A Comprehensive Analysis of Clinical and Laboratory Characteristics of Thyroid Abnormalities in a Two-Year Outpatient Cross-Sectional Study

Main Article Content

Davaasuren Damdindorj Oyunbileg Bavuu Bolormaa Ganbaatar Sainbileg Sonomtseren Bayasgalan Tumenbayar

Abstract

Background: The prevalence of thyroid disorders, particularly disseminated Graves’ disease and thyroid nodules, is escalating within the general population. Irregular activation of the immune system is a key factor in causing autoimmune thyroid diseases such as Graves’ disease and Hashimoto thyroiditis. However, the development of autoimmune disorders is influenced by a combination of environmental factors such as urbanization, pollution, and iodine intake.


Methods and Results: The study involved 204 patients with thyroid disorders at the department of endocrinology in the outpatient clinic over the past 2 years. The data collection of demographical and clinical information included age, gender, clinical features, laboratory tests, and instrumental analysis. The mean age of participants was 44.35±14.29 years, and females comprised 91.2% of the cases. Among them, 46.1% had thyroid nodules, 36.8% presented with Grave’s disease, 13.2% with Hashimoto’s thyroiditis, and 3.9% with thyroid hyperplasia. The patients with Grave’s disease, the average levels of thyroid antibodies were as follows: anti-thyroid stimulating hormone receptor (Anti-TSHR ) at 21.91±14.02 IU/L, anti-thyroglobulin (Anti-TG) at 265.91±406.03 IU/ml, and anti-thyroid peroxidase (Anti-TPO) at 319.3±327.1 IU/ml, respectively. Additionally, the mean thyroid enlargement was 29.60±16.08 ml. The participants were categorized based on their geographical region, with the distribution as follows: central region 59.3%, northern region 20.1% western region 10.8%, and eastern region 9.8%. 


Conclusion: Thyroid disorders are prevalent in our population, with greater incidence in females than males. The majority of cases (46.1%) involved thyroid nodules, with a peak age of above 30 years among participants. The central region, particularly the capital city (Ulaanbaatar), exhibited the highest prevalence at 59.3%, as highlighted by the distribution of thyroid abnormalities.

Keywords: thyroid dysfunction, hyperthyroidism, hypothyroidism, thyroid antibodies

Article Details

How to Cite
DAMDINDORJ, Davaasuren et al. A Comprehensive Analysis of Clinical and Laboratory Characteristics of Thyroid Abnormalities in a Two-Year Outpatient Cross-Sectional Study. Medical Research Archives, [S.l.], v. 12, n. 3, mar. 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5111>. Date accessed: 30 apr. 2024. doi: https://doi.org/10.18103/mra.v12i3.5111.
Section
Research Articles

References

1. Ladenson, P. W.; Singer, P. A.; Ain, K. B.; Bagchi, N.; Bigos, S. T.; Levy, E. G.; Smith, S. A.; Daniels, G. H.; Cohen, H. D. American Thyroid Association guidelines for detection of thyroid dysfunction. Arch Intern Med 2000, 160 (11), 1573-1575. DOI: 10.1001/archinte.160.11.1573 From NLM.

2. Strieder, T. G.; Prummel, M. F.; Tijssen, J. G.; Endert, E.; Wiersinga, W. M. Risk factors for and prevalence of thyroid disorders in a cross-sectional study among healthy female relatives of patients with autoimmune thyroid disease. Clin Endocrinol (Oxf) 2003, 59 (3), 396-401. DOI: 10.1046/j.1365-2265.2003.01862.x From NLM.

3. Prabhakar, B. S.; Bahn, R. S.; Smith, T. J. Current Perspective on the Pathogenesis of Graves’ Disease and Ophthalmopathy. Endocrine Reviews 2003, 24 (6), 802-835. DOI: 10.1210/er.2002-0020 (acccessed 2/19/2024).

4. Volpé, R. The pathogenesis of Graves' disease. Endocr Pract 1995, 1 (2), 103-115. DOI: 10.4158/ep.1.2.103 From NLM.

5. Mincer, D. L.; Jialal, I. Hashimoto Thyroiditis. In StatPearls, StatPearls Publishing
Copyright © 2024, StatPearls Publishing LLC., 2024.

6. Ragusa, F.; Fallahi, P.; Elia, G.; Gonnella, D.; Paparo, S. R.; Giusti, C.; Churilov, L. P.; Ferrari, S. M.; Antonelli, A. Hashimotos' thyroiditis: Epidemiology, pathogenesis, clinic and therapy. Best Pract Res Clin Endocrinol Metab 2019, 33 (6), 101367. DOI: 10.1016/j.beem.2019.101367 From NLM.

7. de Benoist, B.; McLean, E.; Andersson, M.; Rogers, L. Iodine deficiency in 2007: global progress since 2003. Food Nutr Bull 2008, 29 (3), 195-202. DOI: 10.1177/156482650802900305 From NLM.

8. Andersson, M.; de Benoist, B.; Rogers, L. Epidemiology of iodine deficiency: Salt iodisation and iodine status. Best Pract Res Clin Endocrinol Metab 2010, 24 (1), 1-11. DOI: 10.1016/j.beem.2009.08.005 From NLM.

9. Bleichrodt, N.; Shrestha, R. M.; West, C. E.; Hautvast, J. G.; van de Vijver, F. J.; Born, M. P. The benefits of adequate iodine intake. Nutr Rev 1996, 54 (4 Pt 2), S72-78. DOI: 10.1111/j.1753-4887.1996.tb03901.x From NLM.

10. Konno, N.; Yuri, K.; Taguchi, H.; Miura, K.; Taguchi, S.; Hagiwara, K.; Murakami, S. Screening for thyroid diseases in an iodine sufficient area with sensitive thyrotrophin assays, and serum thyroid autoantibody and urinary iodide determinations. Clin Endocrinol (Oxf) 1993, 38 (3), 273-281.
DOI: 10.1111/j.1365-2265.1993.tb01006.x From NLM.

11. Cooper, D. S.; Doherty, G. M.; Haugen, B. R.; Kloos, R. T.; Lee, S. L.; Mandel, S. J.; Mazzaferri, E. L.; McIver, B.; Pacini, F.; Schlumberger, M.; et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2009, 19 (11), 1167-1214.
DOI: 10.1089/thy.2009.0110 From NLM.

12. Gharib, H.; Papini, E.; Paschke, R.; Duick, D. S.; Valcavi, R.; Hegedüs, L.; Vitti, P. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical guidelines for clinical practice for the diagnosis and management of thyroid nodules: executive summary of recommendations. Endocr Pract 2010, 16 (3), 468-475. DOI: 10.4158/ep.16.3.468 From NLM.

13. Tran, N. Q.; Le, B. H.; Hoang, C. K.; Nguyen, H. T.; Thai, T. T. Prevalence of Thyroid Nodules and Associated Clinical Characteristics: Findings from a Large Sample of People Undergoing Health Checkups at a University Hospital in Vietnam. Risk Manag Healthc Policy 2023, 16, 899-907. DOI: 10.2147/rmhp.S410964 From NLM.

14. de los Santos, E. T.; Starich, G. H.; Mazzaferri, E. L. Sensitivity, specificity, and cost-effectiveness of the sensitive thyrotropin assay in the diagnosis of thyroid disease in ambulatory patients. Arch Intern Med 1989, 149 (3), 526-532. DOI: 10.1001/archinte.149.3.526 From NLM.

15. Bahn, R. S.; Burch, H. B.; Cooper, D. S.; Garber, J. R.; Greenlee, M. C.; Klein, I.; Laurberg, P.; McDougall, I. R.; Montori, V. M.; Rivkees, S. A.; et al. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Endocr Pract 2011, 17 (3), 456-520. DOI: 10.4158/ep.17.3.456 From NLM.

16. Vitti, P.; Rago, T.; Chiovato, L.; Pallini, S.; Santini, F.; Fiore, E.; Rocchi, R.; Martino, E.; Pinchera, A. Clinical features of patients with Graves' disease undergoing remission after antithyroid drug treatment. Thyroid 1997, 7 (3), 369-375. DOI: 10.1089/thy.1997.7.369 From NLM.

17. Mariotti, S.; Pisani, S.; Russova, A.; Pinchera, A. A new solid-phase immunoradiometric assay for anti-thyroglobulin autoantibody. J Endocrinol Invest 1982, 5 (4), 227-233. DOI: 10.1007/bf03348328 From NLM.

18. Mariotti, S.; Caturegli, P.; Piccolo, P.; Barbesino, G.; Pinchera, A. Antithyroid peroxidase autoantibodies in thyroid diseases. J Clin Endocrinol Metab 1990, 71 (3), 661-669. DOI: 10.1210/jcem-71-3-661 From NLM.

19. Ganbaatar, B. D., D.; Tsogbadrakh, P.; et al.,. Effect of Thyroid Dysfunction on Complete Blood Count. Medical Research Archives 2023, 11. DOI: https://doi.org/10.18103/mra.v11i9.4420.

20. Surenjav, U. S., Ts. Prevalence of thyrotoxicosis in Mongolia. Toxicologie Analytigue et Clinique 2022, 34 (3), S170-S171. DOI: https://doi.org/10.1016/j.toxac.2022.06.294.

21. Zimmermann, M. B. Iodine deficiency. Endocr Rev 2009, 30 (4), 376-408.
DOI: 10.1210/er.2009-0011 From NLM.

22. Katagiri, R.; Yuan, X.; Kobayashi, S.; Sasaki, S. Effect of excess iodine intake on thyroid diseases in different populations: A systematic review and meta-analyses including observational studies. PLoS One 2017, 12 (3), e0173722. DOI: 10.1371/journal.pone.0173722 From NLM.

23. Kiyaev, A. V. P., N M,; et al., . The influence of excess iodine consumption on the functional state of the thyroid gland and the spectrum of its pathology in residents of Turinsk, Svedlovsk region. Clinical and experimental thyroidology. Clinical and experimental thyroidology 2015, 11, 43-49. DOI: https://doi.org/10.14341/ket2015143-49.

24. Yamada, C.; Oyunchimeg, D.; Enkhtuya, P.; Erdenbat, A.; Buttumur, A.; Umenai, T. Current status of iodine deficiency in Mongolia in 1998-1999. Asia Pac J Public Health 2000, 12 (2), 79-84.
DOI: 10.1177/101053950001200205 From NLM.

25. Luo, Y.; Kawashima, A.; Ishido, Y.; Yoshihara, A.; Oda, K.; Hiroi, N.; Ito, T.; Ishii, N.; Suzuki, K. Iodine excess as an environmental risk factor for autoimmune thyroid disease. Int J Mol Sci 2014, 15 (7), 12895-12912. DOI: 10.3390/ijms150712895 From NLM.

26. Pang, X.; Ge, M.; Wang, C.; He, J. Effects of geographical factors on reference values of the thyroid stimulating hormone in healthy adults in China and its clinical significance. Geospat Health 2022, 17 (1).
DOI: 10.4081/gh.2022.1030 From NLM.

Most read articles by the same author(s)