Analysis of subclinical hypothyroidism in elderly women

Balasubramaniam, S (2006) Analysis of subclinical hypothyroidism in elderly women. Masters thesis, Stanley Medical College, Chennai.


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INTRODUCTION: Subclinical hypothyroidism (SH) is characterized by an elevated serum concentration of thyroid stimulating hormone (TSH) and normal serum concentration of free thyroxine (FT4) in the presence or absence of symptoms1. This biochemical state has been given a variety of other names, including mild thyroid failure, as well as compensated, early, late, minimally symptomatic, and pre-clinical hypothyroidism. Although the term subclinical hypothyroidism is widely used, mild hypothyroidism may be more appropriate. Subclinical hypothyroidism is a common disorder with prevalence ranging from 1–10% of the, mostly adult, population, with the highest rate approaching 26% in elderly women. In a study conducted in Saudi Arabia the prevalence in elderly women more than 50 years of age reached 35%. Clinical manifestations of subclinical hypothyroidism include abnormal lipid metabolism, cardiac dysfunction, and neurological and mental dysfunction, and several cross-sectional studies have suggested that it confers an elevated risk of atherosclerosis and coronary heart disease. However, neither of these associations has been confirmed by others. This discrepancy may reflect the small size of the studies or participation in studies limited to one sex. Also, only few longitudinal studies have been conducted. The relationship between subclinical hypothyroidism and cardiovascular disease is therefore controversial, and possible outcomes of the condition remain unclear. Importantly, several previous studies suggesting that thyroid autoimmunity is a risk factor for coronary heart disease remain surrounded by controversy. Women with subclinical hypothyroidism did not differ from controls with regard to BMI, hypertension, and diabetes mellitus in previous studies. The present study has been performed to estimate the prevalence of subclinical hypothyroidism and its relation to hypertension, diabetes, and ischemic heart disease among women above the age of 50 years attending Medical outpatient clinic at Government Stanley Medical College and Hospital. AIM OF THE STUDY: 1. To estimate the prevalence of Subclinical Hypothyroidism among women above the age of 50 years. 2. To study the relationship of Subclinical Hypothyroidism to Hypertension, Diabetes Mellitus and Ischemic Heart Disease in those patients. MATERIALS AND METHODS: Case selection: Women above the age of 50 years attending the Medical outpatient clinic at Stanley Medical College and Hospital, Chennai, from June 2005 to December 2005 were studied. A sample of 140 women was randomly selected. All the participating women were examined for thyroid function. Women with subclinical hypothyroidism (defined as TSH > 5.5 μIU/ml with normal free T4 and free T3) were considered as cases, and women without subclinical hypothyroidism were considered as controls. Laboratory measurements and clinical assessments were carried out on all the participants. Exclusion criteria: Those with • Known thyroid disease. • History of neck irradiation. Chronic renal failure. • Severe illness (such as infection, recent myocardial infarction, severe heart failure, or recent intensive care admission). • Taking pharmaceuticals such as beta-blockers, amiodarone, interferon-α were excluded. RESULTS: 140 women above the age of 50 years who visited the Medical outpatient clinic during the study period were studied. 41 women were found to have the criteria set for the definition of subclinical hypothyroidism, which meant a rate of 29.2%. Patients with subclinical hypothyroidism were regarded as cases and the remaining 99 patients were the control group. There were differences in the mean age distribution among cases and controls. The mean age for patients with subclinical hypothyroidism was 64.7±8.1 years. The mean age for controls was 63.1±8.8 years. CONCLUSION: Subclinical hypothyroidism is highly prevalent in elderly women above the age of 50 years (29.2%). Most of those with subclinical hypothyroidism have the TSH level below 10 μIU/ml. • Mild symptoms of hypothyroidism are prevalent in patients with subclinical hypothyroidism (29% of patients in this study). Fatigability being the most common symptom. • Patients with subclinical hypothyroidism are more prone to develop ischemic heart disease. • There is no increased risk for developing hypertension and diabetes mellitus in patients with subclinical hypothyroidism.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Analysis ; Subclinical Hypothyroidism ; Elderly Women.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 23 Mar 2018 02:55
Last Modified: 23 Mar 2018 02:55

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