Published date: Dec 31 2024

Journal Title: Sudan Journal of Medical Sciences

Issue title: Sudan JMS: Volume 19 (2024), Issue No. 4

Pages: 449 – 459

DOI: 10.18502/sjms.v19i4.15542

Cherry Bansaldrcherrybansal@gmail.comDepartment of Pathology, Dr S S Tantia Medical College, Hospital & Research Center, Sri Ganganagar, Rajasthan, India

Amanpreet Singh amanpreetrattan1992@gmail.comDepartment of Pathology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India

Pragya Pandeypragyapandeyshukla83@gmail.comDepartment of Pathology, Rama Medical College, Hospital & Research Center, Kanpur, Uttar Pradesh, India

Background: Thyroid hormones control metabolism and growth functions. Incidence of thyroid dysfunction – hypothyroidism, hyperthyroidism, and autoimmune disorders are on the rise. There are minimal data reports regarding thyroid disorders prevalence in North India. The present study aims to report their prevalence in the general population.
Methods: The current retrospective study was conducted at a tertiary care institute for five years. Archives of thyroid function tests (Free T3 [FT3], Free T4 [FT4], and Thyroid-stimulating Hormone [TSH]) and antithyroid antibodies (Antithyroid Peroxidase and Anti-thyroglobulin) were screened. Duplicate/repeated test entries and follow-ups were excluded. For data analysis, the study population was grouped into hypothyroid (low FT3, low FT4, and high TSH), hyperthyroid (high FT3, high FT4, and low TSH), and others – including all other biochemical patterns. Statistical analysis was done using the IBM-SPSS software, version 20.
Results: Out of the initially screened 16,884 patients, a total of 12,775 meeting inclusion criteria were included in the study. The overall prevalence of thyroid dysfunction was 24% (3133/12,775). Hypothyroidism was most prevalent, constituting 51% (1603/3133), followed by hyperthyroidism in 26% (819/3133). The majority affected were females – 68% (2136/3133), commonly occurring in the 18–35 years of age range. The prevalence of antithyroid antibodies was 34% (1073/3133), anti-TPO constituted 77.6% (833/1073), and anti-thyroglobulin antibodies 22.4% (270/1073).
Conclusion: The prevalence of thyroid disorders is high in North India. Females in reproductive age group of 18–35 years are commonly affected. Study aids in early recognition of vulnerable populations for timely treatment of thyroid disorders.

Keywords: thyroid function, TSH, autoimmunity, anti-TPO

[1] Dhanwal, D. K., Bajaj, S., Rajput, R., Subramaniam, K. A., Chowdhury, S., Bhandari, R., Dharmalingam, M., Sahay, R., Ganie, A., Kotwal, N., & Shriram, U. (2016). Prevalence of hypothyroidism in pregnancy: An epidemiological study from 11 cities in 9 states of India. Indian Journal of Endocrinology and Metabolism, 20(3), 387–390. https://doi.org/10.4103/2230-8210.179992

[2] Armstrong, M., Asuka, E., & Fingeret, A. (2023). Physiology, thyroid function. StatPearls Publishing.

[3] Shahid, M. A., Ashraf, M. A., & Sharma, S. (2023). Physiology, thyroid hormone. StatPearls Publishing.

[4] De Leo, S., Lee, S. Y., & Braverman, L. E. (2016). Hyperthyroidism. Lancet, 388(10047), 906– 918. https://doi.org/10.1016/S0140-6736(16)00278-6

[5] Hoogendoorn, E. H., Hermus, A. R., de Vegt, F., Ross, H. A., Verbeek, A. L., Kiemeney, L. A., Swinkels, D. W., Sweep, F. C., & den Heijer, M. (2006). Thyroid function and prevalence of antithyroperoxidase antibodies in a population with borderline sufficient iodine intake: Influences of age and sex. Clinical Chemistry, 52(1), 104–111. https://doi.org/10.1373/clinchem.2005.055194

[6] Unnikrishnan, A. G., & Menon, U. V. (2011). Thyroid disorders in India: An epidemiological perspective. Indian Journal of Endocrinology and Metabolism, 15(Suppl 2), S78–S81. https://doi.org/10.4103/2230- 8210.83329

[7] Devaraj, T. V., & Salina, S. (2023). Prevalence of hypothyroidism in Kannur; A coastal district in Kerala. Thyroid Research and Practice., 18(2), 55– 60. https://doi.org/10.4103/trp.trp_1_22

[8] Fröhlich, E., & Wahl, R. (2017). Thyroid autoimmunity: Role of anti-thyroid antibodies in thyroid and extrathyroidal diseases. Frontiers in Immunology, 8, 521. https://doi.org/10.3389/fimmu.2017.00521

[9] Chaudhary, K., Mani, P., Yadav, L., & Tyagi, M. (2021). Prevalence and complications of hypothyroidism during pregnancy in western Uttar Pradesh. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 10(2), 632. https://doi.org/10.18203/2320-1770.ijrcog20210318

[10] Ahmad, N., Panthari, M., Gupta, A., Chandra, P., & Nafees, S. (2013). Prevalence of hypothyroidism among patients of Meerut, Uttar Pradesh - A hospital based study. International Journal of Medical Science and Public Health, 2(3), 539. https://doi.org/10.5455/ijmsph.2013.080320132

[11] Mahajan, S. L., Sharma, M., Devgun, P., & Gill, K. P. (2014). Burden of disease trends in India in 21st Century. Indian Journal of Public Health Research & Development, 5(3), 312. https://doi.org/10.5958/0976-5506.2014.00325.8

[12] Shruthi, H. S., Arunkumar, N., & Patil, R. N. (2021). Prevalence of anti-thyroid peroxidase antibodies in the first trimester pregnancy and its impact on maternal and fetal outcomes in a tertiary care centre in Bangalore. Indian Journal of Obstetrics and Gynecology Research, 8(2), 182–187. https://doi.org/10.18231/j.ijogr.2021.039

[13] Yadav, K., & Pandav, C. S. (2018). National Iodine Deficiency Disorders Control Programme: Current status & future strategy. The Indian Journal of Medical Research, 148(5), 503–510. https://doi.org/10.4103/ijmr.IJMR_1717_18

[14] Sheehan, M. T. (2016). Biochemical testing of the thyroid: TSH is the best and, oftentimes, only test needed - A review for primary care. Clinical Medicine & Research, 14(2), 83–92. https://doi.org/10.3121/cmr.2016.1309

[15] Kumar, M., Dheeraj, D., Kant, R., & Kumar, A. (2022). The association between anti-thyroid peroxidase antibody and dyslipidemia in subclinical hypothyroidism among the rural population of central India. Cureus, 14(2), e22317. https://doi.org/10.7759/cureus.22317

[16] Taylor, P. N., Lansdown, A., Witczak, J., Khan, R., Rees, A., Dayan, C. M., & Okosieme, O. (2023). Age-related variation in thyroid function - A narrative review highlighting important implications for research and clinical practice. Thyroid Research, 16(1), 7. https://doi.org/10.1186/s13044-023-00149-5

[17] Ganie, M. A., Charoo, B. A., Sahar, T., Bhat, M. H., Ali, S. A., Niyaz, M., Sidana, S., & Yaseen, A. (2020). Thyroid function, urinary iodine, and thyroid antibody status among the tribal population of Kashmir valley: Data from endemic zone of a sub-Himalayan region. Frontiers in Public Health, 8, 555840. https://doi.org/10.3389/fpubh.2020.555840

[18] Shukla, S. K., Pant, P., Singh, G., & Ahmad, S. (2024). Cytomorphological profile of graves’ disease and its co-relation with anti-TPO antibody. Journal of Medical Sciences and Health, 10(1), 8–15. https://doi.org/10.46347/jmsh.v10.i1.23.322

[19] Gopaliah, R. (2016). Prevalence of thyroid dysfunction: Experience of a tertiary care centre in Kerala. International Journal of Medical Research and Review, 4(1), 12–18. https://doi.org/10.17511/ijmrr.2016.i01.002

[20] Gedam, J.K., Rajput, D.A. (2017). Prevalence of thyroid disorders among patients attending the antenatal clinic at tertiary care centre, Parel, Mumbai, India. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 6(4), 1235.

[21] Gairola, K., Lahon, K., Mingwal, B. S., & Rawat, P. (2023). Estimation of prevalence and patterns of thyroid dysfunction in a tertiary care centre in Uttarakhand, India: A cross-sectional study. Journal of Clinical and Diagnostic Research, 17(7), BC16BC21. https://www.doi.org/10.7860/JCDR/ 2023/64465/18254

[22] Gopal, H., Khaira, H. K., Sinha, S., & Singh, S. (2019). Study of hypothyroidismin pregnancy of Punjab Women. International Journal of Contemporary Medicine, 7(1), 60. https://doi.org/10.5958/2321- 1032.2019.00012.3

[23] Kumar, R., Bansal, R., Shergill, H. K., & Garg, P. (2023). Prevalence of thyroid dysfunction in pregnancy and its association with feto-maternal outcomes: A prospective observational study from a tertiary care institute in Northern India. Clinical Epidemiology and Global Health, 19, 101201. https://doi.org/10.1016/j.cegh.2022.101201

[24] Poojary, B., Wilson, M., Jose, R., Sam, S.P., George, A. & Jeeragi, M.V. (2023). Identifying factors associated with cognitive impairment in thyroid disorders and prediction of risk using machine learning approach: A comprehensive study. Ankara Medical Journal, 23(3), 256–268. https://doi.org/10.5505/amj.2023.89990

[25] Kamrul-Hasan, A. M., Aalpona, F. T., Mustari, M., Akter, F., Chanda, P. K., Rahman, M., Mahbub, M. I., & Selim, S. (2020). Prevalence of thyroid dysfunction and thyroid autoimmunity in polycystic ovary syndrome: A multicenter study from Bangladesh. Thyroid Research and Practice, 17, 76– 81. https://doi.org/10.4103/trp.trp_6_20

[26] Mammen, J. S. R., & Cappola, A. R. (2021). Autoimmune thyroid disease in women. Journal of the American Medical Association, 325(23), 2392– 2393. https://doi.org/10.1001/jama.2020.22196

[27] Jantikar, M. A. (2020). A study on relationship between thyroid peroxidase antibodies (Anti-TPO antibodies) and thyroid dysfunction patients. International Journal of Clinical Biochemistry and Research, 7(2), 238–242.

[28] Chandey, M., Kaur, R., Mohan, G., & Mannan, R. (2016). Prevalence of hypothyroidism in adults by screening TSH: A study from North India. International Journal of Advances in Medicine, 3, 44–46. https://doi.org/10.18203/2349-3933.ijam20160186

[29] Sokal, A., Jarmakiewicz-Czaja, S., Tabarkiewicz, J., & Filip, R. (2021). Dietary intake of endocrine disrupting substances presents in environment and their impact on thyroid function. Nutrients, 13(3), 867. https://doi.org/10.3390/nu13030867

[30] Deshmukh, V., Behl, A., Iyer, V., Joshi, H., Dholye, J. P., & Varthakavi, P. K. (2013). Prevalence, clinical and biochemical profile of subclinical hypothyroidism in normal population in Mumbai. Indian Journal of Endocrinology and Metabolism, 17(3), 454–459. https://doi.org/10.4103/2230-8210.111641

[31] Bose, A., Sharma, N., Hemvani, N., & Chitnis, D. S. (2015). Hospital-based prevalence study on thyroid disorders in the Malwa region of Central India. International Journal of Current Microbiology and Applied Sciences, 4(6), 604–611.

[32] Abraham, R., Srinivasa Murugan, V., Pukazhvanthen, P., & Sen, S. K. (2009). Thyroid disorders in women of Puducherry. Indian Journal of Clinical Biochemistry, 24(1), 52–59. https://doi.org/10.1007/s12291- 009-0009-y

[33] Tipu, H. N., Ahmed, D., Bashir, M. M., & Asif, N. (2018). Significance of testing anti-thyroid autoantibodies in patients with deranged thyroid profile. Journal of Thyroid Research, 2018, 9610497. https://doi.org/10.1155/2018/9610497

[34] Unnikrishnan, A. G., Kalra, S., Sahay, R. K., Bantwal, G., John, M., & Tewari, N. (2013). Prevalence of hypothyroidism in adults: An epidemiological study in eight cities of India. Indian Journal of Endocrinology and Metabolism, 17(4), 647–652. https://doi.org/10.4103/2230-8210.113755

[35] Jayashankar, C.A., Avinash, S., Shashidharan, B., Vijaya Sarathi., Shruthi, K.R., Nikethan, D., Harshavardhan, J. (2015). The prevalence of antithyroid peroxidase antibodies in subclinical and clinical hypothyroid patients. International Journal of Research in Medical Sciences, 3, 3564–3566.

[36] Mohanty, S., Amruthlal, W., Reddy, G. C., Kusumanjali, G., Kanagasabapathy, A. S., & Rao, P. (2008). Diagnostic strategies for subclinical hypothyroidism. Indian Journal of Clinical Biochemistry, 23(3), 279– 282. https://doi.org/10.1007/s12291-008-0062-y

[37] Bjoro, T., Holmen, J., Krüger, O., Midthjell, K., Hunstad, K., Schreiner, T., Sandnes, L., Brochmann, H., & The Health Study of Nord-Trondelag (HUNT). (2000). Prevalence of thyroid disease, thyroid dysfunction and thyroid peroxidase antibodies in a large, unselected population. European Journal of Endocrinology, 143(5), 639–647. https://doi.org/10.1530/eje.0.1430639

[38] Ghoraishian, S. M., Hekmati Moghaddam, S. H., & Afkhami-Ardekani, M. (2006). Relationship between anti-thyroid peroxidase antibody and thyroid function test. Iranian Journal of Immunology, 3(3), 146– 149.

[39] Swain, M., Swain, T., & Mohanty, B. K. (2005). Autoimmune thyroid disorders-An update. Indian Journal of Clinical Biochemistry, 20(1), 9–17. https://doi.org/10.1007/BF02893034