Thyroid dysfunctions and sonographic characteristics in northern Turkey: a population-based study

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Abstract

BACKGROUND AND OBJECTIVES

In this study, it was aimed to investigate thyroid functions, sonographic characteristics of thyroid gland, relation of thyroid functions, and cardiovascular risk factors in adult population living in northern Turkey.

DESIGN AND SETTINGS

The study was conducted in 70 areas (12 urban and 58 rural) in the province of Tokat in northern Turkey from 2005 to 2006.

PATIENTS AND METHODS

The study included about 530 000 inhabitants of 18 years and older. Demographic characteristics and thyroid sonographic findings were noted for each subject, and blood samples were collected for measuring serum lipids and thyroid function tests.

RESULTS

A total of 1095 subjects (541 males, 554 females) were included, and their mean age (SD) was 41.4 (17) years. Mean thyrotropin (TSH) and free T4 levels (SD) were 1.5 (1.6) μIU/mL and 1.2 (0.1) ng/dL, respectively, in males, and 2.2 (6.6) μIU/mL and 1.2 (0.3) ng/dL, respectively, in females ( P<.05). According to mean TSH levels, the prevalence of overt hypothyroidism, overt hyperthyroidism, subclinical hypothyroidism, and subclinical hyperthyroidism was detected as 1.6%, 0.5%, 2.7%, and 4.9%, respectively. Nodular goiter, multinodular goiter, and thyroid heterogeneity were determined as 13.8, 32.1, and 15.6%, respectively. The correlation between cardiovascular risk factors and serum TSH levels was not statistically significant ( P>.05). The age was independently and significantly associated with serum TSH levels ( P<.0001).

CONCLUSION

In terms of high prevalence of thyroid dysfunction and nodular goiter, thyroid diseases must be concluded as a public health problem, and accurate and effective strategies must be identified.

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Most cited references 34

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Thyroid status, disability and cognitive function, and survival in old age.

Jacobijn Gussekloo, Eric van Exel, Anton J. M. De Craen … (2004)

Despite the equivocal outcomes of randomized controlled trials, general clinical opinion favors screening and treatment of elderly individuals with subclinical thyroid disorders. To determine whether subclinical thyroid dysfunction should be treated in old age and the long-term impact of thyroid dysfunction on performance and survival in old age. A prospective, observational, population-based follow-up study within the Leiden 85-Plus Study of 87% of a 2-year birth cohort (1912-1914) in the municipality of Leiden, the Netherlands. A total of 599 participants were followed up from age 85 years through age 89 years (mean [SD] follow-up, 3.7 [1.4] years). Complete thyroid status at baseline; disability in daily life, depressive symptoms, cognitive function, and mortality from age 85 years through 89 years. Plasma levels of thyrotropin and free thyroxine were not associated with disability in daily life, depressive symptoms, and cognitive impairment at baseline or during follow-up. Increasing levels of thyrotropin were associated with a lower mortality rate that remained after adjustments were made for baseline disability and health status. The hazard ratio (HR) for mortality per SD increase of 2.71 mIU/L of thyrotropin was 0.77 (95% confidence interval [CI], 0.63-0.94; P = .009). The HR for mortality per SD increase of 0.21 ng/dL (2.67 pmol/L) of free thyroxine increased 1.16-fold (95% CI, 1.04-1.30; P = .009). In the general population of the oldest old, elderly individuals with abnormally high levels of thyrotropin do not experience adverse effects and may have a prolonged life span. However, evidence for not treating elderly individuals can only come from a well-designed, randomized placebo-controlled clinical trial.

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Obesity and thyroid function.

Thomas Reinehr (2010)

A moderate elevation of thyrotropin (TSH) concentrations, which is associated with triiodothyronine (T3) values in or slightly above the upper normal range, is frequently found in obese humans. These alterations seem rather a consequence than a cause of obesity since weight loss leads to a normalization of elevated thyroid hormone levels. Elevated thyroid hormone concentrations increase the resting energy expenditure (REE). The underlying pathways are not fully understood. As a consequence of the increased REE, the availability of accumulated energy for conversion into fat is diminished. In conclusion, the alterations of thyroid hormones in obesity suggest an adaptation process. Since rapid weight loss is associated with a decrease of TSH and T3, the resulting decrease in REE may contribute towards the difficulties maintaining weight loss. Leptin seems to be a promising link between obesity and alterations of thyroid hormones since leptin concentrations influence TSH release. 2009 Elsevier Ireland Ltd. All rights reserved.

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Prevalence of thyroid disease, thyroid dysfunction and thyroid peroxidase antibodies in a large, unselected population. The Health Study of Nord-Trondelag (HUNT).

O Krüger, K Hunstad, J Holmen … (2000)

To examine the prevalence of thyroid disease and dysfunction including thyroid autoimmunity in Norway. All inhabitants 20 years and older (94009) in Nord-Trondelag were invited to participate in a health survey with a questionnaire and blood samples. The prevalence of former diagnosed hyperthyroidism was 2.5% in females and 0.6% in males, hypothyroidism 4.8% and 0.9%, and goitre 2.9% and 0.4% respectively. In both sexes the prevalence increased with age. In individuals without a history of thyroid disease the median, 2.5 and 97.5 percentiles for TSH (mU/l) were 1.80 and 0.49-5.70 for females and 1. 50 and 0.56-4.60 for males. The TSH values increased with age. When excluding individuals with positive thyroid peroxidase antibodies (TPOAb) (>200U/ml), the 97.5 percentiles dropped to 3.60 mU/l and 3. 40 mU/l respectively. The prevalence of pathological TSH values in females and males were TSH >/=10mU/l 0.90% and 0.37%; TSH 4.1-9. 9mU/l 5.1% and 3.7%; and TSH 200U/ml) was 13.9% in females and 2.8% in males. In females the lowest percentage (7.9%) of positive TPOAb was seen with TSH 0.2-1.9mU/l and increased both with lower and higher levels of TSH. The percentage of males with positive TPOAb was lower than in females in all TSH groups except for those with TSH>10mU/l (85% TPOAb positive). In spite of a high prevalence of recognised thyroid disease in the population a considerable number of inhabitants have undiagnosed thyroid dysfunction and also positive TPOAb.

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Author and article information

Journal

Journal ID (nlm-ta): Ann Saudi Med

Journal ID (iso-abbrev): Ann Saudi Med

Title: Annals of Saudi Medicine

Publisher: King Faisal Specialist Hospital and Research Centre

ISSN (Print): 0256-4947

ISSN (Electronic): 0975-4466

Publication date (Print): May-Jun 2013

Volume: 33

Issue: 3

Pages: 253-259

Affiliations

[a ]Faculty of Medicine, Endorcrinology and Metabolism, Gaziosmanpasa University, Tokat, Turkey

[b ]Faculty of Medicine, Department of Gastroenterology, Gaziosmanpasa University, Tokat, Turkey

[c ]Faculty of Medicine, Department of Medical Oncology, Gaziosmanpasa University, Tokat, Turkey

[d ]Faculty of Medicine, Department of Biochemistry, Gaziosmanpasa University, Tokat, Turkey

[e ]Faculty of Medicine, Department of Radiology, Gaziosmanpasa University, Tokat, Turkey

[f ]Faculty of Medicine, Department of Biostatistics, Gaziosmanpasa University, Tokat, Turkey

[g ]Faculty of Medicine, Department of Public Health, Gaziosmanpasa University, Tokat, Turkey

Author notes

Correspondence: Dr. Faruk Kutluturk, Faculty of Medicine, Endorcrinology and Metabolism, Gaziosmanpa University, Tokat 60100, Turkey, T:+905072477398, F:+903562122142, fkutluturk@ 123456yahoo.com

Article

Publisher ID: asm-3-253

DOI: 10.5144/0256-4947.2013.253

PMC ID: 6078520

PubMed ID: 23793427

SO-VID: 439a0d1c-b201-4979-a65f-d8ae4a21d47a

License:

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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Thyroid dysfunctions and sonographic characteristics in northern Turkey: a population-based study

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Abstract

BACKGROUND AND OBJECTIVES

DESIGN AND SETTINGS

PATIENTS AND METHODS

RESULTS

CONCLUSION

Related collections

Bioscientifica Open Endocrinology

Most cited references 34

Thyroid status, disability and cognitive function, and survival in old age.

Obesity and thyroid function.

Prevalence of thyroid disease, thyroid dysfunction and thyroid peroxidase antibodies in a large, unselected population. The Health Study of Nord-Trondelag (HUNT).

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