Паёми Сино (Dec 2024)
EPIDEMIOLOGICAL CHARACTERISTICS OF SUBCLINICAL HYPOTHYROIDISM
Abstract
Objective: To study the prevalence of subclinical hypothyroidism (SH) in the middle-aged and elderly population of Dushanbe. Methods: The results of clinical, instrumental examination of the thyroid gland (TG), and its hormonal function assessment were analyzed in 5,857 people who visited endocrinologists for consultation or treatment in 2018-2022. Among the examined patients, there were 3765 women (64.3%) and 2092 men (35.7%). Their age ranged from 35 to 65 years, averaging 40.2±1.2 years. In addition to clinical examination and thyroid palpation, all respondents underwent ultrasound examination of the TG, blood tests for thyroid stimulating hormone (TSH), free thyroxine (free T4) and triiodothyronine (free T3), and antibodies to thyroid peroxidase (AB to TPO). Results: TSH levels were elevated in 1,743 (29.8%) respondents and decreased in 373 (6.3%), among which 278 were women (7.4%) and 95 men (4.5%). Normal range of TSH was found in 3,741 (63.9%) of those examined. SH was detected in 1,279 cases (21.84%), and manifest hypothyroidism (MH) was found in 464 of examined patients (7.92%); the latter being 2.6 times more common in females (n=334; 71.9%) than in males (n=130; 28.1%) (p0.05). Among the cohort with SH, thyroid ultrasound examination revealed increased echogenicity of the TG in 26.2%, decreased echogenicity in 48.0%, and normal echogenicity in 25.8% of cases. Among all examined patients, diffuse Grade I and II enlargement of the TG was found in 2,577 (43.99%), nodular goiter – in 1528 (26.1%), and mixed goiter – in 1956 (33.4%) observations. In the group of respondents with SH, women had diffuse enlargement of the TG 2.5 times more often (25.3% versus 10.2%; p0.05). The level of AB to TPO was higher in women than in men (p<0.05), while there were no statistically significant differences in the level of TSH and thyroid hormones in the blood serum between males and females. A direct correlation was found between the TSH and the AB to TPO levels in the examined cohort (r=0.26325; p<0.05). Conclusion: The prevalence of SH in Dushanbe, based on the data from the examined cohort, was 21.8%; most commonly the disease started in young age, mainly in active females of working age. Ultrasound examination revealed significant changes in the structure of the TG in 70.1% of all examined patients, and in 89.9% of patients with SH. It is of interest to continue investigation of SH prevalence in the population of highland areas, as well as the causes and risk factors associated with the development of SH.
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