Title: Hypothyroidism and its Associations- An Observational Study in North India

Authors: Shadab Samad, Sunil Kumar Gupta, Maaz Ozair, Ashvanee Kumar, Waseem Ramzan Dar, Uday Joshi, Arun Kumar

 DOI: https://dx.doi.org/10.18535/jmscr/v8i2.50

Abstract

Hypothyroidism has broad clinical with high prevalence in Indian population. Hypothyroidism has been associated with many co morbid clinical conditions. Current Study conducted as retrospective study using data of newly diagnosed hypothyroid patients collected from outpatient department of Medicine. Study results showed that Female patients were in higher number than males. A total of 46% patients were overweight and 33.3% patients were obese. 58% patients presented with fatigue which was the commonest symptom among patients. Thyroid swelling was observed in 40% of participants. Menstrual abnormalities were reported by 80% female participants. Female participants had lower mean systolic blood pressure than male participants. Overall TSH level among all patients was 24.6 ±32.5mIU/L. Subclinical hypothyroidism was found in 16%patients. Female patients had higher mean TSH as compared to males. 10.6 % of patients were diagnosed to be suffering with Diabetes Mellitus. The current Study concludes that Hypothyroid patients should be evaluated for other co morbid associations  for better patient management and outcome.

References

  1. Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, Spencer CA, Braverman LE .Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab. 2002 Feb; 87(2):489-99.
  2. Hoogendoorn EH, Hermus AR, de Vegt F, Ross HA, Verbeek AL, Kiemeney LA, Swinkels DW, Sweep FC, denHeijer .Thyroid function and prevalence of anti-thyroperoxidase antibodies in a population with borderline sufficient iodine intake: influences of age and sex. Clin Chem. 2006 Jan; 52(1):104-11.
  3. http://www.ias.ac.in/currsci/oct252000/n%20kochupillai.PDF .
  4. Unnikrishnan AG, Kalra S, Sahay RK, Bantwal G, John M, Tewari N. Prevalence of hypothyroidism in adults: An epidemiological study in eight cities of India. Indian J Endocrinol Metab 2013; 17:647-52
  5. Dörr and H. Völzke. Cardiovascular morbidity and mortality in thyroid dysfunction. Minerva Endocrinol. 2005 Dec;30(4):199-216
  6. Chaker L, Bianco AC, Jonklaas J, Peeters RP. Hypothyroidism. Lancet. 2017;390 (10101):1550–1562.
  7. https://www.nhp.gov.in/disease/non-communicable-disease/obesity
  8. Usha Menon V, Sundaram KR, Unnikrishnan AG, Jayakumar RV, Nair V, Kumar H. High prevalence of undetected thyroid disorders in an iodine sufficient adult South Indian population. J Indian Med Assoc 2009;107:72-7
  9. Gaitonde DY, Rowley KD, Sweeney LB. Hypothyroidism: An update. S AfrFamPract 2012;54:384-90.
  10. Khandelwal D, Tandon N. Overt and subclinical hypothyroidism: Who to treat and how. Drugs 2012;72:17-33
  11. Xu, R., Huang, F., Zhang, S. et al. Thyroid function, body mass index, and metabolic risk markers in euthyroid adults: a cohort study. BMC EndocrDisord 19, 58 (2019).
  12. Meng Z, Liu M, Zhang Q, et al. Gender and Age Impacts on the Association Between Thyroid Function and Metabolic Syndrome in Chinese. Medicine (Baltimore). 2015;94(50):e2193
  13. Sethi B, Barua S, Raghavendra MS, Gotur J, Khandelwal D, Vyas U, et al. The thyroid registry: Clinical and hormonal characteristics of adult Indian patients with hypothyroidism. Indian J EndocrinolMetab. 2017;21:302–7.
  14. Delemer B, Aubert JP, Nys P, Landron F, Bouée S. An observational study of the initial management of hypothyroidism in France: The ORCHIDÉE study. Eur J Endocrinol 2012;167:817-23.
  15. Nair A, jayakumari c, Jabbar PK, Raizada Nishant, Gopi A. Prevalence and Associations of Hypothyroidism in Indian Patients with Type 2 Diabetes Mellitus. Journal of thyroid Research. Volume 2018, Article ID 5386129, 7 pages
  1. Papazafiropoulou, “Prevalence of thyroid dysfunction among greek Type 2 diabetic patients attending an outpatient clinic,” Journal of Clinical Medicine Research, vol. 2, no. 2, pp. 75–78, 2010.
  2. H. Akbar, M. M. Ahmed, and J. Al-Mughales, “Thyroid dysfunction and thyroid autoimmunity in Saudi type 2 diabetics,” Acta Diabetologica, vol. 43, no. 1, pp. 14–18, 2006.
  3. Comparison of TSH, T4 and T3 Levels in Primary Hypothyroidism in relation to Gender and age in a Tertiary Care Hospital Ann. Pak. Inst. Med. Sci. 2011; 7(4): 186-190.

Corresponding Author

Dr Sunil Kumar Gupta

Associate Professor, Department of Medicine, S Medical College and Hospital, Hapur, U.P., India 245304