Prevalence of Subclinical Thyroid Failure in Insulin-Dependent Diabetes

Gray, R S; Borsey, D. Q.; Seth, John; Herd, R. M.; Brown, N. S.; Clarke, B F

doi:10.1210/jcem-50-6-1034

Cited by 68 publications

(39 citation statements)

References 17 publications

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“…The prevalence of subclinical hyperthyroidism was 2.1%, and subclinical hypothyroidism was 10.3% in this study. These percentages are comparable with those reported in some other studies [9,13,15,22], yet are higher than those reported by others [8,23,24]. Estimates of subclinical hypothyroidism prevalence vary by the type of population accessed, i.e., sampled from community, hospital, nursing home or primary care, concurrent comorbidity and the TSH assay, and cut-off values used [25].…”

Section: Discussionsupporting

confidence: 84%

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

Eidan

Rahman

Qahtani

et al. 2018

Journal of Community Hospital Internal Medicine Perspectives

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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.

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Section: Discussionsupporting

confidence: 84%

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

Eidan

Rahman

Qahtani

et al. 2018

Journal of Community Hospital Internal Medicine Perspectives

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“…Nossos achados concordam com os de vários outros autores que encontraram prevalências semelhantes (5,7,8). Gray e cols.…”

Section: Resultsunclassified

“…Gray e cols. (5), estudando 605 pacientes com DM1 (311 do sexo feminino), entre 21 e 84 anos de idade, encontraram TSH aumentado em 71 (11,7%) pacientes, sendo 53 (17%) mulheres e 18 (6,1%) homens. Não houve associação significativa entre a presença do hipotireoidismo primário e a duração do diabetes.…”

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Prevalência de doença tireoideana em pacientes com diabetes tipo 1

Ramos

Costa

Benício

et al. 2003

Arq Bras Endocrinol Metab

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RESUMOIntrodução: O diabetes mellitus tipo 1 (DM1) freqüentemente se acompanha de outras doenças autoimunes, principalmente doença autoimune da tireóide (DAT). Objetivo: Determinar a prevalência de DAT em pacientes com DM1 e investigar possível relacionamento com outros fatores. Métodos: Em 126 pessoas com DM1, foram mensurados TSH, T 4 livre, anticorpo anti-peroxidase e hemoglobina A1c. Resultados: DAT foi encontrada em 26 pacientes (20,6%), sendo 11 (8,7%) com hipotireoidismo clínico, 6 (4,8%) com hipotireoidismo subclínico e 9 (7,1%) com tireoidite sem disfunção tireoideana. Em um paciente (0,8%), a DAT (hipertireoidismo) precedeu o DM1. Houve relação entre DAT e idade atual e no diagnóstico do DM1. Não foram encontradas significâncias para sexo, grupo racial, duração do DM, paridade e local de moradia. Conclusões: A prevalência de DAT é bastante alta para justificar seu rastreamento e está relacionada com a idade atual e a idade do diagnóstico do DM1. (DM1) is frequently associated with other immune diseases, especially autoimmune thyroid disease (ATD). Objective: To determine the prevalence of ATD in subjects with DM1 and to investigate possible association with other factors. Methods: TSH, free T 4 , antiperoxydase antibody, and hemoglobin A1c were measured in 126 DM1 patients. Results: ATD was found in 26 (20.6%) patients being 11 (8.7%) with overt hypothyroidism, 6 (4.8%) with subclinical hypothyroidism and 9 (7.1%) with thyroiditis without thyroid dysfunction. In one patient (0.8%), ATD (hyperthyroidism) preceded DM1. ATD was associated with current age and age at diagnosis of DM1. No associations of ATD with sex, race, duration of DM1, parity, and home place were observed. Conclusions: The prevalence of ATD in DM1 patients is high enough to justify screening and is related to current age and to the age at the diagnosis of DM1. Keywords: Type 1 diabetes mellitus; Thyroid diseases; Hypothyroidism; Prevalence A TUALMENTE, O MELHOR ATENDIMENTO aos pacientes com diabetes mellitus tipo 1 (DM1), aliado aos avanços diagnósticos, tem possibilitado a detecção precoce de outras endocrinopatias autoimunes nestes indivíduos, algumas ainda na fase pré-clínica. Essa associação de endocrinopatias autoimunes num mesmo indivíduo (síndrome poliglandular) aparentemente não tem relação com o controle do DM1 e sim com o status imunogenético do paciente e/ou com fatores ambientais. Nas síndromes poliglandulares autoimunes, pode haver associação de DM1 com doenças autoimunes da artigo original

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“…At each visit blood was drawn to measure thyrotrophin (TSH), free thyroxine (FT 4 ), free tri-iodothyronine (FT 3 ), TPO-ab, TSH-receptor binding inhibiting immunoglobulins (TBII) and glycosylated haemoglobin (HbA1c). FT 3 fluoroimmunoassay (Delfia; Wallac Oy) was performed in the case of a decreased TSH but a normal FT 4 to detect a possible T 3 toxicosis; reference values 4.6 -7.8 pmol/l. TSH was determined using a time-resolved fluoroimmunoassay (Delfia hTSH Ultra; Wallac Oy); reference range 0.15 -2.0 mU/l, as defined for 225 non-pregnant women aged 20 -40 years originating from the region Kempenland in the southeast Netherlands, using the International Federation of Clinical Chemistry recommendations for defining reference values (17).…”

Section: Methodsmentioning

confidence: 99%

“…Women with DM1 are found to have anti-thyroid peroxidase antibodies (TPO-ab) in a higher proportion (up to 20%) than the background population (3), and their prevalence of auto-immune hypothyroidism is also higher (4,5).…”

Section: Introductionmentioning

confidence: 99%

Thyroid dysfunction during pregnancy and in the first postpartum year in women with diabetes mellitus type 1

Gallas

Stolk

Bakker

et al. 2002

European Journal of Endocrinology

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Background: The prevalence of thyroid dysfunction in pregnancy and in the first postpartum year (postpartum thyroid dysfunction (PPTD)) in women with diabetes mellitus type 1 (DM1) is known to be higher than in the general population. To assess prevalence, incidence and risk factors in The Netherlands we performed a prospective cohort study. Design: From 1994 to 1998, 126 women with DM1 from eight Dutch clinics were included. TSH, free thyroxine, free tri-iodothyronine and anti-thyroid peroxidase antibodies (TPO-ab) were measured prepregnancy, in the first and last trimester of pregnancy and at 1.5, 3, 6, 9 and 12 months after delivery. Results: Eighty-two women completed the study. Thyroid dysfunction during pregnancy was observed in 22.5% (first trimester) and 18.4% (third trimester), and mostly consisted of subclinical hypothyroidism. Baseline characteristics of women with thyroid dysfunction in pregnancy did not differ from those without thyroid dysfunction. Overt PPTD was seen in 15.9%. Incidence of PPTD was 10%. Patients with PPTD were slightly older than those without PPTD and the prevalence of TPO-ab was higher in these women. Conclusion: In women with DM1 the prevalence of thyroid dysfunction during pregnancy and overt PPTD is 3-fold higher than in the general Dutch population. Risk factors are age and TPO-ab. Given the possible impact on psychomotor development of the offspring and on well-being of the mother these data suggest there is a case for screening (pre-)pregnant women with DM1 for TSH and TPO-ab.

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Prevalence of Subclinical Thyroid Failure in Insulin-Dependent Diabetes

Cited by 68 publications

References 17 publications

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

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

Prevalência de doença tireoideana em pacientes com diabetes tipo 1

Thyroid dysfunction during pregnancy and in the first postpartum year in women with diabetes mellitus type 1

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