DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20151399

The prevalence of anti-thyroid peroxidase antibodies in subclinica and clinical hypothyroid patients

Jayashankar C.A., Avinash S., Shashidharan B., Vijaya Sarathi, Shruthi K.R., Nikethan D., Harshavardhan J.

Abstract


Background: Subclinical hypothyroidism is a state of mild thyroid failure and is essentially a laboratory diagnosis with elevated serum thyroid stimulating hormone (TSH) and a normal free thyroxine (FT4) concentration. The main objective of study is to evaluate the prevalence of anti-thyroid peroxidise (anti-TPO) antibodies among patients with clinical and subclinical hypothyroidism.

Methods: A prospective study was conducted involving 50 patients with biochemical evidence of hypothyroidism. Subclinical hypothyroidism was defined as thyroid stimulating hormone (TSH) >5.0 µIU/ml with normal FT4 and clinical hypothyroidism as free thyroxine (FT4) and high TSH. A detailed history, clinical examination, and investigations comprising of complete haemogram, fasting plasma glucose, fasting FT4, TSH, anti-TPO antibodies and lipid profile were done for all the patients.

Results: Out of 50 cases, 28 subjects had clinical hypothyroidism (25 females and 3 males) and 22 had subclinical hypothyroidism (14 females and 8males). Among the 50 subjects with clinical and subclinical hypothyroidism, 33 were anti-TPO positive. The corresponding percentage of anti-TPO positivity noted in the clinical hypothyroidism and subclinical hypothyroidism groups were 80 % and 50% respectively.

Conclusions: Serum TSH and anti-TPO analyses are essential in determining the etiology of hypothyroidism and risk of progression to overt hypothyroidism in patients with subclinical.

 


Keywords


Clinical hypothyroidism, Subclinical hypothyroidism, Anti-TPO antibodies

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References


Cooper DS. Subclinical hypothyroidism. JAMA.1987;258(2):246-7.

Tunbridge WMG, Evered DC, Hall R, Appleton D, Brewis M, Clark F et al. The spectrum of thyroid disease in a Community: the Whickham survey. Clin Endocrinol (Oxf). 1977;7:481-93.

Jeena EJ, Malathi M, Sudeep K. A hospital-based study of anti-TPO titer in patients with thyroid disease. J Med Sci Res. 2013;4:74-7.

Mohanty S, Amruthlal W, Reddy GC, Kusumanjali G, Kanagasabapathy AS, Rao P. Diagnostic strategies for subclinical hypothyroidism. Indian J Clin Biochem. 2008;23(3):279-82.

Dhadhal R, Mulchandani V, Parakh R, Joshee A, Mangukiya K, Bathwar N. A cross sectional study of prevalence of hypothyroidism in adult population of udaipur district.GJBB. 2015;4(1):103-6.

Bjoro T, Holmen J, Krüger O, Midthjell K, Hunstad K, Schreiner T et al. Prevalence of thyroid disease, thyroid dysfunction and thyroid peroxidase antibodies in a large, unselected population. The Health Study of Nord-Trondelag (HUNT). Eur J Endocrinol. 2000;143(5):639-47.

Silva LM, Chavez J, Canalli MHB, Zanetti CR. Determination of IgG subclasses and avidity of antithyroid peroxidase antibodies in patients with subclinical hypothyroidism - a comparison with patients with overt hypothyroidism. Horm Res. 2003;59(3):118-24.

Lock RJ, Marden NA, Kemp HJ, Thomas PH, Goldie DJ, Gompels MM. Subclinical hypothyroidism: a comparison of strategies to achieve adherence to treatment guidelines. Ann Clin Biochem. 2004;41(Pt 3):197.

Unnikrishnan AG, Kalra S, Sahay RK, Bantwal G, John M, Tewari N. Prevalence of hypothyroidism in adults: An epidemiological study in eight cities of India. Indian Journal of Endocrinology and Metabolism. 2013;17(4):647-52.

Marwaha RK, Tandon N, Ganie MA, Kanwar R, Garg MK, Singh S. Status of thyroid function in Indian adults: Two decades after universal salt iodization. J Assoc Physicians India. 2012;60:32-6.

UshaMenon V, Sundaram KR, Unnikrishnan AG, Jayakumar RV, Nair V, Kumar H. High prevalence of undetected thyroid disorders in an iodine sufficient adult south Indian population. J Indian Med Assoc. 2009;107:72-7.

Ghoraishian SM, Hekmati Moghaddam SH, Afkhami-Ardekani M. Relationship between Anti-Thyroid Peroxidase Antibody and Thyroid Function Test. Iran J Immunol. 2006;3:146-9.

Swain M, Swain T, Mohanty BK. Autoimmune thyroid disorders-an update. Indian J Clin Biochem. 2005;20(1):9-17.