Saadeh Nesreen A, Saadeh Rami, Rousan Liqa A, Rawashdeh Dalia, Obeidat Aya, Saadeh Abdullah M
Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Int J Gen Med. 2020 Jun 15;13:305-310. doi: 10.2147/IJGM.S252114. eCollection 2020.
Early diagnosis and management of subclinical hypothyroidism (SCH) are important to avoid the risk of developing overt hypothyroidism. This study aimed to evaluate patients with subclinical hypothyroidism (SCH), in regard to their biochemical characteristics, and ultrasound features, and factors associated with initiating treatment for this condition.
This was a retrospective study, which reviewed the data of patients who visited the Endocrinology clinic of a tertiary hospital in Jordan, King Abdullah University Hospital. Patients who visited the clinic with SCH over 1 year, Jan 2016-Dec 2016, were included. The charts were reviewed again 2 years later to check patients who started L-thyroxine for the different indications of treatment of SCH. Thyroid function tests (free T3, free T4, and TSH) and thyroid peroxidase antibodies (TPO-Ab) were found to be measured for all cases (n=287), among whom, thyroid ultrasound was done for 43 patients.
Most patients were females (88.1%). Mean age was 42.36 (±15.36 years). Positive TPO-Ab status was associated with higher TSH (p=0.056), lower free T4 levels (p= 0.012), and more patients treated with L- thyroxine for SCH in 2 years (p=0.001). On ultrasound, hypoechogenicity was more predominant among TPO-Ab positive patients than TPO-Ab negative patients (78% vs 30%).
SCH patients with positive TPO-Abs were more likely to be treated for this condition based on the various indications, and more likely to have had hypoechogenicity on ultrasound. Hence, thyroid ultrasonography and TPO-Ab status should be implemented early in evaluating and treating patients with SCH.
亚临床甲状腺功能减退症（SCH）的早期诊断和管理对于避免发展为显性甲状腺功能减退症的风险至关重要。本研究旨在评估亚临床甲状腺功能减退症（SCH）患者的生化特征、超声特征以及与启动该疾病治疗相关的因素。
这是一项回顾性研究，回顾了约旦阿卜杜拉国王大学医院一家三级医院内分泌科就诊患者的数据。纳入了2016年1月至2016年12月期间因SCH就诊超过1年的患者。两年后再次查阅病历，以检查因SCH的不同治疗指征开始使用左甲状腺素的患者。发现所有病例（n = 287）均进行了甲状腺功能测试（游离T3、游离T4和促甲状腺激素）和甲状腺过氧化物酶抗体（TPO - Ab）检测，其中43例患者进行了甲状腺超声检查。
大多数患者为女性（88.1%）。平均年龄为42.36（±15.36岁）。TPO - Ab阳性状态与较高的促甲状腺激素水平（p = 0.056）、较低的游离T4水平（p = 0.012）以及两年内更多接受左甲状腺素治疗的SCH患者相关（p = 0.001）。在超声检查中，TPO - Ab阳性患者的低回声比TPO - Ab阴性患者更常见（78%对30%）。
TPO - Abs阳性的SCH患者更有可能基于各种指征接受该疾病的治疗，并且在超声检查中更有可能出现低回声。因此，在评估和治疗SCH患者时应尽早进行甲状腺超声检查和TPO - Ab状态检测。
