Nature and Science of Sleep (Sep 2020)

Prevalence of Hypothyroidism in a Large Sample of Patients with Obesity Hypoventilation Syndrome

  • BaHammam AS,
  • Aleissi S,
  • Olaish AH,
  • Almeneessier AS,
  • Jammah AA

Journal volume & issue
Vol. Volume 12
pp. 649 – 659

Abstract

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Ahmed S BaHammam,1,2 Salih Aleissi,1 Awad H Olaish,1 Aljohara S Almeneessier,1,3 Anwar A Jammah4 1University Sleep Disorders Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 2Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, Riyadh, Saudi Arabia; 3Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 4Endocrinology Unit, Thyroid Diseases Section, Department of Medicine, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Ahmed S BaHammamUniversity Sleep Disorders Center, College of Medicine, King Saud University, Box 225503, Riyadh 11324, Saudi ArabiaTel +966-11-467-9495Fax +966-11-467-9179Emails [email protected] S AlmeneessierFamily and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi ArabiaTel +966-11-467-9495Fax +966-11-467-9179Email [email protected]: Data on hypothyroidism in patients with obesity hypoventilation syndrome (OHS) are scarce. This study assessed the prevalence of hypothyroidism among a large group of patients with OHS.Patients and Methods: This was a prospective observational study of 308 consecutive patients with OHS seen between January 2002 and December 2018. Serum thyroid-stimulating hormone (TSH) and free-thyroxine (FT4) levels were measured in all patients. The OHS patients were compared with 445 patients with obstructive sleep apnoea (OSA) matched for age, sex, and body mass index (BMI).Results: The OHS patients had a mean age of 55.1 ± 13.8 years and a BMI of 43.9 ± 14.8 kg/m2; apnoea hypopnea index was ≥ 30 events/hr in 222 (72%). Clinical hypothyroidism was diagnosed in 58 (18.8%) of the OHS patients; only two cases (0.6%) were diagnosed in the sleep disorders clinic (newly diagnosed cases). Subclinical hypothyroidism was diagnosed in 19 (6.2%) of the OHS patients based on elevated TSH and normal FT4 levels; all cases were newly diagnosed. A logistic regression model identified female sex as the only predictor of clinical hypothyroidism in OHS patients (odds ratio: 2.801 [1.386– 5.662], p = 0.004). There was no significant difference in clinical hypothyroidism prevalence between the OHS and OSA patients; however, subclinical hypothyroidism was more common in OHS than in OSA patients (6.2% vs 2.9%, respectively, p = 0.03).Conclusion: Clinical hypothyroidism was prevalent among patients with OHS; however, newly diagnosed cases of clinical hypothyroidism were relatively low. Female sex was the only predictor of clinical hypothyroidism.Keywords: menopause, obstructive sleep apnoea, subclinical hypothyroidism, TSH, thyroxine

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