A Hospital-based Study for Clinico-investigative Profile of Newly Diagnosed Patients of Hypothyroidism

Abstract

Introduction: Hypothyroidism in adults has an insidious onset with a range of non-specific symptoms resulting in delayed diagnosis. Hypothyroidism is characterized by a broad clinical spectrum ranging from an overt state of myxedema, end-organ effects and multisystem failure to an asymptomatic or subclinical condition with normal levels of thyroxine and triiodothyronine and mildly elevated levels of serum thyrotropin. Thyroid dysfunction leads to altered glucose and lipid metabolism leading to insulin resistance, which is an important risk factor for cardio vascular diseases. This study attempts to study clinical and biochemical profile of patients with subclinical hypothyroidism or overt hypothyroidism. Aim of study: To study clinical and investigative profile of hypothyroidism in the newly diagnosed patients of hypothyroidism. Methods: All newly diagnosed hypothyroidism patients fulfilling inclusion and exclusion criteria were taken in to study. Demographic profile of all enrolled patients was recorded. They were subjected to detailed history and examination and the findings were recorded as a predesigned Performa. The clinical diagnosis of hypothyroidism was made as per Indian thyroid society guidelines. The following laboratory investigations were performed: serum lipid profile and serum uric acid using enzymatic assay, fasting insulin, creatinine, direct bilirubin, and the following liver function parameters: aspartate aminotransferase (AST), alanine aminotransferase (ALT). Thyroid-hormone profile, including thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4), including anti-thyroid peroxidase (TPO). Observation and results: Between October 1, 2015 and September 30, 2016, 226 patients with newly diagnosed hypothyroidism were studied. Out of 226 patients, 48 patients excluded from the study. Central hypothyroidism was present in 4 patients and 44 were pregnant and lactating women. 178 patients with newly diagnosed hypothyroidism were enrolled in study. Out of 178 patients’ subclinical hypothyroidism was present in 29(16.9%) patients. Out of 178 patients, 131 (73.6%) were females and 47 (26.4%) were males and various parameters were studied. Conclusion: Our study confirms that dyslipidemia, insulin resistance and metabolic syndrome correlate positively with newly diagnosed hypothyroid patients.