Clinical Perspective on Thyroid Hormones and Autoantibodies in Subclinical Hypothyroidism
Abstract
This study examines biochemical and immunological markers in individuals with subclinical hypothyroidism (SCH), particularly focusing on thyroid autoantibodies' role in disease progression. We recruited 200 patients from Vinayaka Mission Medical College and Research Institute having normal levels of triiodothyronine (T3) and tetraiodothyronine (T4) and excessive levels of thyroid stimulating hormone (TSH) (>4.0 mIU/L). Overt hypothyroidism, pregnancy, thyroid medication, and other illnesses that affect thyroid function were among the exclusion criteria. Chemiluminescent immunoassay and the Enzyme Linked Immunosorbent Assay were used to test fasting blood samples for serum TSH, T3, T4, Anti-Thyroglobulin Antibodies (AB-TG), and Anti-Thyroid Peroxidase Antibodies (AB-TPO). Thyroid compensation was indicated by aberrant T3 and T4 levels and markedly raised TSH levels (6.3 ± 0.16 mIU/L) in SCH patients. A strong association between TSH and AB-TPO levels (r = 0.45, p < 0.01) suggests an autoimmune involvement, as do elevated levels of AB-TG (170.97 ± 3.617 IU/mL) and AB-TPO (11.77 ± 0.313 IU/mL). These results emphasize the autoimmune aspect of SCH and imply that tracking thyroid autoantibodies may help with the course and treatment of the condition. Future research should explore gender-specific strategies in SCH diagnosis and clinical care.
Keywords:
Subclinical Hypothyroidism, Gender Differences, TSH, T3, T4, Anti-Thyroglobulin Antibodies, Anti-Thyroid Peroxidase AntibodiesDOI
https://doi.org/10.25004/References
Ayyappan S, Dhas PK. Selenium and selenium-dependent enzymes in hypothyroidism. Chettinad Health City Med J. 2024;13(1):87–91. Available from: doi.org 10.24321/2278.2044.202415.
Biondi B, Cooper DS. The clinical significance of subclinical thyroid dysfunction. Endocr Rev. 2008;29(1):76–131. Available from: doi.org/10.1210/er.2006-0043
Vanderpump MPJ, Tunbridge WMG. The epidemiology of thyroid diseases. In: Braverman LE, Utiger RD, editors. Werner and Ingbar’s The Thyroid: A Fundamental and Clinical Text. 9th ed. Lippincott Williams & Wilkins; 2002. p. 398–406.
Weetman AP. Autoimmune thyroid disease. Thyroid. 1997;7(1):175–183. Available from: doi.org/10.1089/thy.1997.7.175
Azim S, Nasr C. Subclinical hypothyroidism: When to treat. Cleve Clin J Med. 2019. Available from: doi.org/10.3949/ccjm.86a.17053
Vanderpump MP, Tunbridge WM, French JM, et al. The incidence of thyroid disorders in the community: A twenty-year follow-up of the Whickham Survey. Clin Endocrinol (Oxf). 1995;43(1):55–68. Available from: doi.org/10.1111/j.1365-2265.1995.tb01894.x
Pearce SH, Brabant G. Subclinical hypothyroidism: Is it a cardiovascular risk factor? Lancet. 2007;370(9600):1062–1063. Available from: https://doi.org/10.1016/S0140-6736(07)61596-4
Caturegli P, Kimura H, Rocchi R. Autoimmune thyroid diseases. Autoimmun Rev. 2007;6(6):457–462. Available from: doi.org/10.1016/j.autrev.2007.02.012
Antonelli A, Fallahi P, Ferrari SM, et al. Hashimoto’s thyroiditis: Clinical features, pathogenesis, and therapy. J Clin Transl Endocrinol. 2015;2(3):125–137. Available from: doi.org/10.1016/j.jcte.2015.02.005
Cellini M, Santaguida MG, Virili C, et al. Hashimoto’s thyroiditis and autoimmune gastritis. Front Endocrinol. 2017;8:92. Available from: doi.org/10.3389/fendo.2017.00092
Gharib H, Tuttle RM, Baskin HJ, et al. Subclinical thyroid dysfunction: A joint statement on management from the American Association of Clinical Endocrinologists, the American Thyroid Association, and The Endocrine Society. J Clin Endocrinol Metab. 2005;90(1):581–587. Available from: doi.org/10.1210/jc.2004-1231
Knudsen N, Laurberg P, Rasmussen LB, et al. Small differences in thyroid function may be important for body mass index and the occurrence of obesity in the population. J Clin Endocrinol Metab. 2005;90(7):4019–4024. Available from: doi.org/10.1210/jc.2005-0218
Baloch Z, Carayon P, Conte-Devolx B, et al. Laboratory medicine practice guidelines: Laboratory support for the diagnosis and monitoring of thyroid disease. Thyroid. 2003;13(1):3–126. Available from: doi.org/10.1089/105072503321086962
Yoo WS, Chung HK. Subclinical hypothyroidism: Prevalence, health impact. Curr Opin Endocr Metab Res. 2021;10:12–18. Available from: doi.org/10.1016/j.coemr.2021.02.003
Monzani F, Caraccio N, Del Guerra P, et al. The effect of L-thyroxine on thyroid volume and function in children with chronic autoimmune thyroiditis. Thyroid. 2002;12(12):1093–1098. Available from: doi.org/10.1089/105072502321085211
Carlé A, Laurberg P, Pedersen IB, et al. Age modifies the pituitary response to thyroid failure. Thyroid. 2006;16(12):1155–1160. Available from: doi.org/10.1089/thy.2006.16.1155
Van Der Spoel E, Van Vliet NA, Poortvliet RKE, et al. Incidence and determinants of spontaneous normalization of subclinical hypothyroidism in older adults. J Clin Endocrinol Metab. 2024;109(3):e1167–e1174. Available from: doi.org/10.1210/clinem/dgad623
Chakrabarti S, Pearce EN. Autoimmune thyroid disease in women. J Womens Health. 2011;20(12):1751–1763. Available from: doi.org/10.1089/jwh.2011.3183
Bogusławska J, Godlewska M, Gajda E, Piekiełko-Witkowska A. Cellular and molecular basis of thyroid autoimmunity. Eur Thyroid J. 2022. Available from: doi.org/10.1530/ETJ-21-0024
Sharma et al. Subclinical hypothyroidism: Recent research. BMC Endocr Disord. 2023;23:221. Available from: doi.org/10.1186/s12902-023-01480-6
Bauer M, Silverman DH, Schlagenhauf F, et al. Brain glucose metabolism in hypothyroidism: A positron emission tomography study before and after thyroid hormone replacement therapy. J Clin Endocrinol Metab. 2008;93(6):2301–2307. Available from: doi.org/10.1210/jc.2007-1817
Hage M, Azar ST. The link between thyroid function and depression. J Thyroid Res. 2012. Available from: doi.org/10.1155/2012/590648
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