Professional Documents
Culture Documents
Copyright @2015
ISSN: 2319-5886
Accepted: 9th May 2015
PREVALENCE AND AT EARLY AGE ONSET OF HYPO AND HYPERTHYROIDISM IN POSTIODIZATION ERA: A HOSPITAL BASED STUDY FROM SOUTH INDIA
Fathima Nusrath1, Baderuzzaman2, Anees Syyeda 2, N Parveen4, Siraj M3, N, *Ishaq M1
1
in the post-iodization era appears to be of autoimmune type i.e. hypothyroidism. The important
signs and symptoms of hypothyroidism are fatigue,
weight gain, constipation and cold intolerance
whereas anxiety, palpitation, weight loss, increased
appetite and sweating are important signs of
hyperthyroidism. In a study by Doufas et al (1999)[5]
it has been reported that apart from genetic and other
environmental factors iodine excess in postiodization era is considered to play an important role
in the rising incidence of hypothyroidism of
autoimmune type. Due to less awareness as well as
less attention towards diagnostics of hypo and hyper
thyroidism in India a considerable percentage of
population, particularly women suffer from thyroid
dysfunction which is considered as a common organ
specific autoimmune disorder.[1]
A nation-wide study by Unnikrishnan et al. (2013)[ 6]
on epidemiology of thyroid dysfunction in selected
cities of India suggested the need for further studies in
order to have a more comprehensive analysis of
epidemiological aspects for better awareness and
control of this endocrine disorder. Important factors
that have been considered in such studies are age at
onset, and gender ratio, and the relative prevalence
rates of hypothyroidism and hyperthyroidism. In the
present study emphasis has also been laid on the
prevalence of subclinical hypothyroidism which may
have various consequences such as increasing risk of
cardiovascular disease, hyperlipidemia, somatic and
neuromuscular symptoms, reproductive and other
consequences as thyroid stimulating hormone (TSH)
levels above the normal range can cause such ailments.
In 1983 when India adopted the universal salt
iodization programme it is noted that in post iodization
period there was decline in goiter prevalence in several
parts of the country. But the prevalence is estimated
about that still 42 million people suffering from
thyroid dysfunction. [7] There is a need for further
studies on the prevalence of thyroid disorder in post
iodization period in order to investigate the new
emerging trends in the prevalence of TD.
MATERIALS AND METHODS
The study was conducted after taking approval from
Institutional Review Board, Deccan college of Medical
Sciences, Hyderabad.
This was a unicentric, prospective based study. A
total of 516 subjects visiting Department of
Fathima et al.,
Serum TSH
Total T3
Total T4
Normal
Range
Hypo
thyroidism
0.3-5IU/ml
0.6-3.3 nmol/L
60-120nmol/L
7IU/ml
3.3 nmol/L
120nmol/L
Subclinical
Hypothyroidism
5-7IU/ml
Normal
Normal
Hyper
thyroidism
0.2IU/ml
0.6nmol/L
60nmol/L
Hypothyroidism versus hyperthyroidism and subclinical hypothyroidism cases were found statistically significant
(p<0.05)
Table 2: Percentages of patients suffering from hypothyroid, subclinical hypothyroidism and hyperthyroid
cases.
Number
Percentage
Total number
of subjects
Hypo
thyroid
Hyper
thyroid
Subclinical
hypothyroidism
516
100
185***
35.85%
22
4.26%
39
7.5%
***p<0.0003
Table 3: The number and percentage of newly and already diagnosed cases of hypo and hyperthyroidism
Hypothyroidism
Newly
Diagnosed
*Already Diagnosed
Total
Hyperthyroidism
Female
37 (7.17%)
Male
3 (0.38%)
Female
12 (2.32%)
Male
1(0.19%)
136 (26.35%)
173 (33.52%)
9 (1.93%)
12 (2.32%)
9(1.74%)
21(4.06%)
0
1(0.19%)
*Already diagnosed hypothyroid cases versus newly diagnosed hypothyroid cases p<0.001
Table 4: Prevalence of hypo and hyperthyroidism in males and females in different age groups
Subclinical
Hyperthyroidism
Age group Hypothyroidism
hypothyroidism
(Year)
F
M
F
M
F
M
10-20
27 (15.60%)
1(8.33 %)
2(5.12%)
0
3 (14.28%)
1
*21-30
64 (36.99%)
1(8.33%)
13(33.33%)
0
11 (52.38 %)
0
31-40
39 22.54%)
6(50.0%)
5(12.82%)
0
6 (28.57%)
0
41-50
20 11.56%)
2(16.6%)
9(23.07%)
0
0
0
51-60
10 (5.78%)
2(16.6%)
4(10.25%)
0
1 (4.76%)
0
61-70
12 (6.93%)
0
4(10.25%)
0
0
0
71-75
1 (0.57%)
0
2
0
0
0
492
Fathima et al.,
Fig2: Percentage distribution of overt and subclinical hypothyroidism cases (females only)
DISCUSSION
Post-iodization studies on the occurrence of thyroid
disorders in different populations across the globe
have indicated trends of increase in the prevalence
rates of these disorders particularly in hypothyroidism
and hyperthyroidism. [6] Even the incidence of antithyroid peroxidase (TPO) antibody positive subjects
has been shown to be significantly increased. [9]
In the present study we report a prevalence rate of
35.84% of hypothyroidism (185/516) which is
similar to another hospital based study published by
Shekhar et al. (2012)[10] where the authors reported
have found 31.3% cases with overt hypothyroidism
in a cross sectional hospital based study from coastal
Andhra Pradesh, India. In our study hypothyroidism
cases (35.84%) included 7.55% (n=39) newly
diagnosed and 28.29% (n=146) already diagnosed
Fathima et al.,
Fathima et al.,
Fathima et al.,
495