Prevalence of subclinical hypothyroidism in adults visiting primary health-care setting in Riyadh

Abstract

Background and objectives: Subclinical hypothyroidism is an asymptomatic condition with normal thyroxin and raised thyroid stimulating hormone (TSH) level. The objective of the study was to determine the prevalence of subclinical hypothyroidism in primary health care (PHC) settings in Riyadh and explore the relationship of TSH level with age, gender, family history, body mass index, and co-morbid conditions. Subjects and methods: A cross-sectional study of adult visitors to nine satellites PHC clinics in military housing in Riyadh was carried out. TSH concentration and free T4 levels were measured. Data were collected by nurses and physicians during routine clinical practice in primary care. Descriptive analysis was performed on all variables in study, and relationships were explored using chi-square, t-test, analysis of variance, and linear regression. Results: A total of 340 out of 394 participants in the study gave blood samples. Subclinical hyperthyroidism was identified in 2.1% (p = .001) and subclinical hypothyroidism in 10.3% (p = .001) of the PHC visitors. TSH levels were found to be significantly higher (p = .047) in elderly population of ≥60 years and those with family history of thyroid disease. Non-significant upward trends were noted in TSH levels with hyperlipidemia and increasing blood pressure. No overt hyperthyroidism or hypothyroidism was found in our study sample. Conclusion: Subclinical hypothyroidism has a prevalence of 10% of adults visiting PHC’s. TSH levels are higher in the elderly, which warrants screening of those aged 60 years and above.

Association between subclinical hypothyroidism and metabolic disorders: A retrospective chart review study in an emerging university hospital

“…A considerable number of persons with subclinical hypothyroidism eventually develop overt hypothyroidism on a yearly rate of 4.3%-8%, with a larger predisposition in the aged population11 On a similar note, Wickham survey revealed 10% of women aged 55-64 years having higher TSH levels 23. This proposes that our study population might reasonably represent the general population.…”

“…21 In a cross-sectional study, which was a population-based Nord-Trøndelag Health Study, the risk of mortality due to coronary heart disease was significantly higher in people with an average age of about 60.1. 22 A considerable number of persons with subclinical hypothyroidism eventually develop overt hypothyroidism on a yearly rate of 4.3%-8%, with a larger predisposition in the aged population 11 On a similar note, Wickham survey revealed 10% of women aged 55-64 years having higher TSH levels. 23 This proposes that our study population might reasonably represent the general population.…”

“…Cai et al 24 in a meta-analysis indicated the association of subclinical hypothyroidism with increased systolic and diastolic blood pressures, whereas non-significant upward trend was noticed in TSH levels with increasing blood pressure, BMI, and hyperlipidemia in the population of Riyadh, which was in accordance with our study results. 11 Hajieh et al 25…”

“…A considerable number of persons with subclinical hypothyroidism eventually develop overt hypothyroidism on a yearly rate of 4.3%-8%, with a larger predisposition in the aged population11 On a similar note, Wickham survey revealed 10% of women aged 55-64 years having higher TSH levels 23. However, increasing the sample size might show any potential relationship between other factors under study with subclinical hypothyroidism.Cai et al 24 in a meta-analysis indicated the association of subclinical hypothyroidism with increased systolic and diastolic blood pressures, whereas non-significant upward trend was noticed in TSH levels with increasing blood pressure, BMI, and hyperlipidemia in the population of Riyadh, which was in accordance with our study results 11. However, increasing the sample size might show any potential relationship between other factors under study with subclinical hypothyroidism.Cai et al 24 in a meta-analysis indicated the association of subclinical hypothyroidism with increased systolic and diastolic blood pressures, whereas non-significant upward trend was noticed in TSH levels with increasing blood pressure, BMI, and hyperlipidemia in the population of Riyadh, which was in accordance with our study results 11.…”

“…10 Another study from Saudi Arabia reported 28.5% of patients with type 2 diabetes have thyroid dysfunction, 9 while a non-significant trend was noted in TSH levels with high blood pressure and hyperlipidemia. 11 Unfortunately, there are no studies done in Saudi Arabia or even in Arab countries to determine the correlation between subclinical hypothyroidism and metabolic diseases. The study aimed to investigate any association between subclinical hypothyroidism and metabolic disorders in Al Kharj city.…”