Evaluation of thyroid dysfunction and thyroid autoimmunity in diabetes mellitus subjects at Effia Nkwanta Regional Hospital, Sekondi, Western Region.
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Date
2017-01-24
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Abstract
Diabetes mellitus and thyroid disorders are the two most common endocrine disorders in clinical practice. Presence of thyroid dysfunction in diabetic patients makes management of the disease more difficult. The objective of this hospital based cross sectional study at the Diabetic Clinic of Effia Nkwanta Regional Hospital, Sekondi, was to investigate the prevalence of thyroid dysfunction and thyroid autoimmunity in clinically euthyroid type 1 and type 2 diabetes mellitus patients and also to correlate the glycated haemoglobin levels with thyroid function markers. One hundred and thirty-two (132) clinically euthyroid type 1 and type 2 diabetes mellitus patients and 132 age-matched and sex- matched non-diabetic control subjects were included in the study. Data on sociodemography of patients and controls such as age, sex, duration of diabetes, mode of glycaemic control were obtained using a pre-tested questionnaire. The serum levels of thyroid biomarkers (TSH, FT3, FT4, anti-TPO anti-TG) were evaluated using standard methods. The mean serum FT3 (p=0.2044) and TSH (p=0.1869) in diabetic subjects were not significantly different when compared to their control peers but the levels of FT4 was significantly higher in the diabetic mellitus subjects compared to the levels recorded among the control group (p <0.0001). The prevalence of thyroid dysfunction among the diabetic group was 11.36% (6.82% subclinical hypothyroidism and 4.54 % subclinical hyperthyroidism) with 117 (88.64 %) euthyroid. The prevalence of thyroid autoimmunity among the diabetic subjects was5.30% and 3.79 % respectively for anti-thyroid peroxidase autoantibody (anti-TPO) and anti- thyroglobulin autoantibody (anti-TG). Though not statistically different, the auto-antibody reactivity was observed to be higher among the diabetic group compared to the controls. Among the thyroid biomarkers assayed, increasing FT4 levels was significantly associated with increasing additive levels of fasting blood glucose and glycated haemoglobin after Bivariate Pearson correlations analysis.
In conclusion, this study has shown that, the prevalence of thyroid dysfunction among the diabetic population seen at Effia Nkwanta Regional Hospital in Sekondi, Ghana was 11.36 % and the prevalence of thyroid autoantibody reactivity (3.79-5.30 %) in the diabetes mellitus subjects was not significantly different from non-diabetic subjects.
Description
A thesis submitted in fulfillment
of the requirements for the
degree of
Master of Philosophy
(Chemical Pathology)
in the
Department of Molecular Medicine,
School of Medical Sciences
College of Health, 2016.