Saima Naz, Farkhanda Ghafoor, Amir Razi, Shahid Ghafoor.
Thyroid dysfunction and autoimmunity in females in goitre endemic area.
Pak J Med Res Jan ;48(2):25-30.

Objective: To study thyroid dysfunction and thyroid autoimmunity among females with and without goitre in goitre endemic area. Subjects and Methods: A cross sectional survey was carried out during the year 2007 in Chakar, district Muzafarabad. A group of 100 females 18-65 years of age were included; among them 50% having goitre were included in group I as cases and 50% asymptomatic females were included in group II as asymptomatic controls. Goitre was graded according to World Health Organization recommended criteria. For each study participant thyroid function status was assessed by T3, T4, thyroid stimulating hormone levels and thyroid autoimmunity by anti thyroid peroxidase and anti thyroglobin antibody levels. Data was analyzed using SPSS 12. Results: Mean thyroid stimulating hormone levels were found higher (18.0±7.4) in cases (group I) than in asymptomatic controls (group II) (3.2±1.6). On the basis of thyroid stimulating hormone, among cases 32 (64%) were primary hypothyroid, 11 (22%) were subclinical hypothyroid and 7 (14%) were euthyroid, whereas among asymptomatic controls it was 10 (20%), 13 (26%) and 27 (54%) respectively. Mean thyroid stimulating hormone decreased from 27.3 to 13.0 mIU/ml in goitre and from 5.6 to 1.2 mIU/ml in non-goitre at 16-65 years of age. Frequency of anti thyroid peroxidase and anti thyroglobin antibody was found 22 (44%) and 18 (36%) among cases, while 16 (32%) and 15 (30%) among asymptomatic controls respectively. No association was found between age and presence of goitre with anti thyroglobin or anti thyroid peroxidase positive antibodies (p>0.05), whereas association between anti thyroglobin and anti thyroid peroxidase antibodies with high thyroid stimulating hormone levels among study groups was found significant (p<0.05). High proportions of anti thyroid peroxidase and anti thyroglobin positive cases were found between ages 26-45 years. Conclusion: The frequency of thyroid dysfunction and autoantibody in females of goitre endemic area was high, but showed no relation with the presence of goitre. Thyroid stimulating hormone had an inverse relationship with age among goitre and non-goitre cases. Positive anti thyroid peroxidase and anti thyroglobin antibodies were not age related, however they were found to be associated with elevated levels of thyroid stimulating hormone.

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