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Detectability of Asymptomatic Hypothyroidism and Thyroperoxidase Antibodies Content in Patients from a Multidisciplinary In-patient Hospital

DOI:10.31550/1727-2378-2019-165-10-52-56
Bibliography link: Volkova А.R., Dygun O.D., Galkina O.V., Bobreshova T.Yu., Azizova K.V., Emanuel Yu.V. Detectability of Asymptomatic Hypothyroidism and Thyroperoxidase Antibodies Content in Patients from a Multidisciplinary In-patient Hospital. Doctor.Ru. 2019; 10(165): 52–56. (in Russian) DOI: 10.31550/1727-2378-2019-165-10-52-56
Detectability of Asymptomatic Hypothyroidism and Thyroperoxidase Antibodies Content in Patients from a Multidisciplinary In-patient Hospital
11 September 11:02

Objective: to identify the concentration of thyroperoxidase antibodies (anti-TPO) in patients with asymptomatic hypothyroidism (AH) irrespective of sex and age.

Design: cross-sectional study.

Materials and Methods. 7,466 patients from various clinical units of I.P. Pavlov First St. Petersburg State Medical University took part in the study. All patients were screened for thyroid-stimulating hormone (TSH) levels. If TSH level was > 4.0 MIU/l, free T4 was measured. TSH level below 0.4 MIU/l was considered a low value (group 0). TSH level of 0.4 to 2.4 MIU/l was normal (group 1).TSH concentration of 2.5 to 3.9 MIU/l (both inclusive) was a breakpoint (group 2), whereas 4.0 to 10.0 MIU/l denoted AT with normal free Т4 (group 3). TSH concentration above 10.0 MIU/l was considered overt hypothyroidism with low free T4 (group 4). Also, patients were age-ranked: group 0 – juvenile patients (18–24 years old); group 1 – young patients (25–44 years old); group 2 – middle-aged patients (45–59 years old); group 3 – elderly patients (60–74 years old); group 4 – senile patients (75–89 years old), and group 5 – long-livers (90+ years old).

Results. There were 2,231 (29.88%) males and 5,235 (70.12%) females. The age of patients varied from 18 to 99 years, with the mean age being 55.09 ± 17.14 years. The mean age of the males was 55.22 ± 16.41 years old; that of females was 55.04 ± 17.45 years old. TSH level measured 0.00 to 100.00 MIU/l, with the mean value being 2.62 MIU/l (median: 1.73 (1.11–2.71) MIU/l). In general, 2.5 and 97.5 percentiles accounted for 0.10 and 8.88 MIU/l, respectively. The TSH median in males was 1.56 (0.97–2.31) MIU/l, whereas in females it made 1.82 (1.17–2.90) MIU/l.

TSH concentration in females was significantly higher than in males (р < 0.0001). Elevated TSH was diagnosed more often in elderly patients. When analysing TSH in age sub-groups vs. sex, significant differences were revealed between group 2 (45–59 years old) and group 3 (60–74 years old). In both cases, TSH levels in females was significantly higher than in males (р < 0.0001). Elevated thyroid peroxidase antibodies level was associated with higher TSH levels (r = 0.117, p = 0.043).

Conclusion. The article presents the results of a study enrolling a large group of patients from multidisciplinary in-patient clinics in the North-Western region. AH was diagnosed in 9.78% of patients seeking consultation. Elevated TSH levels were recorded mostly in females and elderly patients. It is likely that, in a majority of cases, moderate increase in TSH concentration (4–6.9 MIU/l) was not associated with autoimmune thyroid gland disorders. In elderly patients, slightly elevated TSH level may be caused by other conditions. Approximately in 40% of cases, moderate THS elevation is reversible, and when measured again, it is usually normal.

Contribution: Volkova, A.R. — thematic publications reviewing, study design, approval of the manuscript for publication; Dygun, O.D. — thematic publications reviewing, study design, collection of clinical materials, data processing, analysis and interpretation, statistical processing; Galkina, O.V. — thematic publications reviewing, study design, laboratory analyses, data analysis and interpretation, approval of the manuscript for publication; Bobreshova, T.Yu. and Azizova, K.V. — thematic publications reviewing, collection of clinical materials, data processing, analysis and interpretation; Emanuel, Yu.V. — study design, data analysis and interpretation, approval of the manuscript for publication.

Conflict of interes: The authors declare that they do not have any conflict of interests.


А.R. Volkova — I.P. Pavlov First St. Petersburg State Medical Universityof the Ministry of Health of the Russian Federation; 6-8 Lev Tolstoy Str., 197022St. Petersburg, Russian Federation 197022. E-mail: ejvcons@mail.ru

O.D. Dygun — I.P. Pavlov First St. Petersburg State Medical Universityof the Ministry of Health of the Russian Federation; 6-8 Lev Tolstoy Str., 197022St. Petersburg, Russian Federation 197022. E-mail: ejvcons@mail.ru

O.V. Galkina — I.P. Pavlov First St. Petersburg State Medical Universityof the Ministry of Health of the Russian Federation; 6-8 Lev Tolstoy Str., 197022St. Petersburg, Russian Federation 197022. E-mail: ejvcons@mail.ru

T.Yu. Bobreshova — I.P. Pavlov First St. Petersburg State Medical Universityof the Ministry of Health of the Russian Federation; 6-8 Lev Tolstoy Str., 197022St. Petersburg, Russian Federation 197022. E-mail: ejvcons@mail.ru

K.V. Azizova — I.P. Pavlov First St. Petersburg State Medical Universityof the Ministry of Health of the Russian Federation; 6-8 Lev Tolstoy Str., 197022St. Petersburg, Russian Federation 197022. E-mail: ejvcons@mail.ru

Yu.V. Emanuel — I.P. Pavlov First St. Petersburg State Medical Universityof the Ministry of Health of the Russian Federation; 6-8 Lev Tolstoy Str., 197022St. Petersburg, Russian Federation 197022. E-mail: ejvcons@mail.ru

Detectability of Asymptomatic Hypothyroidism and Thyroperoxidase Antibodies Content in Patients from a Multidisciplinary In-patient Hospital
11 September 11:02
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