Cargando…
Severity of hypothyroidism is inversely associated with impaired quality of life in patients referred to an endocrine clinic
PURPOSE: We investigated the association between health-related quality of life (HRQL) and the severity of hypothyroidism at diagnosis in patients referred to a secondary hospital clinic. METHODS: Sixty-seven adult patients referred from primary care were enrolled. All patients had newly diagnosed h...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10472621/ https://www.ncbi.nlm.nih.gov/pubmed/37658415 http://dx.doi.org/10.1186/s13044-023-00178-0 |
_version_ | 1785100117932507136 |
---|---|
author | Larsen, Camilla B. Winther, Kristian Hillert Cramon, Per Karkov Rasmussen, Åse Krogh Feldt-Rasmussen, Ulla Groenvold, Mogens Bjorner, Jakob Bue Hegedüs, Laszlo Watt, Torquil Bonnema, Steen Joop |
author_facet | Larsen, Camilla B. Winther, Kristian Hillert Cramon, Per Karkov Rasmussen, Åse Krogh Feldt-Rasmussen, Ulla Groenvold, Mogens Bjorner, Jakob Bue Hegedüs, Laszlo Watt, Torquil Bonnema, Steen Joop |
author_sort | Larsen, Camilla B. |
collection | PubMed |
description | PURPOSE: We investigated the association between health-related quality of life (HRQL) and the severity of hypothyroidism at diagnosis in patients referred to a secondary hospital clinic. METHODS: Sixty-seven adult patients referred from primary care were enrolled. All patients had newly diagnosed hypothyroidism due to autoimmune thyroiditis and were treated with levothyroxine (LT4). The dose was adjusted according to thyroid function tests aiming at a normal plasma thyrotropin. Patients were stratified according to the severity of hypothyroidism in two different ways: the conventional approach (subclinical or overt hypothyroidism) and a novel approach according to the change (decrease or increase) in plasma level of free triiodothyronine index (FT3I) following LT4 treatment. The ThyPRO-39 questionnaire was used for measurement of HRQL at referral to the Endocrine Outpatient Clinic (higher score corresponds to worse HRQL). RESULTS: Free thyroxine index (FT4I) at diagnosis correlated positively with the scores on the Hypothyroid Symptoms and Tiredness scales (p = 0.018 for both). In accordance, patients with subclinical hypothyroidism (n = 36) scored higher on Hypothyroid Symptoms (p = 0.029) than patients with overt hypothyroidism (n = 31). The difference in HRQL was more pronounced if patients were stratified according to the dynamics in FT3I following LT4 treatment. Thus, patients who showed a decrease in FT3I following treatment (n = 24) scored significantly worse for Anxiety (p = 0.032) and Emotional Susceptibility (p = 0.035) than patients with an increase in FT3I (n = 43). CONCLUSION: Patients referred to an endocrine clinic with mild hypothyroidism had an impaired HRQL, compared to patients with more severe hypothyroidism. The most likely explanation of this finding is a lower threshold for seeking medical consultation and secondary care referral if HRQL is deteriorated. The dynamics in plasma FT3I following treatment may be more sensitive for such a discrimination in HRQL than a stratification according to the thyroid function tests at diagnosis. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13044-023-00178-0. |
format | Online Article Text |
id | pubmed-10472621 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-104726212023-09-02 Severity of hypothyroidism is inversely associated with impaired quality of life in patients referred to an endocrine clinic Larsen, Camilla B. Winther, Kristian Hillert Cramon, Per Karkov Rasmussen, Åse Krogh Feldt-Rasmussen, Ulla Groenvold, Mogens Bjorner, Jakob Bue Hegedüs, Laszlo Watt, Torquil Bonnema, Steen Joop Thyroid Res Research PURPOSE: We investigated the association between health-related quality of life (HRQL) and the severity of hypothyroidism at diagnosis in patients referred to a secondary hospital clinic. METHODS: Sixty-seven adult patients referred from primary care were enrolled. All patients had newly diagnosed hypothyroidism due to autoimmune thyroiditis and were treated with levothyroxine (LT4). The dose was adjusted according to thyroid function tests aiming at a normal plasma thyrotropin. Patients were stratified according to the severity of hypothyroidism in two different ways: the conventional approach (subclinical or overt hypothyroidism) and a novel approach according to the change (decrease or increase) in plasma level of free triiodothyronine index (FT3I) following LT4 treatment. The ThyPRO-39 questionnaire was used for measurement of HRQL at referral to the Endocrine Outpatient Clinic (higher score corresponds to worse HRQL). RESULTS: Free thyroxine index (FT4I) at diagnosis correlated positively with the scores on the Hypothyroid Symptoms and Tiredness scales (p = 0.018 for both). In accordance, patients with subclinical hypothyroidism (n = 36) scored higher on Hypothyroid Symptoms (p = 0.029) than patients with overt hypothyroidism (n = 31). The difference in HRQL was more pronounced if patients were stratified according to the dynamics in FT3I following LT4 treatment. Thus, patients who showed a decrease in FT3I following treatment (n = 24) scored significantly worse for Anxiety (p = 0.032) and Emotional Susceptibility (p = 0.035) than patients with an increase in FT3I (n = 43). CONCLUSION: Patients referred to an endocrine clinic with mild hypothyroidism had an impaired HRQL, compared to patients with more severe hypothyroidism. The most likely explanation of this finding is a lower threshold for seeking medical consultation and secondary care referral if HRQL is deteriorated. The dynamics in plasma FT3I following treatment may be more sensitive for such a discrimination in HRQL than a stratification according to the thyroid function tests at diagnosis. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13044-023-00178-0. BioMed Central 2023-09-01 /pmc/articles/PMC10472621/ /pubmed/37658415 http://dx.doi.org/10.1186/s13044-023-00178-0 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Larsen, Camilla B. Winther, Kristian Hillert Cramon, Per Karkov Rasmussen, Åse Krogh Feldt-Rasmussen, Ulla Groenvold, Mogens Bjorner, Jakob Bue Hegedüs, Laszlo Watt, Torquil Bonnema, Steen Joop Severity of hypothyroidism is inversely associated with impaired quality of life in patients referred to an endocrine clinic |
title | Severity of hypothyroidism is inversely associated with impaired quality of life in patients referred to an endocrine clinic |
title_full | Severity of hypothyroidism is inversely associated with impaired quality of life in patients referred to an endocrine clinic |
title_fullStr | Severity of hypothyroidism is inversely associated with impaired quality of life in patients referred to an endocrine clinic |
title_full_unstemmed | Severity of hypothyroidism is inversely associated with impaired quality of life in patients referred to an endocrine clinic |
title_short | Severity of hypothyroidism is inversely associated with impaired quality of life in patients referred to an endocrine clinic |
title_sort | severity of hypothyroidism is inversely associated with impaired quality of life in patients referred to an endocrine clinic |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10472621/ https://www.ncbi.nlm.nih.gov/pubmed/37658415 http://dx.doi.org/10.1186/s13044-023-00178-0 |
work_keys_str_mv | AT larsencamillab severityofhypothyroidismisinverselyassociatedwithimpairedqualityoflifeinpatientsreferredtoanendocrineclinic AT wintherkristianhillert severityofhypothyroidismisinverselyassociatedwithimpairedqualityoflifeinpatientsreferredtoanendocrineclinic AT cramonperkarkov severityofhypothyroidismisinverselyassociatedwithimpairedqualityoflifeinpatientsreferredtoanendocrineclinic AT rasmussenasekrogh severityofhypothyroidismisinverselyassociatedwithimpairedqualityoflifeinpatientsreferredtoanendocrineclinic AT feldtrasmussenulla severityofhypothyroidismisinverselyassociatedwithimpairedqualityoflifeinpatientsreferredtoanendocrineclinic AT groenvoldmogens severityofhypothyroidismisinverselyassociatedwithimpairedqualityoflifeinpatientsreferredtoanendocrineclinic AT bjornerjakobbue severityofhypothyroidismisinverselyassociatedwithimpairedqualityoflifeinpatientsreferredtoanendocrineclinic AT hegeduslaszlo severityofhypothyroidismisinverselyassociatedwithimpairedqualityoflifeinpatientsreferredtoanendocrineclinic AT watttorquil severityofhypothyroidismisinverselyassociatedwithimpairedqualityoflifeinpatientsreferredtoanendocrineclinic AT bonnemasteenjoop severityofhypothyroidismisinverselyassociatedwithimpairedqualityoflifeinpatientsreferredtoanendocrineclinic |