Subclinical Thyroid Dysfunction and Depressive Symptoms among the Elderly: A Prospective Cohort Study

Blum, Manuel R.; Wijsman, Liselotte W.; Virgini, Vanessa; Bauer, Douglas C.; Elzen, Wendy P. J. den; Jukema, J. Wouter; Buckley, Brendan M.; Craen, Anton J. M. de; Kearney, Patricia M.; Stott, David J.; Gussekloo, Jacobijn; Westendorp, Rudi G.J.; Mooijaart, Simon P.; Rodondi, Nicolas

doi:10.1159/000437387

Cited by 56 publications

(38 citation statements)

References 45 publications

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“…B. 's et al and Delitala, A. P.'s et al studies confirmed thyroid hormone relates to depression, while some other articles concluded that no significant difference in depressive symptoms has been found between euthyroid and SCH patients [27][28][29][30][31] . Recently, Kim, M. D. et al found that depressed individuals with SCH are more likely to meet the criteria for MetS, indicating the existence of the complicated relation among depression, SCH and MetS 32 .…”

Section: Discussionmentioning

confidence: 90%

Subclinical hypothyroidism and anxiety may contribute to metabolic syndrome in Sichuan of China: a hospital-based population study

Zhang

Luo

et al. 2020

Sci Rep

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the prevalence of Metabolic syndrome (MetS) in Sichuan of china has not yet been estimated. Meanwhile the association among anxiety, subclinical hypothyroidism (SCH) and MetS was less wellstudied. The data was retrieved retrospectively from Health Promotion Center of West China Hospital database between 2014 and 2017. Internal validation by randomizing into training and testing panel by 9:1 and external validation with National Health and Nutrition Examination Survey (NHNES) were conducted. 19006 subjects were included into analysis, and 3530 (18.6%) of them were diagnosed with MetS. In training panel, age, sex (male), SCH (presence), SAS score, alcohol (Sometimes & Usual) and smoking (Active) were identified as independent risk factors for MetS, which was confirmed in testing panel internally. NHNES data validated externally the association between free thyroxine (fT4) and MetS components. The C-indices of predicting MetS nomogram were 0.705 (95% CI: 0.696-0.714) and 0.728 (95% CI: 0.701-0.754) in training and testing panel respectively. In conclusion, MetS prevalence was 18.6% in Sichuan. SCH and anxiety may be associated with MetS independently. A risk scale-based nomogram with accurate and objective prediction ability was provided for check-up practice, but more cohort validation was needed.

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Section: Discussionmentioning

confidence: 90%

Subclinical hypothyroidism and anxiety may contribute to metabolic syndrome in Sichuan of China: a hospital-based population study

Zhang

Luo

et al. 2020

Sci Rep

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“…For example, some studies applied drug utilization approaches or electronic health record analysis based on prescriptions data, pharmacy claims, or surveys to identify consumption of antithyroid medication and estimate the prevalence of treated hypothyroidism [21, 51-54]. Furthermore, many studies investigated the prevalence of this disorder or its role as a risk factor for other diseases in specific populations, for example in pregnant women, patients with diabetes, patients with cardiovascular diseases, or immunocompromised individuals [12, 24, 55-59]. Therefore, there is room and need for systematically review of the evidence on the prevalence of undiagnosed hypothyroidism in the general population.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Undiagnosed Hypothyroidism in Europe: A Systematic Review and Meta-Analysis

Mendes

Alves

Silverio³

et al. 2019

Eur Thyroid J

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Background: Patients with undiagnosed hypothyroidism are not treated for the disease and are at high risk of developing serious complications, with major impact on public health. There is a need to systematically review the available evidence on this topic. Objective: To identify the prevalence of undiagnosed hypothyroidism in Europe. Methods: A systematic review of the literature (Medline, EMBASE, and Cochrane Central) was performed to identify epidemiological studies on the prevalence of undiagnosed hypothyroidism among European populations published between January 2008 and April 2018. The Newcastle-Ottawa Scale was used to assess the methodological quality of the included studies. Random-effects meta-analyses were performed to pool estimates of proportions (with 95% confidence intervals [CIs]) of undiagnosed (1) subclinical, (2) overt, and (3) total hypothyroidism. Results: The search returned 15,565 citations (4,526 duplicates). Twenty papers were included in the study. Fourteen and 6 studies were of good and moderate methodological quality, respectively. The results of the meta-analyses were as follows for the prevalence of undiagnosed hypothyroidism: subclinical, 4.11% (95% CI 3.05–5.31%, I² = 99.32%); overt, 0.65% (95% CI 0.38–0.99%, I² = 96.67%); and total, 4.70% (95% CI 2.98–6.79%, I² = 99.53%). According to the sensitivity analysis, the prevalence of hypothyroidism tends to be higher in female patients, in those aged ≥65 years, among studies with lower sample sizes, in those with thyroid-stimulating hormone levels <4.5 mIU/L, and in Eastern and Southern Europe. Conclusions: The current evidence suggests that a considerable proportion of the European population has hypothyroidism, particularly subclinical hypothyroidism, which is undiagnosed. This issue deserves further investigation because of possible deleterious consequences for public health.

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“…Berent et al represented that free thyroid hormone concentrations were associated with depression severity (9). Blum et al's study revealed that after a three-year follow-up, depressive symptoms were not associated with hypothyroidism in the elderly population; however, GDS scores were significantly higher in hyperthyroid patients (8). Kamble et al reported a significant decrease in the T3 level and an increase in the T4 level in depressed middle-aged adults (mean age 40.2 ± 10.3 years) (20).…”

Section: Discussionmentioning

confidence: 98%

“…Thyroid hormones have well-known impacts on metabolic activities in the adult brain and thyroid dysfunction has been associated with different neuropsychiatric problems such as depressive disorders. The American Psychiatric Association guidelines suggest a thyroid function examination when evaluating depressive patients (8). Previous studies demonstrated various associations between depressive symptoms and thyroid function; some showed this association with hypothyroidism; some others with hyperthyroidism; and a few studies reported the association between depression and euthyroidism (8-12).…”

Section: Introductionmentioning

confidence: 99%

Thyroid Function and Depressive Symptoms in Older Adults: A Five-Year Follow-Up

et al. 2020

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Background: Thyroid function and depressive disorders have a reciprocal correlation. Objectives: This study was performed to assess the association between thyroid function and depressive symptoms in older adults. Methods: In this cohort study, all older adults (aged 60 or over) recruited in the Amirkola Health and Ageing Cohort Project (AHAP) were followed from 2011 to 2016. At a baseline examination, depressive symptoms were assessed using the geriatric depression scale (GDS). Thyroid function was evaluated with the serum levels of T3, T4, and thyroid stimulating hormone (TSH). Older adults whose GDS scores showed no depressive symptoms at the baseline were followed for five years. The t-test, ANOVA, logistic regression model, and Pearson's correlation coefficient were used for data analysis. Results: Totally, 1,463 individuals completed the first phase of the study. We showed that 623 (45.3%) persons with a mean age of 69.6 ± 7.3 years had mild-to-severe depression and 840 (54.7%) individuals had no depressive symptoms. The baseline thyroid function of the participants showed that the mean levels of T3 (0.330), T4 (0.312), and TSH (0.064) had no significant difference between patients with depressive symptoms and individuals without these symptoms. After the baseline assessment, 571 individuals who did not have depressive symptoms were followed for five years. The results showed that 69 (12.1%) persons were hypothyroid and six (1.1%) were hyperthyroid. Overt or subclinical hypo (P = 0.103) or hyper (P = 0.128) thyroid function had no significant difference between older adults who were depressed and non-depressed. Conclusions: A five-year follow-up of elderly people revealed no significant correlation between depressive symptoms and thyroid function in this population.

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Subclinical Thyroid Dysfunction and Depressive Symptoms among the Elderly: A Prospective Cohort Study

Cited by 56 publications

References 45 publications

Subclinical hypothyroidism and anxiety may contribute to metabolic syndrome in Sichuan of China: a hospital-based population study

Subclinical hypothyroidism and anxiety may contribute to metabolic syndrome in Sichuan of China: a hospital-based population study

Prevalence of Undiagnosed Hypothyroidism in Europe: A Systematic Review and Meta-Analysis

Thyroid Function and Depressive Symptoms in Older Adults: A Five-Year Follow-Up

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