학술논문
Hashimoto's thyroiditis affects symptom load and quality of life unrelated to hypothyroidism: a prospective case-control study in women undergoing thyroidectomy for benign goiter
IMMUNOLOGY, AUTOIMMUNITY, AND GRAVES' OPHTHALMOPATHY
IMMUNOLOGY, AUTOIMMUNITY, AND GRAVES' OPHTHALMOPATHY
Document Type
Report
Author
Source
Thyroid. February 2011, Vol. 21 Issue 2, p161, 7 p.
Subject
Language
English
ISSN
1050-7256
Abstract
Introduction Chronic autoimmune thyroiditis (Hashimoto's thyroiditis [HT]) is a common disease, and is the most prevalent cause of subclinical or overt hypothyroidism in areas with sufficient iodine intake (1). The [...]
Background: Hashimoto's thyroiditis (HT) is a common disease, and is the most prevalent cause of hypothyroidism. Symptoms and diseases associated with HT are considered to be caused by hypothyroidism. We hypothesized that higher antithyroperoxidase (anti-TPO) antibody levels would be associated with an increased symptom load and a decreased quality of life in a female euthyroid patient collective. Methods: In a prospective cohort study 426 consecutive euthyroid female patients undergoing thyroid surgery for benign thyroid disease were included. Main outcome measures were preoperative anti-TPO levels, a symptom questionnaire and the SF-36 questionnaire, and lymphocytic infiltration of the thyroid tissue as evaluated by histology. Results: Histology revealed HT in 28/426 (6.6%) subjects. To maximize the sum of the predictive values, a cutoff point for anti-TPO of 121.0 IU/mL was calculated (sensitivity 93.3% [95% confidence interval: 77.9%-99.0%]; specificity 94.7% [95% confidence interval: 92.0%-96.7%]) to predict the presence of histological signs of HT. The mean number of reported symptoms was significantly higher in patients with anti-TPO levels >121.0 IU/mL than in the other group (6.7 [+ or -] 2.5 vs. 4.1 [+ or -] 2.8; p < 0.001). There were no differences in preoperative thyroidstimulating hormone levels (1.7 [+ or -] 1.3 vs. 1.5 [+ or -] 1.4 [micro]U/mL, respectively; p = 0.155). Chronic fatigue, dry hair, chronic irritability, chronic nervousness, a history of breast cancer and early miscarriage, and lower quality-of life levels were significantly associated with anti-TPO levels exceeding the cut-off point (p < 0.05). Conclusions: Women with HT suffer from a high symptom load. Hypothyroidism is only a contributing factor to the development of associated conditions.
Background: Hashimoto's thyroiditis (HT) is a common disease, and is the most prevalent cause of hypothyroidism. Symptoms and diseases associated with HT are considered to be caused by hypothyroidism. We hypothesized that higher antithyroperoxidase (anti-TPO) antibody levels would be associated with an increased symptom load and a decreased quality of life in a female euthyroid patient collective. Methods: In a prospective cohort study 426 consecutive euthyroid female patients undergoing thyroid surgery for benign thyroid disease were included. Main outcome measures were preoperative anti-TPO levels, a symptom questionnaire and the SF-36 questionnaire, and lymphocytic infiltration of the thyroid tissue as evaluated by histology. Results: Histology revealed HT in 28/426 (6.6%) subjects. To maximize the sum of the predictive values, a cutoff point for anti-TPO of 121.0 IU/mL was calculated (sensitivity 93.3% [95% confidence interval: 77.9%-99.0%]; specificity 94.7% [95% confidence interval: 92.0%-96.7%]) to predict the presence of histological signs of HT. The mean number of reported symptoms was significantly higher in patients with anti-TPO levels >121.0 IU/mL than in the other group (6.7 [+ or -] 2.5 vs. 4.1 [+ or -] 2.8; p < 0.001). There were no differences in preoperative thyroidstimulating hormone levels (1.7 [+ or -] 1.3 vs. 1.5 [+ or -] 1.4 [micro]U/mL, respectively; p = 0.155). Chronic fatigue, dry hair, chronic irritability, chronic nervousness, a history of breast cancer and early miscarriage, and lower quality-of life levels were significantly associated with anti-TPO levels exceeding the cut-off point (p < 0.05). Conclusions: Women with HT suffer from a high symptom load. Hypothyroidism is only a contributing factor to the development of associated conditions.