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Food Security and Income Are Predictors of Low Thyroid Stimulating Hormone (TSH) Levels in Latinx Adults With Euthyroidism – A Community-Based Study

OBJECTIVES: Health disparities are present in thyroid disorders because of multiple systemic and patient factors. Thyroid dysfunction may be a risk factor for cardiovascular disease, within the euthyroid range and other outcomes such as mood disorders may be impacted. The aim of this study was to ex...

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Autores principales: Martinez, Sabrina, Gutierrez, Margaret, Maisonet, Jezabel, Ayala, Juan, Pierre, Aydeivis Jean, Hospital, Michelle, Kallus, Laura, Martinez, Janet Diaz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9193384/
http://dx.doi.org/10.1093/cdn/nzac051.057
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author Martinez, Sabrina
Gutierrez, Margaret
Maisonet, Jezabel
Ayala, Juan
Pierre, Aydeivis Jean
Hospital, Michelle
Kallus, Laura
Martinez, Janet Diaz
author_facet Martinez, Sabrina
Gutierrez, Margaret
Maisonet, Jezabel
Ayala, Juan
Pierre, Aydeivis Jean
Hospital, Michelle
Kallus, Laura
Martinez, Janet Diaz
author_sort Martinez, Sabrina
collection PubMed
description OBJECTIVES: Health disparities are present in thyroid disorders because of multiple systemic and patient factors. Thyroid dysfunction may be a risk factor for cardiovascular disease, within the euthyroid range and other outcomes such as mood disorders may be impacted. The aim of this study was to examine the relationship between thyroid function (TSH) and social determinants of health and clinical measures in an euthyroid Latinx patient sample from a community health clinic. METHODS: A needs assessments was completed using a random sample of 93 de-identified medical records of individuals seeking mental health care at Caridad Center in Boynton Beach, Fl. Demographics, diagnoses, laboratory tests results and the Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE) questionnaire data were abstracted. The cut-off point for high TSH was ≥2 mU/L and low TSH as <2 mU/L. Statistical analyses included descriptive statistics, Mann-Whitney U, chi-squared tests, and logistic regression. RESULTS: The mean age was 51.9 ± 11.8 years and 82.8% were female. Over 75% were within 100% of the federal poverty level (FPL) and over 30% were food insecure. Those with low TSH compared with high TSH, had a higher proportion of food insecurity (43.5% vs 18.8%, P = 0.009) and 100% FPL level (86.4% vs. 63.4%, p = 0.013). In the univariate models, food insecurity (OR 3.33, 95% CI 1.31–8.44, P = 0.011) and 100% FPL (OR 4.68, 95% CI 1.51–14.48, P = 0.007) was positively associated with the risk of having low TSH. These relationships remained in the multivariate models for food security (OR 3.69, 95% CI 1.27–10.75, P = 0.016) and 100% FPL (OR 4.03, 95% CI 1.30–12.45, P = 0.015), adjusted for age, sex, BMI, hypertension, diabetes, cardiovascular disease risk factors, multimorbidity, and unemployment. CONCLUSIONS: In a euthyroid Latinx adult population who received mental health care at a community clinic, lower TSH levels was independently associated with measures of poverty. There is controversy in the literature about the normal range of TSH, especially since subclinical hypothyroidism within the normal range may still be associated with adverse health outcomes. These relationships warrant further study in order to inform future public health policies and follow-up care for underserved and vulnerable communities. FUNDING SOURCES: FIU RCMI/NIMHD.
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spelling pubmed-91933842022-06-14 Food Security and Income Are Predictors of Low Thyroid Stimulating Hormone (TSH) Levels in Latinx Adults With Euthyroidism – A Community-Based Study Martinez, Sabrina Gutierrez, Margaret Maisonet, Jezabel Ayala, Juan Pierre, Aydeivis Jean Hospital, Michelle Kallus, Laura Martinez, Janet Diaz Curr Dev Nutr Community and Public Health Nutrition OBJECTIVES: Health disparities are present in thyroid disorders because of multiple systemic and patient factors. Thyroid dysfunction may be a risk factor for cardiovascular disease, within the euthyroid range and other outcomes such as mood disorders may be impacted. The aim of this study was to examine the relationship between thyroid function (TSH) and social determinants of health and clinical measures in an euthyroid Latinx patient sample from a community health clinic. METHODS: A needs assessments was completed using a random sample of 93 de-identified medical records of individuals seeking mental health care at Caridad Center in Boynton Beach, Fl. Demographics, diagnoses, laboratory tests results and the Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE) questionnaire data were abstracted. The cut-off point for high TSH was ≥2 mU/L and low TSH as <2 mU/L. Statistical analyses included descriptive statistics, Mann-Whitney U, chi-squared tests, and logistic regression. RESULTS: The mean age was 51.9 ± 11.8 years and 82.8% were female. Over 75% were within 100% of the federal poverty level (FPL) and over 30% were food insecure. Those with low TSH compared with high TSH, had a higher proportion of food insecurity (43.5% vs 18.8%, P = 0.009) and 100% FPL level (86.4% vs. 63.4%, p = 0.013). In the univariate models, food insecurity (OR 3.33, 95% CI 1.31–8.44, P = 0.011) and 100% FPL (OR 4.68, 95% CI 1.51–14.48, P = 0.007) was positively associated with the risk of having low TSH. These relationships remained in the multivariate models for food security (OR 3.69, 95% CI 1.27–10.75, P = 0.016) and 100% FPL (OR 4.03, 95% CI 1.30–12.45, P = 0.015), adjusted for age, sex, BMI, hypertension, diabetes, cardiovascular disease risk factors, multimorbidity, and unemployment. CONCLUSIONS: In a euthyroid Latinx adult population who received mental health care at a community clinic, lower TSH levels was independently associated with measures of poverty. There is controversy in the literature about the normal range of TSH, especially since subclinical hypothyroidism within the normal range may still be associated with adverse health outcomes. These relationships warrant further study in order to inform future public health policies and follow-up care for underserved and vulnerable communities. FUNDING SOURCES: FIU RCMI/NIMHD. Oxford University Press 2022-06-14 /pmc/articles/PMC9193384/ http://dx.doi.org/10.1093/cdn/nzac051.057 Text en © The Author 2022. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Community and Public Health Nutrition
Martinez, Sabrina
Gutierrez, Margaret
Maisonet, Jezabel
Ayala, Juan
Pierre, Aydeivis Jean
Hospital, Michelle
Kallus, Laura
Martinez, Janet Diaz
Food Security and Income Are Predictors of Low Thyroid Stimulating Hormone (TSH) Levels in Latinx Adults With Euthyroidism – A Community-Based Study
title Food Security and Income Are Predictors of Low Thyroid Stimulating Hormone (TSH) Levels in Latinx Adults With Euthyroidism – A Community-Based Study
title_full Food Security and Income Are Predictors of Low Thyroid Stimulating Hormone (TSH) Levels in Latinx Adults With Euthyroidism – A Community-Based Study
title_fullStr Food Security and Income Are Predictors of Low Thyroid Stimulating Hormone (TSH) Levels in Latinx Adults With Euthyroidism – A Community-Based Study
title_full_unstemmed Food Security and Income Are Predictors of Low Thyroid Stimulating Hormone (TSH) Levels in Latinx Adults With Euthyroidism – A Community-Based Study
title_short Food Security and Income Are Predictors of Low Thyroid Stimulating Hormone (TSH) Levels in Latinx Adults With Euthyroidism – A Community-Based Study
title_sort food security and income are predictors of low thyroid stimulating hormone (tsh) levels in latinx adults with euthyroidism – a community-based study
topic Community and Public Health Nutrition
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9193384/
http://dx.doi.org/10.1093/cdn/nzac051.057
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