Prevalence of hypothyroid dysfunction among third trimester pregnant women and its effect on maternal and fetal outcome

Background: Thyroid disorders are the predominant endocrinological afflictions of pregnancy that if were to affect the mother and her child, would lead to various complications.Methods: A randomized study among 450 third trimester admitted cases for any indication were subjected to thyroid functions by TSH, Free T4 and TPO Ab. Total 61 mothers (54 hypothyroidism and 7 sub clinical hyperthyroidism) had thyroid dysfunction. These 54 hypothyroid mothers were further evaluated during the remaining course of gestation for feto-maternal outcomes.Results: Out of 450 third trimester ANC cases 61(13.5%) had deranged thyroid functions in third trimester. Out of 61patients, 18 (29.50%) patients had TPO Ab positive. Prevalence of subclinical hypothyroidism, overt hypothyroidism, and subclinical hyperthyroidism was 9.6%, 2.45%, and 1.5%, respectively. Anemia was found in 9.3% of SCH and 27.3% cases in OH cases. Preeclampsia was found in 16.2% cases of SCH and 18.2% cases in OH cases. Gestational diabetes mellitus was noticed among 16.27% cases of SCH and 18.18% cases of OH. Previous abortions were present among 65.1% cases of SCH and 45.45% cases of OH. Placental abruption and cardiac failure were observed in 4.65% and 2.34% of SCH only. Cesarean delivery occurred in 18.6% of SCH and 36.36% of overt hypothyroidism.Conclusions: This study concludes a high prevalence of thyroid disorders as subclinical hypothyroidism (9.6%), overt hypothyroidism (2.5%) and subclinical hyperthyroidism (1.5%) in third trimester pregnancy.

A cross sectional study on the frequency of thyroid disorders in pregnancy and the asssociated obstetric complications

Background: Thyroid disorders have a yet unclear impact on obstetric complications. The studies have been varied and mostly contradictory. The aim of the study was to examine the pattern of thyroid disorders and its obstetric complications.Methods: This cross-sectional study enrolled 334 pregnant women of less than 12 weeks of gestation. After routine clinical and ultrasound evaluation of all cases, all baseline investigations and TSH was done. In all cases with low TSH free T3 and free T4 was done. All patients were followed up till delivery and the obstetric events were recorded. The data collected were analysed using chi-square test.Results: Of the 334 enrolled the data on pregnancy related events were available for 276 patients. Subclinical hypothyroidism was detected in 10.1% of the population while 3.6% were having overt (clinical) hypothyroidism. Anaemia was more in subclinical hypothyroidism (39.3%) and overt hypothyroidism (40%). Pre-eclampsia was seen 17.85% with subclinical hypothyroidism and 30% with overt hypothyroidism. Eclampsia was seen in 3.7% of subclinical hypothyroidism and 10% of clinical hypothyroidism. Gestational diabetes mellitus (GDM) was more in patients with subclinical hypothyroidism (25%) and overt hypothyroidism (20%). Oligohydramnios and IUGR were higher in the subclinical hypothyroidism (21.42%, 10.7%) and overt hypothyroidism (20%, 10%). There was no difference between the euthyroid, subclinical hypothyroidism and overt hypothyroidism groups with respect to any of the other variables.Conclusions: There was a high frequency of thyroid disorders among pregnant women in our study and this had adverse obstetric consequences.

Thyroid dysfunction in human immuno-deficiency virus infected patients: a non-randomized, cross-sectional, single-center study

Background: Increasing prevalence of thyroid dysfunction has been reported in human immuno-deficiency virus (HIV)-infected patients. However, there is insufficient evidence to recommend routine thyroid screening of asymptomatic individuals. Hence, this study was undertaken in an attempt to resolve these issues. Objectives of this non-randomized, cross-sectional, single-center study was to study thyroid function in HIV positive patients at various stages of disease. Methods: This single-center study was carried out at Al-Ameen Medical College Hospital and Government District Hospital Bijapur, Karnataka, India from December 2020 to December 2022. The final selected study population included newly diagnosed adult and adolescent (17-60 years) HIV+ patients was composed of 100 participants of either gender. Patients were interviewed and enrolled in the study after examining in detail according to the proforma and then by taking their written consent and explaining the purpose of the study. The thyroid hormone assays (S. TSH, FT3 and FT4) were done by chemiluminescence immuno assay (CLIA) using ADVIA Centaur-equipment. Results: Overall mean age was 36 years (range in years: 17–66 years) and 66 patients (66%) were males. Male: female ratio of 1.94:1 was recorded. In the 50 patients having acquired immuno-deficiency virus (AIDS), FT3 levels ranged from 0.230 to 4.0 picogram/ml with a mean of 2.131+0.9826 picogram/ml. In 50 patients having AIDS, the FT4 levels ranged from 0.30 to 1.90 nanogram/dI with a mean 1.179±0.4484 nanogram/dl. Conclusions: All forms of thyroid dysfunction were observed.

Serum FT4 / FT3 Ratio, a Predictive Biochemical Marker for Subclinical Hypothyroidism in Patients with Chronic Kidney Disease.

Subclinical hypothyroidism (ScHt) is an early stage of hypothyroidism which can progress to overt hypothyroidism and lead to adverse metabolic abnormalities. Surge in frequency of hypothyroidism is seen in chronic kidney disease (CKD) cases, including those receiving dialysis. Many studies reported the relation amid thyroid function with metabolic syndrome, though the link among the Free T3: Free T4 and ScHt is not clearly determined. We wanted to investigate the Free T3:Free T4 ratio in predicting ScHt in CKD. MethodsIn this study, 53 known CKD subjects who have not undergone haemodialysis and 60 normal healthy subjects were included. In both study groups, creatinine and estimated glomerulus filtration rate (eGFR) are determined to evaluate the kidney function. Thyroid function parameters namely serum FT3, FT4 and TSH were measured to determine the FT3 / FT4 ratio. ResultsTSH levels were significantly increased in patients with CKD not undergoing dialysis as compared to patients in the control group (P<0.034). Low Free T3 level (P<0.001) and FT3 / FT4 ratio is highly significant (P< 0.001) in study subjects as compared to controls. Area Under the Curve (AUC) of ROC for the continuous variables of serum FT4 / FT3 ratio was 0.914 with CI: 0.832 to 0.997. ConclusionsIndividually FT3, FT4 have very little sensitivity in the diagnosis of sub clinical hypothyroidism in chronic kidney disease. FT4/FT3 ratio determination is a very useful step in diagnosing ScHt with chronic kidney disease.

To Evaluate Subclinical Hypothyroidism in Type 2 Diabetes Mellitus

Introduction: Diabetes is the most common endocrinal disorder seen in clinical practice. The prevalence of diabetes in westis between 6 and 7.6%. Type 2 diabetes mellitus is the predominant form of diabetes accounts for 90% of cases globally.Aims and Objectives: This study aims to know the prevalence of subclinical hypothyroidism in Type 2 diabetes mellitus duringthe study period of 1 year 6 months patients attending Government General Hospital/Government Medical College, Suryapet.Materials and Methods: This study was done on patients attending Government General Hospital/Government Medical College,Suryapet. The total duration of study was 1 year 6 months. Patients attending Government General Hospital who were eitherpreviously or newly diagnosed Type 2 diabetes mellitus were included in the study.Results: Fifty known or newly detected cases of Type 2 diabetes mellitus more than 30 years were selected randomly from thepatients attending to the Diabetic Clinic Government General Hospital during the study period September 2018 to February 2020.Conclusion: Subclinical hypothyroidism has been associated with a greater prevalence of cardiovascular disease and isrelatively common in patients with Type 2 DM. Hence, it effects would be exaggerated in patient with Type 2 DM.

Prevalence of Subclinical Hypothyroidism in Non-Pregnant Females of Childbearing Age Coming to North Bengal Medical College Out Patient Department.

Hypothyroidism is widespread in sub-Himalayan region and is particularly prevalent in females of reproductive age group. Since the signs and symptoms of subclinical hypothyroidism are often overlooked by the patients themselves, the diagnosis gets often delayed. In this study, we tried to estimate the prevalence of subclinical hypothyroidism in reproductive age group female population coming to the outpatient department of a government hospital in North Bengal.METHODSAll the non-pregnant women attending the blood collection center of the Department of Biochemistry, North Bengal Medical College and Hospital, were enrolled in the study after institutional ethics approval. Women of age ranging from 10 years to 65 years were included in the study to compare the possible difference of prevalence existing between different age groups. The women with known thyroid disease and other autoimmune disorders were excluded from the study. Fasting blood samples of study participants were analysed for thyroid hormone profile. In addition, all study participants were tested for Hb%, FBS, LFT, KFT, and lipid profile. Microsoft Excel and SPSS version 22 was used for data analysis.RESULTSSubclinical hypothyroidism prevalence was found to be 13.4% in reproductive age group women. The prevalence is not different from the general population as such. The prevalence of overt hypothyroidism was also similar in overall population and reproductive age group females. The prevalence of subclinical hypothyroidism was found to be higher in females of age group 10-19 years (16.7%) and 60-65 years (16.2%) than that seen in reproductive age group females.CONCLUSIONSThe prevalence of subclinical hypothyroidism is quiet high in female population and the result in this study goes parallel to the findings of other studies. In this study, subclinical hypothyroidism is found to be more prevalent in both higher and lower age group females compared to the females of reproductive age group

​A Study on “Correlation of Thyroid Profile with the Components of Metabolic Syndrome”

Introduction: As there is an exponential rise in the prevalence of metabolic syndrome (MetS) in pandemic proportions as wellas a steady increase in incidence of subclinical hypothyroidism (SCH),Material and Methods: A cross-sectional study of association between these two entities is been carried. Authors studiedthyroid function tests in 100 cases of MetS and 50 controls.Results: The results were analyzed and we found that the prevalence of SCH in MetS was found to be 21% when compared toonly 6% in the control population. This association with SCH is more frequent among women. The thyroid dysfunction in MetSis statistically significantly associated with the serum triglycerides, followed closely by the waist circumference. This associationis not found with the other components of MetS.Conclusion: Due to the alarming rise, in CV mortality and morbidity, the people at risk have to be identified at the earliest andtheir risk factors modified. Hence, diagnosing MetS should become a routine practice among the medical fraternity.

Preliminary Evaluation of Clinical Efficacy ofShenqi Unguent on Sub-clinical Hypothyroidism Patients with Qi-deficiency Constitution / 中国中医药信息杂志

Objective To observe the clinical efficacy ofShenqi Unguent on sub-clinical hypothyroidism patients with qi-deficiency constitution.Methods A total of 60 patients were randomly divided into treatment group and control group. The treatment group took the traditional Chinese medicine ofShenqi Unguent, while the control group took euthyrox orally for 6 months. Changes of carotid intima-media thickness (CIMT), thyroid function (FT3, FT4, TSH, TG-Ab, TPO-Ab), and TCM syndrome integral before and after treatment of the two groups were observed. Results After treatment, the TCM syndrome integrals of the treatment group were significantly improved, compared with the control group (P<0.01). Similarly, CIMT of the treatment group were obviously increased, compared with the control group (P<0.05). Meanwhile, levels of serum TG-Ab and TPO-Ab were distinctly reduced than that of the control group (P<0.01).ConclusionShenqi Unguent has marked clinical efficacy on sub-clinical hypothyroidism patients with qi-deficiency constitution.