Severity of hypothyroidism is inversely associated with impaired quality of life in patients referred to an endocrine clinic
Abstract 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 diag...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | Thyroid Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13044-023-00178-0 |
| _version_ | 1797453673487400960 |
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| author | Camilla B. Larsen Kristian Hillert Winther Per Karkov Cramon Åse Krogh Rasmussen Ulla Feldt-Rasmussen Mogens Groenvold Jakob Bue Bjorner Laszlo Hegedüs Torquil Watt Steen Joop Bonnema |
| author_facet | Camilla B. Larsen Kristian Hillert Winther Per Karkov Cramon Åse Krogh Rasmussen Ulla Feldt-Rasmussen Mogens Groenvold Jakob Bue Bjorner Laszlo Hegedüs Torquil Watt Steen Joop Bonnema |
| author_sort | Camilla B. Larsen |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-03-09T15:26:47Z |
| format | Article |
| id | doaj.art-e9a97aa12c1a4e228ae5f699069b9675 |
| institution | Directory Open Access Journal |
| issn | 1756-6614 |
| language | English |
| last_indexed | 2024-03-09T15:26:47Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Thyroid Research |
| spelling | doaj.art-e9a97aa12c1a4e228ae5f699069b96752023-11-26T12:31:53ZengBMCThyroid Research1756-66142023-09-0116111010.1186/s13044-023-00178-0Severity of hypothyroidism is inversely associated with impaired quality of life in patients referred to an endocrine clinicCamilla B. Larsen0Kristian Hillert Winther1Per Karkov Cramon2Åse Krogh Rasmussen3Ulla Feldt-Rasmussen4Mogens Groenvold5Jakob Bue Bjorner6Laszlo Hegedüs7Torquil Watt8Steen Joop Bonnema9Department of Endocrinology, Odense University HospitalDepartment of Endocrinology, Odense University HospitalDepartment of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital RigshospitaletDepartment of Endocrinology and Metabolism, Copenhagen University Hospital RigshospitaletDepartment of Endocrinology and Metabolism, Copenhagen University Hospital RigshospitaletInstitute of Clinical Medicine, Faculty of Health and Clinical Sciences, Copenhagen UniversityDepartment of Public Health, University of CopenhagenDepartment of Endocrinology, Odense University HospitalDepartment of Endocrinology and Metabolism, Copenhagen University Hospital RigshospitaletDepartment of Endocrinology, Odense University HospitalAbstract 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.https://doi.org/10.1186/s13044-023-00178-0HypothyroidismAutoimmune thyroiditisHealth Related Quality of Life (HRQL)Disease severityTriiodothyronine (T3)Levothyroxine (LT4) substitution |
| spellingShingle | Camilla B. Larsen Kristian Hillert Winther Per Karkov Cramon Åse Krogh Rasmussen Ulla Feldt-Rasmussen Mogens Groenvold Jakob Bue Bjorner Laszlo Hegedüs Torquil Watt Steen Joop Bonnema Severity of hypothyroidism is inversely associated with impaired quality of life in patients referred to an endocrine clinic Thyroid Research Hypothyroidism Autoimmune thyroiditis Health Related Quality of Life (HRQL) Disease severity Triiodothyronine (T3) Levothyroxine (LT4) substitution |
| 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 | Hypothyroidism Autoimmune thyroiditis Health Related Quality of Life (HRQL) Disease severity Triiodothyronine (T3) Levothyroxine (LT4) substitution |
| url | https://doi.org/10.1186/s13044-023-00178-0 |
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