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Subclinical hyperthyroidism is associated with socioeconomic deprivation in elderly subjects
The background of the study. The frequency of thyroid dysfunction increases with age, but the reasons for the increase are not clear. This study was done to determine the frequency of thyroid dysfunction and to identify other health and socioeconomic factors associated with thyroid dysfunction in a cohort of elderly people.
How the study was done. The study subjects were 5872 subjects (2980 women and 2892 men) aged 65 years or more who attended family practices in the Birmingham (United Kingdom) area. The subjects were questioned about current medical diagnoses, and the Index of Medical Deprivation score was determined; this index is based on residence location and includes seven domains of deprivation (income, employment, health deprivation and disability, education and training, housing and services, crime, and living conditions). Serum thyrotropin (TSH) and free T4 were measured in all subjects.
The results of the study. Among the 5872 subjects, 5538 (94.3 percent) were euthyroid, with normal serum TSH concentrations, 15 (0.2 percent) had overt hyperthyroidism, 128 (2.2 percent) had subclinical hyperthyroidism, 168 (2.9 percent) had subclinical hypothyroidism, and 23 (0.4 percent) had overt hypothyroidism. The frequency of these disorders was similar in women and men, except that subclinical hypothyroidism was more common in women (3.6 vs. 2.1 percent).
The deprivation score was slightly higher (more deprived) in the subjects with subclinical hyperthyroidism and lower (less deprived) in those with subclinical hypothyroidism, as compared with the euthyroid subjects.
There was little difference in the frequency of 10 nonthyroidal disorders (among them, hypertension, neurologic disease, rheumatic disease, and vascular disease) in the subjects with subclinical hyperthyroidism or subclinical hypothyroidism and the euthyroid subjects.
The conclusions of the study. Among elderly subjects, subclinical hyperthyroidism is associated with greater socioeconomic deprivation and subclinical hypothyroidism with less socioeconomic deprivation, as compared with normal thyroid function.
The original article. Wilson S, Parle JV, Roberts LM, Roalfe AK, Hobbs FD, Clark P, Sheppard MC, Gammage MD, Pattison HM, Franklyn JA, on behalf on the Birmingham Elderly Thyroid Study Team. Prevalence of subclinical thyroid dysfunction and its relation to socioeconomic deprivation in the elderly: a community-based cross-sectional survey. J Clin Endocrinol Metab 2006;91:4809-16.
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