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Association between subclinical thyroid dysfunction and depressive symptoms in the Korean adult population: The 2014 Korea National Health and Nutrition Examination Survey

BACKGROUND: Clinical hyper and hypothyroidism are associated with a risk for depression. OBJECTIVES: This study was performed to investigate the association between depressive symptoms and subclinical thyroid dysfunction. METHODS: Among the 7,550 subjects who participated in the 2014 Korea National...

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Autores principales: Hong, Jae Won, Noh, Jung Hyun, Kim, Dong-Jun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6091963/
https://www.ncbi.nlm.nih.gov/pubmed/30106989
http://dx.doi.org/10.1371/journal.pone.0202258
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author Hong, Jae Won
Noh, Jung Hyun
Kim, Dong-Jun
author_facet Hong, Jae Won
Noh, Jung Hyun
Kim, Dong-Jun
author_sort Hong, Jae Won
collection PubMed
description BACKGROUND: Clinical hyper and hypothyroidism are associated with a risk for depression. OBJECTIVES: This study was performed to investigate the association between depressive symptoms and subclinical thyroid dysfunction. METHODS: Among the 7,550 subjects who participated in the 2014 Korea National Health and Nutrition Examination Survey, 1,763 participants without overt thyroid disease were included in this study. Serum thyroid stimulating hormone (TSH), serum free thyroxine (fT4), and depressive symptoms were analyzed based on the Patient Health Questionnaire (PHQ9). RESULTS: The percentages of subjects with subclinical hypothyroidism and subclinical hyperthyroidism were 3.3% and 2.6%, respectively. The percentages of subjects with moderate (10–14 points), moderately severe (15–19 points), and severe (≥20 points) depression according to the distribution of PHQ-9 scores were 4.7%, 1.1%, and 0.3%, respectively. TSH, fT4, and the percentage of patients with subclinical hypothyroidism were not significantly associated with PHQ-9 score. However, the percentage of patients with subclinical hyperthyroidism increased significantly with PHQ9 score (P = 0.002). Subjects with subclinical hyperthyroidism had higher PHQ-9 scores than those with normal thyroid function (mean ± standard error [SE], 4.2 ± 0.5 vs. 2.7 ± 0.1 points, P = 0.010). More subjects with subclinical hyperthyroidism had a PHQ9 score ≥ 10 than did those with normal thyroid function (mean ± SE, 17.1 ± 3.5 vs. 5.8 ± 0.6%, P = 0.005). We performed logistic regression analyses for the presence of depressive symptoms, using age, sex, education, household income, alcohol drinking, smoking, diabetes, cerebrovascular disease history, subclinical hypothyroidism, and subclinical hyperthyroidism as variables. Subclinical hyperthyroidism was associated with the presence of clinically relevant depression (PHQ9 score ≥ 10), (odds ratio [OR], 4.04; 95% confidence interval [CI], 1.75–9.31; P = 0.001), and clinically significant depression (PHQ9 score ≥ 15), (OR, 7.05; 95% CI, 1.67–29.67; P = 0.008), respectively. However, subclinical hypothyroidism was not associated with the presence of clinically relevant depression (OR, 1.15; 95% CI, 0.39–3.38; P = 0.800), or clinically significant depression (OR, 3.35; 95% CI, 0.71–15.79; P = 0.127). CONCLUSIONS: We demonstrated that subclinical hyperthyroidism was independently associated with depressive symptoms in the Korean general population using national cross-sectional data.
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spelling pubmed-60919632018-08-30 Association between subclinical thyroid dysfunction and depressive symptoms in the Korean adult population: The 2014 Korea National Health and Nutrition Examination Survey Hong, Jae Won Noh, Jung Hyun Kim, Dong-Jun PLoS One Research Article BACKGROUND: Clinical hyper and hypothyroidism are associated with a risk for depression. OBJECTIVES: This study was performed to investigate the association between depressive symptoms and subclinical thyroid dysfunction. METHODS: Among the 7,550 subjects who participated in the 2014 Korea National Health and Nutrition Examination Survey, 1,763 participants without overt thyroid disease were included in this study. Serum thyroid stimulating hormone (TSH), serum free thyroxine (fT4), and depressive symptoms were analyzed based on the Patient Health Questionnaire (PHQ9). RESULTS: The percentages of subjects with subclinical hypothyroidism and subclinical hyperthyroidism were 3.3% and 2.6%, respectively. The percentages of subjects with moderate (10–14 points), moderately severe (15–19 points), and severe (≥20 points) depression according to the distribution of PHQ-9 scores were 4.7%, 1.1%, and 0.3%, respectively. TSH, fT4, and the percentage of patients with subclinical hypothyroidism were not significantly associated with PHQ-9 score. However, the percentage of patients with subclinical hyperthyroidism increased significantly with PHQ9 score (P = 0.002). Subjects with subclinical hyperthyroidism had higher PHQ-9 scores than those with normal thyroid function (mean ± standard error [SE], 4.2 ± 0.5 vs. 2.7 ± 0.1 points, P = 0.010). More subjects with subclinical hyperthyroidism had a PHQ9 score ≥ 10 than did those with normal thyroid function (mean ± SE, 17.1 ± 3.5 vs. 5.8 ± 0.6%, P = 0.005). We performed logistic regression analyses for the presence of depressive symptoms, using age, sex, education, household income, alcohol drinking, smoking, diabetes, cerebrovascular disease history, subclinical hypothyroidism, and subclinical hyperthyroidism as variables. Subclinical hyperthyroidism was associated with the presence of clinically relevant depression (PHQ9 score ≥ 10), (odds ratio [OR], 4.04; 95% confidence interval [CI], 1.75–9.31; P = 0.001), and clinically significant depression (PHQ9 score ≥ 15), (OR, 7.05; 95% CI, 1.67–29.67; P = 0.008), respectively. However, subclinical hypothyroidism was not associated with the presence of clinically relevant depression (OR, 1.15; 95% CI, 0.39–3.38; P = 0.800), or clinically significant depression (OR, 3.35; 95% CI, 0.71–15.79; P = 0.127). CONCLUSIONS: We demonstrated that subclinical hyperthyroidism was independently associated with depressive symptoms in the Korean general population using national cross-sectional data. Public Library of Science 2018-08-14 /pmc/articles/PMC6091963/ /pubmed/30106989 http://dx.doi.org/10.1371/journal.pone.0202258 Text en © 2018 Hong et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Hong, Jae Won
Noh, Jung Hyun
Kim, Dong-Jun
Association between subclinical thyroid dysfunction and depressive symptoms in the Korean adult population: The 2014 Korea National Health and Nutrition Examination Survey
title Association between subclinical thyroid dysfunction and depressive symptoms in the Korean adult population: The 2014 Korea National Health and Nutrition Examination Survey
title_full Association between subclinical thyroid dysfunction and depressive symptoms in the Korean adult population: The 2014 Korea National Health and Nutrition Examination Survey
title_fullStr Association between subclinical thyroid dysfunction and depressive symptoms in the Korean adult population: The 2014 Korea National Health and Nutrition Examination Survey
title_full_unstemmed Association between subclinical thyroid dysfunction and depressive symptoms in the Korean adult population: The 2014 Korea National Health and Nutrition Examination Survey
title_short Association between subclinical thyroid dysfunction and depressive symptoms in the Korean adult population: The 2014 Korea National Health and Nutrition Examination Survey
title_sort association between subclinical thyroid dysfunction and depressive symptoms in the korean adult population: the 2014 korea national health and nutrition examination survey
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6091963/
https://www.ncbi.nlm.nih.gov/pubmed/30106989
http://dx.doi.org/10.1371/journal.pone.0202258
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