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Biochemical and Ultrasound Characteristics of Subclinical Hypothyroid Patients in North of Jordan: Who Was Treated?

Authors Saadeh NA, Saadeh R, Rousan LA, Rawashdeh D, Obeidat A, Saadeh AM

Received 2 March 2020

Accepted for publication 28 May 2020

Published 15 June 2020 Volume 2020:13 Pages 305—310


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

Nesreen A Saadeh,1 Rami Saadeh,2 Liqa A Rousan,3 Dalia Rawashdeh,1 Aya Obeidat,1 Abdullah M Saadeh1

1Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan; 2Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan; 3Department of Radiology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan

Correspondence: Nesreen A Saadeh P.O.Box 1214, Irbid 21110, Jordan
Tel +962 7970 23157

Background: Early diagnosis and management of subclinical hypothyroidism (SCH) are important to avoid the risk of developing overt hypothyroidism. This study aimed to evaluate patients with subclinical hypothyroidism (SCH), in regard to their biochemical characteristics, and ultrasound features, and factors associated with initiating treatment for this condition.
Methods: This was a retrospective study, which reviewed the data of patients who visited the Endocrinology clinic of a tertiary hospital in Jordan, King Abdullah University Hospital. Patients who visited the clinic with SCH over 1 year, Jan 2016–Dec 2016, were included. The charts were reviewed again 2 years later to check patients who started L-thyroxine for the different indications of treatment of SCH. Thyroid function tests (free T3, free T4, and TSH) and thyroid peroxidase antibodies (TPO-Ab) were found to be measured for all cases (n=287), among whom, thyroid ultrasound was done for 43 patients.
Results: Most patients were females (88.1%). Mean age was 42.36 (± 15.36 years). Positive TPO-Ab status was associated with higher TSH (p=0.056), lower free T4 levels (p= 0.012), and more patients treated with L- thyroxine for SCH in 2 years (p=0.001). On ultrasound, hypoechogenicity was more predominant among TPO-Ab positive patients than TPO-Ab negative patients (78% vs 30%).
Conclusion: SCH patients with positive TPO-Abs were more likely to be treated for this condition based on the various indications, and more likely to have had hypoechogenicity on ultrasound. Hence, thyroid ultrasonography and TPO-Ab status should be implemented early in evaluating and treating patients with SCH.

Keywords: subclinical hypothyroidism, thyroid peroxidase ab, thyroid ultrasound, Jordan

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