ABSTRACT
Objective To investigate the relationship between abnormal bone mineral density (BMD) and subclinical thyroid dysfunction. Methods Thyroid function, biochemical indicators of bone metabolism and BMD were reviewed retrospectively in the subjects who received health checkups from July 1, 2009 to January 31, 2017 in the Health Check-up Department of Peking Union Medical College Hospital. People who had thyroid dysfunction, recognized risk factors for osteoporosis, and medication history were excluded. A cross-sectional analysis of thyroid status and biochemical indicators of bone metabolism was performed by the standard methods. BMD at the lumbar spine and femoral neck was measured using dual energy X-ray absorptiometry. Results A total of 6884 subjects (3726 women and 3158 men) were enrolled in the study, with an average age of (50.74 ± 10.41) years. They were divided into three groups:subclinical hyperthyroid, subclinical hypothyroid, and euthyroidism. The alkaline phosphatase in subclinical hyperthyroid group was higher than that in the euthyroidism group[ (67.95±20.64)U/L vs. (63.88±18.99)U/L]. Calcium and phosphorus in blood were higher in both subclinical hyperthyroid and subclinical hypothyroid groups. The rate of abnormal BMD in male euthyroidism, subclinical hyperthyroid and subclinical hypothyroid groups were 36.10％(1049/2906), 29.27％(12/41) and 27.01％(57/211), respectively. The rate of abnormal BMD showed no difference between subclinical hyperthyroid group and euthyroidism group (P>0.05). The rate of abnormal BMD was lower in subclinical hypothyroid group than in euthyroidism group (χ2=7.0901, P0.05). Conclusion There is no significant difference in the rate of abnormal BMD between subclinical thyroid dysfunction group and euthyroidism group, possibly because abnormal serum biochemical indicators preceded the presence of low BMD. More sensitive methods used to determine the status of bone metabolism await to be developed.
ABSTRACT
Objective@#This study aims to determine the prevalence of subclinical thyroid dysfunction among cardiac patients at the Philippine General Hospital, and its association with mortality. @*Methodology@#163 adult cardiac patients were screened for subclinical thyroid dysfunction, [subclinical hyperthyroidism (SCT), subclinical hypothyroidism (SCHO), non-thyroidal illness syndrome (NTIS)]. Demographic and clinical characteristics were analyzed using ANOVA and Fisher’s exact test. Outcome considered were hospital duration, need for mechanical ventilation, inotropic support and mortality. Crude association between subclinical thyroid dysfunction and outcomes was evaluated using relative risk. @*Results@#Prevalence of subclinical thyroid dysfunction was 32.5% (5.5% SCT, 5.5% SCHO, and 21.5% NTIS). The risk of necessitating mechanical ventilation was about twofold higher in subclinical thyroid dysfunction compared to euthyroid patients (RR=2.64), and was highest in SCHO (RR=3.71). The risk of inotropic support was about twofold higher (RR=2.70) in SCHO compared to euthyroid patients. Overall death rate was higher in subclinical thyroid dysfunction (RR=1.86), and highest in SCHO (RR=2.47) compared to euthyroid patients. @*Conclusion@#There is a significant prevalence of subclinical thyroid dysfunction among hospitalized patients with cardiac disease at 32.5%. Cardiovascular risk factors are not statistically significant. We observed a trend of increased risk of requiring mechanical ventilation, inotropes and overall mortality in SCHO.
Subject(s)
PrevalenceABSTRACT
The elderly are a peculiar group in terms of health management, as they often present with non-specific complaints which are challenging to interpret and may not present with the usual clinical picture of a disease. Objective. The study aims to determine the prevalence of thyroid dysfunction among asymptomatic, elderly Filipinos seen at the Philippine General Hospital (PGH). Methodology. Subjects aged 60 years and older seeking out-patient medical consult for non-thyroidal illness at the PGH were recruited. Patients with known thyroid or pituitary disease, previous thyroid or pituitary surgery, intake of medications known to affect thyroid hormone levels and critical illness were excluded. Fasting blood sugar (FBS), lipid profile, free thyroxine (FT4), thyroid-stimulating hormone (TSH), and anti-thyroperoxidase (anti-TPO) levels were taken. Based on FT4 and TSH levels, subjects were classified as overt hypothyroid, subclinical hypothyroid, euthyroid, subclinical hyperthyroid, or overt hyperthyroid. Results. One hundred eighty subjects were recruited, of whom 152 (84%) were female. Hypertension was the most common comorbidity (58.33%), followed by diabetes (36.67%). One hundred sixty-two (90%) were euthyroid, 12 (6.7%) subclinical hypothyroid, 4 (2.22%) subclinical hyperthyroid, and two (1.11%) overtly hyperthyroid. No one was overtly hypothyroid. There was a trend toward increasing prevalence of diabetes, hypertension, low HDL, obesity and overall cardiovascular risk among those with subclinical hypothyroidism. Conclusion. Subclinical hypothyroidism was the most prevalent thyroid dysfunction among asymptomatic elderly included in the study.
Subject(s)
Humans , Male , Female , Aged , Cardiovascular Diseases , Diabetes Mellitus , Hospitals, General , Hypertension , Hyperthyroidism , Hypothyroidism , Iodide Peroxidase , Iron-Binding Proteins , Obesity , Outpatients , Pituitary Diseases , Thyrotropin , ThyroxineABSTRACT
BACKGROUND: Thyroid hormones play an important role in regulating lipid and glucose metabolism. Thus this study was conducted to investigate the relationship between the thyroid hormone (FT4) or thyroid stimulating hormone (TSH) and the cardiovascular risk factors and metabolic syndrome in the individuals with subclinical thyroid dysfunction. METHODS: The female health examinee with normal range of FT4 were classified into three groups according to the level of TSH; euthyroid group (n=4,410), subclinical hypothyroidism group (n=438) and subclinical hyperthyroidism group (n=66). Age, blood pressure, BMI, fasting glucose, total cholesterol, HDL cholesterol, LDL cholesterol, triglyceride, lipoprotein(a), and high-sensitivity C-reactive protein (hsCRP) levels of serum specimens were compared among the groups and association of FT4 or TSH with these parameters. RESULTS: Fasting glucose was significantly higher in subclinical hyperthyroidism than in euthyroid and subclinical hypothyroidism groups (P=0.031), and total cholesterol was higher in subclinical hypothyroidism than in subclinical hyperthyroidism (P=0.011). But the other factors showed no difference among the groups. The level of TSH increased as triglyceride increased, while FT4 decreased as BMI or triglyceride increased. The FT4 also lowered when fasting glucose was above 126 mg/dL. TSH was not related with the metabolic syndrome, but the possibility of the syndrome was 1.3 times higher in the lowest quartile of the normal range of FT4 than in its highest quartile. CONCLUSIONS: For the interpretation of FT4, its reference interval needs to be divided into 4 quartiles, which can be used as one of the predicting factors of the metabolic syndrome.