Title: Prevalence of Undetected Hypothyroidism and Associated Risk Factors among Adults in a Tertiary Care Hospital in Central Kerala
Authors: Dr Saranraj J., Dr Vibha C Santosh
Introduction: WHO in 2004 has classified India as having optimal iodine nutrition. Despite this India has large burden of thyroid disease, Hypothyroidism is the commonest endocrine disease Autoimmune thyroiditis is an emerging cause for increasing prevalence of hypothyroidism in the population. This study was done to find out the current trend in the prevalence of undetected hypothyroidism in central Kerala, study the risk factors associated with prevalence of hypothyroidism and to determine the Anti TPO antibody titres among those found to have undetected hypothyroidism.
Methods: This was adescriptive (cross sectional) study: Total of 935 subjects including patients, relatives, students, staff and other volunteers of the age group 20-70 years, ina Govt. Medical College, meeting the inclusion criteria (resident of Ernakulam for 5 years) excluding pregnant and post-partum women, history of thyroid surgery/disease/radiation exposure, severe illness, intake of drugs affecting thyroid, and malignancies, were tested for TSH values. In 44 subjects of 157 with raised TSH, Anti TPO antibody titres were assessed.
Results: Total of935 adults were screened, between the ages of 18-70 years. Out of 935 subjects, 157 had raised TSH (16.7%). Only 44 of them could be followed up for further antibody (Anti TPO)testing. Of the 44 (out of 157) hypothyroid study subjects who were tested, 42(95.5%)had raised antibody titres suggestive of autoimmune thyroiditis which is highly significant.
Interpretation and Conclusion: The prevalence of hypothyroidism was found to be higher than studies done in similar population, previously. The study showed an increased prevalence of undetected hypothyroidism in midlife(41-50 yrs. of age) with higher prevalence in females (19.2%).Most of the subjects who were tested for Anti TPO antibodies were found to be having raised Anti TPO antibody titre suggestive of autoimmune thyroiditis .It has been reported as one of the leading causes for hypothyroidism.
There is a large and increasing number of undetected hypothyroidism in the population, affecting the wellbeing, work efficiency and productivity of the community, despite iodine sufficiency. Hypothyroidism being an easily tested and treated condition, larger population based screening studies need to be undertaken.