Prevalence and predictors of adequate treatment of overt hypothyroidism – a population-based study

Authors

  • Julie Lindgård Nielsen Department of Endocrinology, Aalborg University Hospital, DK-9000 Aalborg, Denmark, Tel.: + 45 30 24 10 79; E-mail: julielindgaard@gmail.com https://orcid.org/0000-0003-2333-9771
  • Jesper Karmisholt Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark https://orcid.org/0000-0001-6026-5834
  • Inge Bülow Pedersen Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark https://orcid.org/0000-0003-2033-7957
  • Allan Carlé Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark https://orcid.org/0000-0002-5601-1468

DOI:

https://doi.org/10.17179/excli2021-4291

Keywords:

treatment, population-based study, hypothyroidism, overt hypothyroidism

Abstract

The aim of this study is to evaluate the adequacy of treatment, and to identify factors influencing treatment of hypothyroidism. Patients newly diagnosed with overt hypothyroidism (n=345) were identified via a register linked to a laboratory database. In selected periods with staff available, 165 patients were invited, and 113 (68.5 %) accepted participating in a comprehensive program including blood tests and completion of questionnaires. We performed a longitudinal follow-up on thyroid function tests 10 years after the diagnosis. Time to reach a serum TSH level of 0.2-10 mU/L (termed as clinically acceptable) and biochemical normalization (TSH: 0.2-5.0 mU/L), respectively, were analyzed using Kaplan Meier survival analysis. Predictors for longer duration to reach the normal TSH range were identified using cox proportional hazards regression. Only 67.7 % of the patients were in the euthyroid range on the long term after diagnosis of overt hypothyroidism (2 years: 59.4 %; 10 years: 67.7 %). Median time to the first normal TSH was 8.9 months (95 % CI: 7.6-10.2 months). The factors associated with longer duration until normalization of TSH after multivariate analysis were age (HR 0.79 per 10 years; 95 % CI: 0.66-0.94; P = <0.01), smoking (HR 0.47; 95 % CI: 0.26-0.83; P = <0.01), serum TSH at diagnosis (HR 0.96 per 10 mU/L; 95 % CI: 0.93-0.99; P = 0.02) and BMI (HR 0.96 per kg/m2; 95 % CI: 0.91-0.99; P = 0.03). A considerable number of hypothyroid patients remained inadequately treated. When treating hypothyroid patients, special attention should be addressed to those patients who never or lately obtain euthyroid status.

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Published

2022-01-06

How to Cite

Lindgård Nielsen, J., Karmisholt, J., Bülow Pedersen, I., & Carlé, . A. (2022). Prevalence and predictors of adequate treatment of overt hypothyroidism – a population-based study. EXCLI Journal, 21, 104–116. https://doi.org/10.17179/excli2021-4291

Issue

Vol. 21 (2022)

Section

Original articles

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Copyright (c) 2022 Julie Lindgård Nielsen, Jesper Karmisholt, Inge Bülow Pedersen, Allan Carlé

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