Thyroid disorders in women of Puducherry.
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Journal: 2012/October - Indian Journal of Clinical Biochemistry
ISSN: 0970-1915
Abstract:
Thyroid stimulating hormone (TSH), Free Thyroxine (FT(4)) and Free Triiodothyronine (FT(3)) were assayed in 505 women of this region. 60 women had previous history of thyroid disease. The remaining 445 women formed the "Disease free group". A "Reference group" was obtained by excluding women with previous and present history of thyroid dysfunction. Of the total 505 women examined 15.8% had thyroid dysfunction and 84.2% were euthyroid. 11.5% were hypothyroid (9.5% sub-clinical) and 1.8% hyperthyroid (1.2% clinical). The geometric mean TSH for the total population was 2.65 μIU/ml. It was significantly (p=0.025) lower in the reference population 2.17 μIU/ml. There was no significant difference in the FT(3) and FT(4) values between groups. 19% of women over 60 years had elevated TSH above 4.5 μIU/ml. The 2.5 and 97.5 percentiles of the reference population was 1.1-5.2 μIU/ml. 6.1% of women in the reference group had TSH levels above the reference intervals. Hypothyroidism particularly sub-clinical hypothyroidism is predominantly present amongst women in this iodine sufficient region. Evaluation of thyroid status could help in early detection and treatment.
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Indian J Clin Biochem 24(1): 52-59
PMID: 23105807

Thyroid disorders in women of Puducherry

Abstract

Thyroid stimulating hormone (TSH), Free Thyroxine (FT4) and Free Triiodothyronine (FT3) were assayed in 505 women of this region. 60 women had previous history of thyroid disease. The remaining 445 women formed the “Disease free group”. A “Reference group” was obtained by excluding women with previous and present history of thyroid dysfunction. Of the total 505 women examined 15.8% had thyroid dysfunction and 84.2% were euthyroid. 11.5% were hypothyroid (9.5% sub-clinical) and 1.8% hyperthyroid (1.2% clinical). The geometric mean TSH for the total population was 2.65 μIU/ml. It was significantly (p=0.025) lower in the reference population 2.17 μIU/ml. There was no significant difference in the FT3 and FT4 values between groups. 19% of women over 60 years had elevated TSH above 4.5 μIU/ml. The 2.5 and 97.5 percentiles of the reference population was 1.1–5.2 μIU/ml. 6.1% of women in the reference group had TSH levels above the reference intervals. Hypothyroidism particularly sub-clinical hypothyroidism is predominantly present amongst women in this iodine sufficient region. Evaluation of thyroid status could help in early detection and treatment.

Key Words: Thyroid function, Hypothyroidism, Sub-clinical hypothyroidism

Abstract

Thyroid stimulating hormone (TSH), Free Thyroxine (FT4) and Free Triiodothyronine (FT3) were assayed in 505 women of this region. 60 women had previous history of thyroid disease. The remaining 445 women formed the “Disease free group”. A “Reference group” was obtained by excluding women with previous and present history of thyroid dysfunction. Of the total 505 women examined 15.8% had thyroid dysfunction and 84.2% were euthyroid. 11.5% were hypothyroid (9.5% sub-clinical) and 1.8% hyperthyroid (1.2% clinical). The geometric mean TSH for the total population was 2.65 μIU/ml. It was significantly (p=0.025) lower in the reference population 2.17 μIU/ml. There was no significant difference in the FT3 and FT4 values between groups. 19% of women over 60 years had elevated TSH above 4.5 μIU/ml. The 2.5 and 97.5 percentiles of the reference population was 1.1–5.2 μIU/ml. 6.1% of women in the reference group had TSH levels above the reference intervals. Hypothyroidism particularly sub-clinical hypothyroidism is predominantly present amongst women in this iodine sufficient region. Evaluation of thyroid status could help in early detection and treatment.

Key Words: Thyroid function, Hypothyroidism, Sub-clinical hypothyroidism

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
1. Kochupillai N. Clinical Endocrinology in India. Curr Sci. 2000;79:1061–1067.[Google Scholar]
2. Delang F. The Disorders induced by iodine deficiency. Thyroid. 1994;4:107–128. doi: 10.1089/thy.1994.4.107. [PubMed] [CrossRef] [Google Scholar]
3. Laurberg P., Pedersen K.M., Hreidarsson A., Sigfusson N., Iversen E., Knudsen P.R. Iodine intake and the pattern of thyroid disorders: a comparative epidemiological study of thyroid abnormalities in the elderly in Iceland and in Jutland, Denmark. J Clin Endocrinol Metab. 1998;83:765–769. doi: 10.1210/jc.83.3.765. [PubMed] [CrossRef] [Google Scholar]
4. Vanderpump M.P., Turnbridge W.M. Epidemiology and prevention of clinical and subclinical hypothyroidism. Thyroid. 2002;12:839–847. doi: 10.1089/105072502761016458. [PubMed] [CrossRef] [Google Scholar]
5. Tunbridge W.M., Vanderpump M.P.J. Population Screening for autoimmune thyroid disease. Endocrinol Metab Clin North Am. 2000;29:239–253. doi: 10.1016/S0889-8529(05)70129-8. [PubMed] [CrossRef] [Google Scholar]
6. Kapil U., Ramachandran S., Tandon M. Assessment of Iodine deficiency in Pondicherry. Ind Pediatrics. 1998;35:357–359. [PubMed] [Google Scholar]
7. Hak A.E., Pols H.A.P., Visser T.J., Drexhage H.A., Hoffman A., Witteman J.C.M. Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: The Rotterdam Study. Ann Intern Med. 2000;132:270–278. [PubMed] [Google Scholar]
8. Morris M.S., Bostom A.G., Jacques P.F., Selhub J., Rosenberg I.H. Hyperhomocysteinemia and hypercholesterolemia associated with hypothyroidism in the third U.S. National Health and Nutrition Examination Survey. Atherosclerosis. 2001;155:195–200. doi: 10.1016/S0021-9150(00)00537-2. [PubMed] [CrossRef] [Google Scholar]
9. Hoogendoorn E.H., Hermus A.R., Vegt F., Ross A.H., Verbeek A.L.M., Kiemeney L.A.L.M., et al. Thyroid function and prevalence of Antithyroperoxidase Antibodies in a population with Borderline Sufficient Iodine Intake: Influences of Age and Sex. Clin Chem. 2006;52:104–111. doi: 10.1373/clinchem.2005.055194. [PubMed] [CrossRef] [Google Scholar]
10. Hollowel J.G., Staehling N.W., Flanders D.W., Hannon W.H., Gunter E.W., Spencer C.A., et al. Serum TSH, T4 and Thyroid Antibodies in the United States Population (1988–1994): National Health and Nutrition Examination Survey (NHANES III) J Clin Endocrinol Metab. 2002;87:489–499. doi: 10.1210/jc.87.2.489. [PubMed] [CrossRef] [Google Scholar]
11. Kapil U., Singh P., Pathak P. Status of Iodine Nutriture and Salt Iodization in Union Territory of Pondicherry, India. Pak J Nutr. 2002;1(5):234–235. doi: 10.3923/pjn.2002.234.235. [CrossRef] [Google Scholar]
12. Kapil U., Jayakumar P.R., Singh P., Aneja P., Pathak P. Assessment of iodine deficiency in Kottyam district, Kerala state: a pilot study. Asia Pacific J Clin Nutr. 2002;11:33–35. doi: 10.1046/j.1440-6047.2002.00241.x. [PubMed] [CrossRef] [Google Scholar]
13. Kapil U., Ramachandran S., Tandon M. Assessment of iodine deficiency in Andaman district of Union Territory of Andaman and Nicobar. Ind J Maternal and Child Health. 1998;9:19–20.[Google Scholar]
14. Kapil U., Nayar D., Ramachandran S. Assessment of iodine deficiency in Tiswadi block,Goa. The Ind Practitioner. 1996;9:749–750.[Google Scholar]
15. Canaris G.J., Manowitz N.R., Mayor G., Ridgway E.C. The Colorado Thyroid Disease Prevalence Study. Arch Intern Med. 2000;160:526–534. doi: 10.1001/archinte.160.4.526. [PubMed] [CrossRef] [Google Scholar]
16. Sawin C.T., Castelli W.P., Hershman J.M., Mc Namara P., Bacharach P. The aging thyroid. Thyroid deficiency in the Framingham Study. Arch Intern Med. 1985;145:1386–1388. doi: 10.1001/archinte.145.8.1386. [PubMed] [CrossRef] [Google Scholar]
17. Tunbridge W.M., Evered D.C., Hall R., Appelton D., Brewis M., Clark F., et al. The spectrum of thyroid Disease in a community: the Whickham survey. Clin Endocrinol (Oxf) 1977;7:481–493. doi: 10.1111/j.1365-2265.1977.tb01340.x. [PubMed] [CrossRef] [Google Scholar]
18. Bjoro T., Holmen J., Kruger Q., Midthjell K., Hunstad K., Schreiner T., et al. Prevalence of thyroid disease, thyroid dysfunction and thyroid peroxidase antibodies in a large unselected population. The Health Study of Nord-Trondelag (HUNT) Euro J Endocrinol. 2000;143:639–647. doi: 10.1530/eje.0.1430639. [PubMed] [CrossRef] [Google Scholar]
19. Knudsen N., Jorgensen T., Rasmussen S., Christiansen E., Perrild H. The prevalence of thyroid dysfunction in a population with borderline iodine deficiency. Clin Endocrinol. 1999;51:361–367. doi: 10.1046/j.1365-2265.1999.00816.x. [PubMed] [CrossRef] [Google Scholar]
20. Baloch Z., Carayon P., Conte - Devolx B., Demers L.M., Feldt-Rasmussen U., Henry J.F., et al. Laboratory medicine practice guidelines. Laboratory support for the diagnosis and monitoring of thyroid disease. Thyroid. 2003;13:123–126. [PubMed] [Google Scholar]
21. Wartofsky L., Dickey R.A. The evidence for a narrow thyrotropin reference range is compelling. J Clin Endocrinol Metabol. 2005;90:5483–5488. doi: 10.1210/jc.2005-0455. [PubMed] [CrossRef] [Google Scholar]
Department of Biochemistry, Pondicherry Institute of Medical Sciences, Puducherry, 605014 India
Rebecca Abraham, Email: moc.liamtoh@cmc_ar.
Corresponding author.
Copyright © Association of Clinical Biochemists of India 2009
Full Text

References

  • 1. Kochupillai NClinical Endocrinology in India. Curr Sci. 2000;79:1061–1067.[PubMed][Google Scholar]
  • 2. Delang FThe Disorders induced by iodine deficiency. Thyroid. 1994;4:107–128. doi: 10.1089/thy.1994.4.107.] [[PubMed][Google Scholar]
  • 3. Laurberg P., Pedersen K.M., Hreidarsson A., Sigfusson N., Iversen E., Knudsen P.RIodine intake and the pattern of thyroid disorders: a comparative epidemiological study of thyroid abnormalities in the elderly in Iceland and in Jutland, Denmark. J Clin Endocrinol Metab. 1998;83:765–769. doi: 10.1210/jc.83.3.765.] [[PubMed][Google Scholar]
  • 4. Vanderpump M.P., Turnbridge W.MEpidemiology and prevention of clinical and subclinical hypothyroidism. Thyroid. 2002;12:839–847. doi: 10.1089/105072502761016458.] [[PubMed][Google Scholar]
  • 5. Tunbridge W.M., Vanderpump M.P.JPopulation Screening for autoimmune thyroid disease. Endocrinol Metab Clin North Am. 2000;29:239–253. doi: 10.1016/S0889-8529(05)70129-8.] [[PubMed][Google Scholar]
  • 6. Kapil U., Ramachandran S., Tandon MAssessment of Iodine deficiency in Pondicherry. Ind Pediatrics. 1998;35:357–359.[PubMed][Google Scholar]
  • 7. Hak A.E., Pols H.A.P., Visser T.J., Drexhage H.A., Hoffman A., Witteman J.C.MSubclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: The Rotterdam Study. Ann Intern Med. 2000;132:270–278.[PubMed][Google Scholar]
  • 8. Morris M.S., Bostom A.G., Jacques P.F., Selhub J., Rosenberg I.H. Hyperhomocysteinemia and hypercholesterolemia associated with hypothyroidism in the third U.S. National Health and Nutrition Examination Survey. Atherosclerosis. 2001;155:195–200. doi: 10.1016/S0021-9150(00)00537-2.] [[PubMed]
  • 9. Hoogendoorn E.H., Hermus A.R., Vegt F., Ross A.H., Verbeek A.L.M., Kiemeney L.A.L.M., et al Thyroid function and prevalence of Antithyroperoxidase Antibodies in a population with Borderline Sufficient Iodine Intake: Influences of Age and Sex. Clin Chem. 2006;52:104–111. doi: 10.1373/clinchem.2005.055194.] [[PubMed][Google Scholar]
  • 10. Hollowel J.G., Staehling N.W., Flanders D.W., Hannon W.H., Gunter E.W., Spencer C.A., et al Serum TSH, T4 and Thyroid Antibodies in the United States Population (1988–1994): National Health and Nutrition Examination Survey (NHANES III) J Clin Endocrinol Metab. 2002;87:489–499. doi: 10.1210/jc.87.2.489.] [[PubMed][Google Scholar]
  • 11. Kapil U., Singh P., Pathak PStatus of Iodine Nutriture and Salt Iodization in Union Territory of Pondicherry, India. Pak J Nutr. 2002;1(5):234–235. doi: 10.3923/pjn.2002.234.235.[PubMed][Google Scholar]
  • 12. Kapil U., Jayakumar P.R., Singh P., Aneja P., Pathak PAssessment of iodine deficiency in Kottyam district, Kerala state: a pilot study. Asia Pacific J Clin Nutr. 2002;11:33–35. doi: 10.1046/j.1440-6047.2002.00241.x.] [[PubMed][Google Scholar]
  • 13. Kapil U., Ramachandran S., Tandon MAssessment of iodine deficiency in Andaman district of Union Territory of Andaman and Nicobar. Ind J Maternal and Child Health. 1998;9:19–20.[PubMed][Google Scholar]
  • 14. Kapil U., Nayar D., Ramachandran SAssessment of iodine deficiency in Tiswadi block,Goa. The Ind Practitioner. 1996;9:749–750.[PubMed][Google Scholar]
  • 15. Canaris G.J., Manowitz N.R., Mayor G., Ridgway E.CThe Colorado Thyroid Disease Prevalence Study. Arch Intern Med. 2000;160:526–534. doi: 10.1001/archinte.160.4.526.] [[PubMed][Google Scholar]
  • 16. Sawin C.T., Castelli W.P., Hershman J.M., Mc Namara P., Bacharach P. The aging thyroid. Thyroid deficiency in the Framingham Study. Arch Intern Med. 1985;145:1386–1388. doi: 10.1001/archinte.145.8.1386.] [[PubMed]
  • 17. Tunbridge W.M., Evered D.C., Hall R., Appelton D., Brewis M., Clark F., et al The spectrum of thyroid Disease in a community: the Whickham survey. Clin Endocrinol (Oxf) 1977;7:481–493. doi: 10.1111/j.1365-2265.1977.tb01340.x.] [[PubMed][Google Scholar]
  • 18. Bjoro T., Holmen J., Kruger Q., Midthjell K., Hunstad K., Schreiner T., et al. Prevalence of thyroid disease, thyroid dysfunction and thyroid peroxidase antibodies in a large unselected population. The Health Study of Nord-Trondelag (HUNT) Euro J Endocrinol. 2000;143:639–647. doi: 10.1530/eje.0.1430639.] [[PubMed]
  • 19. Knudsen N., Jorgensen T., Rasmussen S., Christiansen E., Perrild HThe prevalence of thyroid dysfunction in a population with borderline iodine deficiency. Clin Endocrinol. 1999;51:361–367. doi: 10.1046/j.1365-2265.1999.00816.x.] [[PubMed][Google Scholar]
  • 20. Baloch Z., Carayon P., Conte - Devolx B., Demers L.M., Feldt-Rasmussen U., Henry J.F., et al. Laboratory medicine practice guidelines. Laboratory support for the diagnosis and monitoring of thyroid disease. Thyroid. 2003;13:123–126.[PubMed]
  • 21. Wartofsky L., Dickey R.AThe evidence for a narrow thyrotropin reference range is compelling. J Clin Endocrinol Metabol. 2005;90:5483–5488. doi: 10.1210/jc.2005-0455.] [[PubMed][Google Scholar]
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