TY - JOUR
T1 - Prevalence and predictors of adequate treatment of overt hypothyroidism – a population-based study
AU - Nielsen, Julie Lindgard
AU - Karmisholt, Jesper
AU - Pedersen, Inge Bulow
AU - Carle, Allan
N1 - Copyright © 2022 Lindgård Nielsen et al.
PY - 2022/1
Y1 - 2022/1
N2 - The aim of this study is to evaluate the adequacy of treatment, and to identify factors influencing treatment of hypothyroidism. Patients newly diagnosed with overt hypothyroidism (
n=345) were identified via a register linked to a laboratory database. In selected periods with staff available, 165 patients were invited, and 113 (68.5 %) accepted participating in a comprehensive program including blood tests and completion of questionnaires. We performed a longitudinal follow-up on thyroid function tests 10 years after the diagnosis. Time to reach a serum TSH level of 0.2-10 mU/L (termed as clinically acceptable) and biochemical normalization (TSH: 0.2-5.0 mU/L), respectively, were analyzed using Kaplan Meier survival analysis. Predictors for longer duration to reach the normal TSH range were identified using cox proportional hazards regression. Only 67.7 % of the patients were in the euthyroid range on the long term after diagnosis of overt hypothyroidism (2 years: 59.4 %; 10 years: 67.7 %). Median time to the first normal TSH was 8.9 months (95 % CI: 7.6-10.2 months). The factors associated with longer duration until normalization of TSH after multivariate analysis were age (HR 0.79 per 10 years; 95 % CI: 0.66-0.94;
P = <0.01), smoking (HR 0.47; 95 % CI: 0.26-0.83;
P = <0.01), serum TSH at diagnosis (HR 0.96 per 10 mU/L; 95 % CI: 0.93-0.99;
P = 0.02) and BMI (HR 0.96 per kg/m
2; 95 % CI: 0.91-0.99;
P = 0.03). A considerable number of hypothyroid patients remained inadequately treated. When treating hypothyroid patients, special attention should be addressed to those patients who never or lately obtain euthyroid status.
AB - The aim of this study is to evaluate the adequacy of treatment, and to identify factors influencing treatment of hypothyroidism. Patients newly diagnosed with overt hypothyroidism (
n=345) were identified via a register linked to a laboratory database. In selected periods with staff available, 165 patients were invited, and 113 (68.5 %) accepted participating in a comprehensive program including blood tests and completion of questionnaires. We performed a longitudinal follow-up on thyroid function tests 10 years after the diagnosis. Time to reach a serum TSH level of 0.2-10 mU/L (termed as clinically acceptable) and biochemical normalization (TSH: 0.2-5.0 mU/L), respectively, were analyzed using Kaplan Meier survival analysis. Predictors for longer duration to reach the normal TSH range were identified using cox proportional hazards regression. Only 67.7 % of the patients were in the euthyroid range on the long term after diagnosis of overt hypothyroidism (2 years: 59.4 %; 10 years: 67.7 %). Median time to the first normal TSH was 8.9 months (95 % CI: 7.6-10.2 months). The factors associated with longer duration until normalization of TSH after multivariate analysis were age (HR 0.79 per 10 years; 95 % CI: 0.66-0.94;
P = <0.01), smoking (HR 0.47; 95 % CI: 0.26-0.83;
P = <0.01), serum TSH at diagnosis (HR 0.96 per 10 mU/L; 95 % CI: 0.93-0.99;
P = 0.02) and BMI (HR 0.96 per kg/m
2; 95 % CI: 0.91-0.99;
P = 0.03). A considerable number of hypothyroid patients remained inadequately treated. When treating hypothyroid patients, special attention should be addressed to those patients who never or lately obtain euthyroid status.
KW - Treatment
KW - hypothyroidism
KW - overt hypothyroidism
KW - population-based study
UR - http://www.scopus.com/inward/record.url?scp=85127700488&partnerID=8YFLogxK
U2 - 10.17179/excli2021-4291
DO - 10.17179/excli2021-4291
M3 - Journal article
C2 - 35145368
SN - 1611-2156
VL - 21
SP - 104
EP - 116
JO - EXCLI journal
JF - EXCLI journal
ER -