Prevalence of Thyroid Dysfunction Among Asymptomatic Elderly Filipinos at the Philippine General Hospital
The elderly are a peculiar group in terms of health management, as they often present with non-specific complaints which are challenging to interpret and may not present with the usual clinical picture of a disease.
Objective. The study aims to determine the prevalence of thyroid dysfunction among asymptomatic, elderly Filipinos seen at the Philippine General Hospital (PGH).
Methodology. Subjects aged 60 years and older seeking out-patient medical consult for non-thyroidal illness at the PGH were recruited. Patients with known thyroid or pituitary disease, previous thyroid or pituitary surgery, intake of medications known to affect thyroid hormone levels and critical illness were excluded. Fasting blood sugar (FBS), lipid profile, free thyroxine (FT4), thyroid-stimulating hormone (TSH), and anti-thyroperoxidase (anti-TPO) levels were taken. Based on FT4 and TSH levels, subjects were classified as overt hypothyroid, subclinical hypothyroid, euthyroid, subclinical hyperthyroid, or overt hyperthyroid.
Results. One hundred eighty subjects were recruited, of whom 152 (84%) were female. Hypertension was the most common comorbidity (58.33%), followed by diabetes (36.67%). One hundred sixty-two (90%) were euthyroid, 12 (6.7%) subclinical hypothyroid, 4 (2.22%) subclinical hyperthyroid, and two (1.11%) overtly hyperthyroid. No one was overtly hypothyroid. There was a trend toward increasing prevalence of diabetes, hypertension, low HDL, obesity and overall cardiovascular risk among those with subclinical hypothyroidism.
Conclusion. Subclinical hypothyroidism was the most prevalent thyroid dysfunction among asymptomatic elderly included in the study.
Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation 2002;106:3143-421.
Tongol MR, Jimeno C, Acampado L. Assessment of the quality of care of patients with hypercholesterolemia seen at the Philippine General Hospital, General Medicine Clinic. Phil J Internal Medicine 2005;42:243-9.
Cooper DS. Subclinical hypothyroidism. N Engl J Med 2001;345(4):260-5.
Hollowell JG, Staehling NW, Flanders WD et al. Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab 2002;87(2):489-99.
Canaris GJ, Manowitz NR, Mayor G et al. The Colorado thyroid disease prevalence study. Arch Intern Med 2000;160(4):526-34.
Ceresini G, Lauretani F, Maggio M et al. Thyroid function abnormalities and cognitive impairment in elderly people: Results of the Invecchiare in Chianti study. J Am Geriatr Soc 2009; 57(1):89-93.
Mariotti S. Mild hypothyroidism and ischemic heart disease: Is age the answer? J Clin Endocrinol Metab 2008;93(8):2969-71.
Efstathiadou Z, Bitsis S, Milionis HJ et al. Lipid profile in subclinical hypothyroidism: Is L-thyroxine substitution beneficial? Eur J Endocrinol 2001;145(6):705-10.
Awayan AM, Justiniano GG, Oribio RU et al. Subclinical hypothyroidism in the elderly: A profile of residents in the home for the aged in Metro Manila. Phil J Internal Medicine 1998;36:307-11.
Carlos-Raboca J, Jasul GV, Kho SA et al. The Philippine thyroid disorders prevalence study (PhilTiDes). Unpublished data.
Hueston WJ, Pearson WS. Subclinical hypothyroidism and the risk of hypercholesterolemia. Ann Fam Med 2004;2(4):351-5.
Imaizumi M, Akahoshi M, Ichimaru S, et al. Risk for ischemic heart disease and all-cause mortality in subclinical hypothyroidism. J Clin Endocrinol Metab 2004;89(7):3365-70.
Hak AE, Pols HA, Visser TJ et al. Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: The Rotterdam study. Ann Intern Med 2000;132(4):270-8.
Razvi S, Weaver JU, Vanderpump MP et al. The incidence of ischemic heart disease and mortality in people with subclinical hypothyroidism: Reanalysis of the Whickham Survey cohort. J Clin Endocrinol Metab 2010;95(4):1734-40.
McDermott MT, Ridgway EC. Subclinical hypothyroidism is mild thyroid failure and should be treated. J Clin Endocrinol Metab 2001;86(10):4585-90.
Danese MD, Ladenson PW, Meinert CL et al. Effect of thyroxine therapy on serum lipoproteins in patients with mild thyroid failure: A quantitative review of the literature. J Clin Endocrinol Metab 2000;85(9):2993-3001.
Surks MI, Ortiz E, Daniels GH et al. Subclinical thyroid disease: Scientific review and guidelines for diagnosis and management. JAMA 2004;291(2):228-38.
Gharib H, Tuttle RM, Baskin HJ et al. Consensus statement: Subclinical thyroid dysfunction: A joint statement on management from the American Association of Clinical Endocrinologists, the American Thyroid Association, and The Endocrine Society. J Clin Endocrinol Metab 2005;90(1):581-5.
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