum irisin concentration with thyroid autoantibody positivity and subclinical hypothyroidism

Journal of International Medical Research ◽

10.1177/03000605211018422 ◽

2021 ◽

Vol 49 (5) ◽

pp. 030006052110184

Author(s):

Zhengyi Chen ◽

Qiao Zhang ◽

Nianchun Peng ◽

Ying Hu ◽

Hong Li ◽

...

Keyword(s):

Subclinical Hypothyroidism ◽

Density Lipoprotein ◽

Cross Sectional Study ◽

Thyroid Stimulating Hormone ◽

Control Group ◽

Thyroid Peroxidase ◽

Serum Samples ◽

Cross Sectional ◽

Thyroid Autoantibody ◽

Glucose Levels

Objective This study evaluated the association of serum irisin level with thyroid autoantibody (TAA) positivity and subclinical hypothyroidism (SH). Methods In this cross-sectional study, 334 participants were assigned to one of the following four age- and sex-matched groups: TAA plus SH (84 patients), isolated TAA (83 patients), isolated SH (83 patients), or healthy controls (84 individuals). Irisin and creatine kinase (CK) were measured in serum samples. Results Patients with TAA plus SH, isolated TAA, and isolated SH had higher irisin levels compared with the controls. There was a significant increase in the irisin level in the TAA plus SH group compared with the control group. Among all participants, the irisin levels were positively associated with thyroglobulin and thyroid peroxidase antibody titers and high-density lipoprotein cholesterol levels, but negatively associated with waist circumference, glycated hemoglobin levels, and fasting plasma glucose levels. The irisin level was not associated with the thyroid-stimulating hormone, free thyroxine, or CK levels. Irisin levels were independently associated with TAA, with or without SH, but they were not associated with SH alone. Conclusions Irisin level may help to predict the risk of developing TAA with or without SH.

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A Retrospective Study on Snakebite Victims in a Tertiary Referral Center

Iranian Jornal of Toxicology ◽

10.32598/ijt.10.4.332.1 ◽

2016 ◽

Vol 10 (3) ◽

pp. 47-50

Author(s):

Nasim Zamani ◽

◽

Leila Modir-Fallah Rad ◽

Kambiz Soltaninejad ◽

Shahin Shadnia ◽

...

Keyword(s):

Hospital Admission ◽

Demographic Data ◽

Clinical Manifestations ◽

Public Health Problem ◽

Cross Sectional Study ◽

Tertiary Referral ◽

Tertiary Referral Hospital ◽

Laboratory Findings ◽

Cross Sectional ◽

Tertiary Referral Center

Background: Snakebite is a serious public health problem in the world. The annual incidence of snakebites ranges from 4.5-9.1 in 100,000 population in Iran. With regard to diversity of envenomation profiles in different geographical parts of Iran, the aim of this study was to determine the demographical data, clinical and laboratory findings, and the outcome of the snakebite victims referred to a tertiary referral hospital. Methods: In this retrospective, cross-sectional study in Loghman Hakim Hospital Poisoning Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran, during a four-year period from March 2007 to March 2011. The demographic data, clinical manifestations, paraclinical findings, treatments performed before hospital admission, time elapsed between the bite and hospital admission, total dose of antivenom and the patients’ outcomes were investigated. Results: Seventy cases (58 males, 12 females) were evaluated. Most of the cases (79%) were older than 20 year old. The most common bite site was upper extremity (67%). Most of the patients were admitted within 5 h after the snakebite. The most common local and systemic manifestations were swelling (90%), pain (81.4%), nausea and vomiting (24.3%). Leukocytosis (35.7%) and thrombocytopenia (25.7%) were the most common laboratory abnormalities. Most of the patients (97.1%) were treated with antivenom. Fifty percent of the patients only received 3-5 vials of antivenom. The mortality rate was 1.4%. Necrosis of the toes and compartment syndrome were the only serious complications. Conclusion: The findings emphasize the importance of early admission to the hospital and treatment with antivenom to avoid morbidity and mortality.

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Subclinical Hypothyroidism Prevalence in Pregnant Ladies in AL-Hilla city in Iraq

Journal of University of Babylon for Pure and Applied Sciences ◽

10.29196/jubpas.v26i8.1682 ◽

2018 ◽

Vol 26 (8) ◽

pp. 157-163

Author(s):

Ban Amer Mousa ◽

Sijal Fadhil Farhood Al Joborae

Keyword(s):

Subclinical Hypothyroidism ◽

First Trimester ◽

Cross Sectional Study ◽

Thyroid Stimulating Hormone ◽

Adverse Outcomes ◽

Screening Tests ◽

Overt Hypothyroidism ◽

Free T4 ◽

Cross Sectional ◽

Normal Value

Recent guidelines adapted unique pregnancy thyroid function screening tests because pregnancy subclinical hypothyroidism is associated with different adverse outcomes. There are no data from Iraq about the prevalence of thyroid hypofunction in the 1st trimester of pregnancy. This study aims to find the prevalence of thyroid dysfunction in the 1st trimester. Patients and Methods: In this descriptive cross-sectional study, thyroid stimulating hormone (TSH) was measured in 100 pregnant women from May 2017-December 2017 in Babylon teaching hospital for maternity and pediatric and in private clinic. If TSH was more than 2.5 mIU/L in the first trimester, free T4 was measured to diagnose then differentiate between subclinical & overt hypothyroidism. If free T4 was in the normal value (0.7-1.8 ng/dl) the diagnosis was subclinical hypothyroidism and if below the normal value, overt hypothyroidism was diagnosed.

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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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Subclinical hypothyroidism in pediatric nephrotic syndrome: the correlations with albumin, globulin, and proteinuria

Paediatrica Indonesiana ◽

10.14238/pi60.2.2020.90-4 ◽

2020 ◽

Vol 60 (2) ◽

pp. 90-4

Author(s):

Erni Nuraeni ◽

Faiisal Faisal ◽

Ahmedz Widiasta ◽

Novina Novina

Keyword(s):

Nephrotic Syndrome ◽

Serum Albumin ◽

Subclinical Hypothyroidism ◽

Serum Albumin Level ◽

Cross Sectional Study ◽

Albumin Level ◽

Thyroid Stimulating Hormone ◽

Hormone Deficiency ◽

Cross Sectional ◽

Univariate Logistic Regression Analysis

Background Nephrotic syndrome causes loss of medium-sized plasma proteins and binding proteins, resulting in thyroid hormone deficiency. Objective To assess for potential correlations between subclinical hypothyroidism in pediatric nephrotic syndrome with albumin, globulin, and proteinuria. Methods This cross-sectional study was conducted in the Department of Pediatrics, Hasan Sadikin General Hospital, Bandung, West Java. All types of nephrotic syndrome patients aged 1 month to < 18 years were included. Blood and urine specimens were collected from the patients for albumin, globulin, thyroid function (T3, fT4 and TSH), and proteinuria tests and analyzed with standard techniques. Results There were 26 subjects, 20 males and 6 females. Ten subjects developed subclinical hypothyroidism, with mean albumin and thyroid-stimulating hormone (TSH) levels of 0.92 g/dL and 6.9 mIU/L, respectively. There was a negative correlation between albumin level and subclinical hypothyroidism (rpb=-0.702; P<0.001) and a positive correlation between proteinuria and subclinical hypothyroidism (r=0.573; P=0.003). Univariate logistic regression analysis revealed that globulin had no impact on the presence of subclinical hypothyroidism, but albumin and proteinuria did have such an impact. The odds ratios of albumin and proteinuria with subclinical hypothyroidism were 27.00 (95%CI 1.69 to 17.7) and 19.80 (95%CI 1.94 to 201.63), respectively. Conclusion Subclinical hypothyroidism correlates with serum albumin level and proteinuria in nephrotic syndrome patients. Tha low serum albumin level has a high likelihood of subclinical hypothyroidism.

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No association between subclinical hypothyroidism and dyslipidemia in children and adolescents

BMC Pediatrics ◽

10.1186/s12887-020-02318-z ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Ashkan Habib ◽

Asadollah Habib

Keyword(s):

Lipid Profile ◽

Subclinical Hypothyroidism ◽

Meta Analysis ◽

Cross Sectional Study ◽

Thyroid Stimulating Hormone ◽

Pediatric Endocrinology ◽

Free T4 ◽

Cross Sectional ◽

Significant Difference ◽

Tsh Levels

Abstract Background There are controversies about the correlation between higher levels of thyroid stimulating hormone (TSH) and dyslipidemia in children. This study was designed to assess the relation between lipid profile components and TSH levels in children. Method This cross-sectional study was performed in a pediatric endocrinology growth assessment clinic in Shiraz, southern Iran. Children aged 2–18 years who referred to the clinic from January until April 2018 were included. TSH levels equal or above 5 mIU/L and lower than 10 mIU/L with normal free T4 (FT4) were considered as having subclinical hypothyroidism (SH). Results Six hundred sixty-six children were euthyroid while 181 had SH. No significant difference was found between the mean serum total cholesterol (P = 0.713), LDL-C (P = 0.369), HDL-C (P = 0.211), non-HDL-C (P = 0.929), and triglyceride (P = 0.215) levels between euthyroid children and subjects with SH. There was also no significant difference in the prevalence of dyslipidemias in any lipid profile components between the two groups. The adjusted correlation was not significant between TSH levels and any lipid profile component. Conclusion Based on the results of our study, we found no correlation between SH and dyslipidemia in children. The association between dyslipidemia and SH in children still seems to be inconsistent based on the results of this and previous studies. We recommend a meta-analysis or a significantly larger retrospective study on this subject.

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Subclinical hypothyroidism in pediatric nephrotic syndrome: the correlations with albumin, globulin, and proteinuria

Paediatrica Indonesiana ◽

10.14238/pi60.2.2020.91-5 ◽

2020 ◽

Vol 60 (2) ◽

pp. 91-5

Author(s):

Erni Nuraeni ◽

Faiisal Faisal ◽

Ahmedz Widiasta ◽

Novina Novina

Keyword(s):

Nephrotic Syndrome ◽

Serum Albumin ◽

Subclinical Hypothyroidism ◽

Serum Albumin Level ◽

Cross Sectional Study ◽

Albumin Level ◽

Thyroid Stimulating Hormone ◽

Hormone Deficiency ◽

Cross Sectional ◽

Univariate Logistic Regression Analysis

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Prevalence and Clinical Significance of Subclinical Hypothyroidism in Diabetic Peripheral Neuropathy

10.53350/pjmhs211594000 ◽

2021 ◽

Vol 15 (9) ◽

pp. 4000-4004

Author(s):

Rahmat Ali ◽

Muhammad Sohrab Khan ◽

Shakeel Ahmad ◽

Syed Imad Hussain ◽

Tahir Mukhtar Sayed

Keyword(s):

Peripheral Neuropathy ◽

Diabetic Neuropathy ◽

Subclinical Hypothyroidism ◽

Diabetic Peripheral Neuropathy ◽

Clinical Manifestations ◽

Clinical History ◽

Cross Sectional Study ◽

P Value ◽

Cross Sectional ◽

Level Of Significance

Background and Objective: The diabetic Mellitus common and spiking complication is Diabetic peripheral neuropathy (DPN). It is frequently associated with thyroid dysfunction. The subclinical hypothyroidism prevalence and clinical outcomes have been investigated by various studies. The present study aims to determine the prevalence of subclinical hypothyroidism in diabetic peripheral neuropathy patients. Methods: This cross-sectional study was carried out on 164 diabetic neuropathy patients attending the medicine department of Qazi Hussain Ahmad Medical Complex, Nowshera KPK during the study period from 2020 to 2021. Patients’ demographic details, clinical history, and neurological examination were recorded. Normal free thyroxin value was set as a referential standard for subclinical hypothyroidism diagnosis among all the patients. Diabetic neuropathy patients’ clinical manifestations were recorded as per neurological screening instrument. The clinical scoring system was utilized for DPN severity categorization into mild (6-8), moderate (9-11), and severe (>12). SPSS version 20 and a logistic regression model were used for data analysis. Results: This study enrolled 164 diabetic peripheral neuropathy patients. Of the total 164, 69 (42.1%) were male and 95 (57.9%) were female. The overall mean age was 49.61±13.72 years. The prevalence of subclinical hypothyroidism was 32 [19.5%; 95% CI; 14.3%-23.7%]. The diabetic peripheral neuropathy patients with subclinical hypothyroidism had a higher prevalence of severity 86 [52.4%; 95%CI] compared to DNP patients without SCH 46 [28.04%; 95% CI] with a 3% level of significance. A higher HbA1c and HOMA-IR was found in patients with their respective values were (8.3±1.1 against 7.2±1.3) where p-value <0.001 and (3.5 ± 0.9 vs. 2.6 ± 0.8, p<0.001) respectively. Conclusion: The diabetic peripheral neuropathy patients are susceptible to have frequent subclinical hypothyroidism independently associated with severity and complications of DPN. Thyroid function should be tested in DM patients and given to DM patients with SCH. Keywords: Diabetes mellitus; Subclinical hypothyroidism; Diabetic peripheral neuropathy

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