Sethi Bipin, Barua Sumitav, Raghavendra M S, Gotur Jagdish, Khandelwal Deepak, Vyas Upal
Department of Endocrinology, CARE Hospital, Hyderabad, Telangana, India.
Department of Medicine, Down Town Hospital, Guwahati, Assam, India.
Indian J Endocrinol Metab. 2017 Mar-Apr;21(2):302-307. doi: 10.4103/ijem.IJEM_387_16.
Appropriate treatment of hypothyroidism requires accurate diagnosis. This registry aimed to study the disease profile and treatment paradigm in hypothyroid patients in India.
We registered 1500 newly diagnosed, treatment-naïve, adult hypothyroid males and nonpregnant females across 33 centers and collected relevant data from medical records. The first analysis report on baseline data is presented here.
The mean age of the study population was 41.1 ± 14.01 years with a female to male ratio of 7:3. The most frequently reported symptoms and signs were fatigue (60.17%) and weight gain with poor appetite (36.22%). Menstrual abnormalities were reported in all women ( = 730) who had not attained menopause. Grades 1 and 2 goiter (as per the WHO) were observed in 15.41% and 3.27% patients, respectively. Comorbidities were reported in 545 patients (36.36%), type 2 diabetes mellitus being the most prevalent (13.54%) followed by hypertension (11.34%). Total serum thyroxine (T4) and thyroid-stimulating hormone (TSH) levels were assessed in 291 (19.47%) patients only. In majority of patients (81%), treatment was based on serum TSH levels alone. The dose of levothyroxine ranged from 12.5 to 375 mcg.
Guidelines suggest a diagnosis of hypothyroidism based on TSH and T4 levels. However, most of the patients as observed in this registry received treatment with levothyroxine based on TSH levels alone, thus highlighting the need for awareness and scientific education among clinicians in India. The use of standard doses (100, 75, and 25 mcg) of levothyroxine may point toward empirical management practices.
甲状腺功能减退症的恰当治疗需要准确诊断。本登记研究旨在探究印度甲状腺功能减退症患者的疾病概况及治疗模式。
我们在33个中心登记了1500例新诊断的、未接受过治疗的成年甲状腺功能减退男性患者及非妊娠女性患者，并从病历中收集相关数据。此处展示了关于基线数据的首份分析报告。
研究人群的平均年龄为41.1±14.01岁，女性与男性的比例为7:3。最常报告的症状和体征为疲劳（60.17%）以及体重增加伴食欲减退（36.22%）。所有未绝经的女性患者（n = 730）均报告有月经异常。分别有15.41%和3.27%的患者观察到1级和2级甲状腺肿（按照世界卫生组织标准）。545例患者（36.36%）报告有合并症，其中2型糖尿病最为常见（13.54%），其次是高血压（11.34%）。仅对291例（19.47%）患者评估了总血清甲状腺素（T4）和促甲状腺激素（TSH）水平。大多数患者（81%）的治疗仅基于血清TSH水平。左甲状腺素的剂量范围为12.5至375微克。
指南建议根据TSH和T4水平诊断甲状腺功能减退症。然而，正如本登记研究中所观察到的，大多数患者仅基于TSH水平接受左甲状腺素治疗，这凸显了印度临床医生提高认识并接受科学教育的必要性。左甲状腺素标准剂量（100、75和25微克）的使用可能表明存在经验性治疗做法。
