Studying the Frequency of Autoimmune Thyroid Diseases in Duhok Province
DOI:
https://doi.org/10.25271/sjuoz.2019.7.2.587Keywords:
Autoimmune, Thyroid, Frequency, Anti-thyroperoxidase, thyroid stimulating hormoneAbstract
Thyroid disorders are one of the most frequent disorders affecting endocrine system. The present study aimed to identify the frequency of thyroid disorder in our locality at Duhok city. To do so, a total of one hundred patients and one hundred apparently healthy control individuals were enrolled in this study. Samples of venous blood (5 ml) were withdrawn from patients and control subjects and analysed. Clinical assessment was performed by a specialist and each patient provided with a document supporting preliminary clinical diagnosis. Measurements of serum TSH, T3, T4, and anti-thyroperoxidase antibodies (anti-TPO antibodies) serum levels were performed. All assays were conducted at Duhok central health laboratory. Out of the one hundred patients and the one hundred control groups, forty-two and thirty candidates were randomly selected, respectively. The mean TSH serum levels of 25.87 (uIU/ml) for the patients significantly differ from that of the control group 3.55 (uIU/ml) (p<0.001). However, T3 and T4 serum levels indicated no significant difference between the two categories. Moreover, there was statisticaly significant difference (p< 0.0001) between the patients and control groups when their mean serum anti-TPO concentrations were compared. In conclusion, considerable number of subjects appeared to be candidates for deranged thyroid functions and is susceptible to autoimmune thyroid disorder.
References
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Marwaha, R. K.; Tandon, N.; Ganie, M. A.; Kanwar, R.; Garg, M. K. and Singh, S. (2012). Status of thyroid function in Indian adults: Two decades after universal salt iodization. J. Assoc. Physicians India., 60: 32-36.
McLachlan, S. M. and Rapoport, B. (2007). Thyroid peroxidase as an autoantigen. Thyroid, 17(10): 939–948.
McLeod D. S. and Cooper, D. S. A. (2012). The incidence and prevalence of thyroid autoimmunity. Endocrine Journal, 42(2): 252–265.
Meikle, A. W.(2004). The interrelationships between thyroid dysfunction and hypo-gonadism in men and boys. Thyroid 14(Suppl 1): S17–25.
Miko´s, H.; Miko´s, M.; Obara-Moszy´nska, M. and Niedziela, M. (2014). The role of the immune system and cytokines involved in the pathogenesis of autoimmune thyroid disease (AITD). Endokrynologia Polska, 65(2): 150–155.
Muñoz-Culla, M.; Irizar, H.; Muñoz-Cuesta, M.; Castillo-Triviño, T.; Osorio-Querejeta, I.; Sepúlveda, L.; López de Munain, A.; Olascoaga, J. and Otaegu, D. (2016). SncRNA (microRNA and snoRNA) opposite expression pattern found in multiple sclerosis relapse and remission is sex dependent. Scientific Report; 6(20126).
Panti, P.; Choudhary, T.; Sekhri, T.; Kanwar, R. and Uniyal, N. (2018). Study of correlation between vaitamin D deficiency and anti-thyroperoxidase antibodies in AITDs. Juornal of Medical Academics, 1(1): 10-14.
Persani, L.; Bonomi, M.; Lleo, A.; Pasini, S.; Civardi, F.; Bianchi, I.; et al. Increased loss of the Y chromosome in peripheral blood cells in male patients with autoimmune thyroiditis.. (2012). Increased loss of the Y chromosome in peripheral blood cells in male patients with autoimmune thyroiditis. J. Autoimmun., 38: J193–196.
Ray, S.; Sonthalia, N.; Kundu, S. and Ganguly, S. (2012). Autoimmune Disorders: An Overview of Molecular and Cellular Basis in Today’s Perspective. Journal of Clinical & Cellular Immunology, S10(003): 1-12.
Ruggeri, R. M.; Vicchio, T. M.; Cristani, M.; Certo, R.; Caccamo, D.; Alibrandi, A.; et al. (2016). Oxidative stress and advanced glycation end products in Hashimoto’s thyroiditis. Thyroid, 26: 504–511.
Silva, L. M.; Chavezm J.; Canalli, M. H. B. and Zanetti, C. R. (2003). Determination of IgG subclasses and avidity of antithyroid peroxidase antibodies in patients with subclinical hypothyroidism - a comparison with patients with overt hypothyroidism. Horm. Res., 59(3): 118-124.
Senthilkumaran, S.; Sathyaprakash V. and Sundhararajan A. (2015). A Study on Prevalence and Distribution of Subclinical Hypothyroidism in Rural Women. Sch. J. Appl. Med. Sci., 3(1D): 287-290.
Sindi, H. A.; Yousef, F. M. and Aljahdali, B. A. (2018). Vitamin D Status and Autoimmune Disease (Hashimoto’s Thyroiditis) in Saudi Arabian Women. International Journal of Pharmaceutical and Phytopharmacological Research (eIJPPR), 8(1): 21-26.
Spencer, C. A.; Schwarzbein, D.; Guttler, R. B.; LoPresti, J. S. and Nicoloff, J. T. (1993). Thyrotropin (TSH)-releasing hormone stimulation test responses employing third and fourth generation TSH assays. J. Clin. Endocrinol. Metab.,76: 494-498.
Straub, R. H. (2007). The complex role of estrogens in inflammation. Endocrine Rev., 28: 521–574.
Stathatos, N. and Daniels, G. H. (2012). Autoimmune thyroid disease. Current Opinion in Rheumatology, 24(1): 70–75.
Swain, M.; Swain, T and Mohanty, B. K. (2005). Autoimmune thyroid disorders - an update . Indian Journal of Clinical Biochemistry, 20 (1): 9-17.
Unnikrishnan, A. G.; Kalra, S.; Sahay, R. K.; Bantwal, G.; John, M. and Tewari, N. (2013). Prevalence of hypothyroidism in adults: An epidemiological study in eight cities of India. Indian Journal of Endocrinology and Metabolism., 17(4): 647-652.
UshaMenon, V., Sundaram, K. R.; Unnikrishnan, A. G.; Jayakumar, R. V.; Nair, V. and Kumar, H. (2009). High prevalence of undetected thyroid disorders in an iodine sufficient adult south Indian population. J. Indian Med. Assoc., 107: 72-77.
Vadiveloo, T.; Donnan, P.; Murphy, M. and Leese, G. (2013). Age and gender specific TSH reference intervals in people with no obvious thyroid disease in Tayside,Scotland :the thyroid epidemiology and research study. J. Cli. Endocrinol. Metab., 98(3): 1147-1153.
Veeramuthumari, P.; Isabel W. and Kannan, K. (2011). A study on the level of T3, T4, TSH and the association of A/G polymorphism with CTLA-4 gene in Graves’ Hyperthyroidism among south Indian population. Ind. J. Clin. Biochem., 26(1): 66–69.
Al-Mofarji, S. T. K. (2013). The Relationship between Thyroid Disorders and Helicobacter pylori Infection. M.Sc thesis. Al-Nahrain University.
Al-Rabia, M. W. (2017). Correlation of thyroid antibodies with TSH, T3 and T4 hormones in patients diagnosed with autoimmune thyroid disorders. Pakistan Journal of Pharmaceutical Sciences, 30(2): 607–612.
Al-Ramahi, I. J. K.(2011). Molecular and Genetic Study in samples of Iraqi patients with Thyroid Disorders. PhD thesis. University of Baghdad. Baghdad, (81-84).
Bianco, A. C.; Salvatore, D.; Gereben, B.; Berry, M. J. and Larsen, P. R. (2002). Biochemistry, cellular and molecular biology, and physiological roles of the iodothyronine selenodeiodinases. Endocrine Reviews, 23(1): 38–89.
Brown, S. J.; Bremner, A. P. and Hadlow, N. C. (2016). The log TSH– free T4 relationship in a community-based cohort is nonlinear and is influenced by age, smoking and thyroid peroxidase antibody status. Clinical Endocrinology, 85( 5): 789–796.
Brunelleschi, S. (2015). Review: Immune response and auto-immune diseases: gender does matter and makes the difference. Ital. J. Gender-Specific Med., 2(1): 5-14.
Cappa, M.; Bizzarri, C. and Crea, F. (2011). Autoimmune Thyroid Diseases in Children. Journal of Thyroid Research: 1–13.
Corrêa da Costa, V. M. and Rosenthal, D. (1996 ). Effect of ageing on thyroidal and pituitary T4 5 deiodinase activity in female rats. Life Sciences, 59: 1515–1520.
Demers, L. M. and Spencer, C. A. (2003). Laboratory medicine practice guidelines: laboratory support for the diagnosis and monitoring of thyroid disease. Clin. Endocrinol., 58 (2): 138–140.
Effraimidis, G. and Wiersinga W. M. (2014). Mechanisms in endocrinology: autoimmune thyroid disease: old and new players. Eur. J. Endocrinol., 170: 241–252.
Fairweather, D.; Frisancho-Kiss, S. and Rose, N. R. (2008). Sex Differences in Autoimmune Disease from a Pathological Perspective “A Review”. The American Journal of Pathology, 173 (3): 600-609.
Foley Jr., T. P. (1998). Mediators of thyroid diseases in children. Journal of Pediatrics, 132(4): 569–570.
Gabriel, B.; Thomas, A.; Kent, F. and Talavera, M. S. (2009). Thyroid Disease. Staff Neurologist, Neurology Service, Philadelphia Veterans. Affairs. Medical Center. Med. Rep., 8(1): 16-19.
Ghoraishian, S. M.; Hekmati Moghaddam, S. H. and Afkhami- Ardekani, M. (2006). Relationship between anti-thyroid peroxidase antibody and thyroid function test. Iranian Journal of Immunology, 3(13): 146–149.
Hasan, B. F.; Al Hudak, N. and Abd, I. D. (2016). Estimation of thyroid hormones and liver enzymes in hypo and hyperthyroidism in Iraqi women. Int. J. Pharm. Bio. Sci., 7(4): B707 -713.
Hoogendoorn, E.H.; Hermus, A. R. and Kiemeney, L. A. (2006). Thyroid function and prevalence of anti- thyroperoxidase antibodies in a population with borderline sufficient iodine intake: influences of age and sex. Clin. Chem., 52: 104-111.
Hutfless, S. M.; Matos, P.; Talor, M. V.; Caturegli, P. and Rose, N. R. (2011). Significance of prediagnostic thyroid antibodies in women with autoimmune thyroid disease. Journal of Clinical Endocrinology & Metabolism, 96( 9): E1466–E1471.
Janssen, O. E.; Mehlmauer, N.; Hahn, S.; Offner, A. H. and Gartner, R. (2004). High prevalence of autoimmune thyroiditis in patients with polycystic ovary syndrome. Eur. J. Endocrinol., 150: 363–369.
Jayan, A., Gautam, N.; Dubey, R. K.; Neupane, Y.; Padmavathi, P.; Jha, S. K. and Sinha, A. K. (2015). Prevalence and impact of thyroid disorders based on TSH level among patients visiting tertiary care hospital of South Western. Nepal. Nepal. Med. Coll. J., 17(1-2): 6-10.
Kublickiene K. and Luksha L. (2008). Gender and the endothelium. Pharmacol. Rep., 60: 49–60.
Lin, L.; Hungs, M. and Mignot, E. (2001 ). Narcolepsy and the HLA region. J. Neuroimmunol., 117: 9–20.
Lock, R. J.; Marden, N. A.; Kemp, H. J.; Thomas, P. H.; Goldie, D. J. and Gompels, M. M. (2004). Subclnical hypothyroidism: a comparison of strategies to achieve adherence to treatment guidelines. Ann. Clin. Biochem., 41(Pt 3): 197.
Loh, T. P.; Tee, J. C. S.; Tee, N. W. S.; et al. (2016). Association between thyroid function tests and anti-thyroid peroxidase (TPO) antibodies in pregnancy. Endocrine Journal, 53(3): 865–867.
Mak, T.W. and Saunders M.E. (2006). The Immune Response:Basic and Clinical Principles. San Diego: Elsevier.
Marwaha, R. K.; Tandon, N.; Ganie, M. A.; Kanwar, R.; Garg, M. K. and Singh, S. (2012). Status of thyroid function in Indian adults: Two decades after universal salt iodization. J. Assoc. Physicians India., 60: 32-36.
McLachlan, S. M. and Rapoport, B. (2007). Thyroid peroxidase as an autoantigen. Thyroid, 17(10): 939–948.
McLeod D. S. and Cooper, D. S. A. (2012). The incidence and prevalence of thyroid autoimmunity. Endocrine Journal, 42(2): 252–265.
Meikle, A. W.(2004). The interrelationships between thyroid dysfunction and hypo-gonadism in men and boys. Thyroid 14(Suppl 1): S17–25.
Miko´s, H.; Miko´s, M.; Obara-Moszy´nska, M. and Niedziela, M. (2014). The role of the immune system and cytokines involved in the pathogenesis of autoimmune thyroid disease (AITD). Endokrynologia Polska, 65(2): 150–155.
Muñoz-Culla, M.; Irizar, H.; Muñoz-Cuesta, M.; Castillo-Triviño, T.; Osorio-Querejeta, I.; Sepúlveda, L.; López de Munain, A.; Olascoaga, J. and Otaegu, D. (2016). SncRNA (microRNA and snoRNA) opposite expression pattern found in multiple sclerosis relapse and remission is sex dependent. Scientific Report; 6(20126).
Panti, P.; Choudhary, T.; Sekhri, T.; Kanwar, R. and Uniyal, N. (2018). Study of correlation between vaitamin D deficiency and anti-thyroperoxidase antibodies in AITDs. Juornal of Medical Academics, 1(1): 10-14.
Persani, L.; Bonomi, M.; Lleo, A.; Pasini, S.; Civardi, F.; Bianchi, I.; et al. Increased loss of the Y chromosome in peripheral blood cells in male patients with autoimmune thyroiditis.. (2012). Increased loss of the Y chromosome in peripheral blood cells in male patients with autoimmune thyroiditis. J. Autoimmun., 38: J193–196.
Ray, S.; Sonthalia, N.; Kundu, S. and Ganguly, S. (2012). Autoimmune Disorders: An Overview of Molecular and Cellular Basis in Today’s Perspective. Journal of Clinical & Cellular Immunology, S10(003): 1-12.
Ruggeri, R. M.; Vicchio, T. M.; Cristani, M.; Certo, R.; Caccamo, D.; Alibrandi, A.; et al. (2016). Oxidative stress and advanced glycation end products in Hashimoto’s thyroiditis. Thyroid, 26: 504–511.
Silva, L. M.; Chavezm J.; Canalli, M. H. B. and Zanetti, C. R. (2003). Determination of IgG subclasses and avidity of antithyroid peroxidase antibodies in patients with subclinical hypothyroidism - a comparison with patients with overt hypothyroidism. Horm. Res., 59(3): 118-124.
Senthilkumaran, S.; Sathyaprakash V. and Sundhararajan A. (2015). A Study on Prevalence and Distribution of Subclinical Hypothyroidism in Rural Women. Sch. J. Appl. Med. Sci., 3(1D): 287-290.
Sindi, H. A.; Yousef, F. M. and Aljahdali, B. A. (2018). Vitamin D Status and Autoimmune Disease (Hashimoto’s Thyroiditis) in Saudi Arabian Women. International Journal of Pharmaceutical and Phytopharmacological Research (eIJPPR), 8(1): 21-26.
Spencer, C. A.; Schwarzbein, D.; Guttler, R. B.; LoPresti, J. S. and Nicoloff, J. T. (1993). Thyrotropin (TSH)-releasing hormone stimulation test responses employing third and fourth generation TSH assays. J. Clin. Endocrinol. Metab.,76: 494-498.
Straub, R. H. (2007). The complex role of estrogens in inflammation. Endocrine Rev., 28: 521–574.
Stathatos, N. and Daniels, G. H. (2012). Autoimmune thyroid disease. Current Opinion in Rheumatology, 24(1): 70–75.
Swain, M.; Swain, T and Mohanty, B. K. (2005). Autoimmune thyroid disorders - an update . Indian Journal of Clinical Biochemistry, 20 (1): 9-17.
Unnikrishnan, A. G.; Kalra, S.; Sahay, R. K.; Bantwal, G.; John, M. and Tewari, N. (2013). Prevalence of hypothyroidism in adults: An epidemiological study in eight cities of India. Indian Journal of Endocrinology and Metabolism., 17(4): 647-652.
UshaMenon, V., Sundaram, K. R.; Unnikrishnan, A. G.; Jayakumar, R. V.; Nair, V. and Kumar, H. (2009). High prevalence of undetected thyroid disorders in an iodine sufficient adult south Indian population. J. Indian Med. Assoc., 107: 72-77.
Vadiveloo, T.; Donnan, P.; Murphy, M. and Leese, G. (2013). Age and gender specific TSH reference intervals in people with no obvious thyroid disease in Tayside,Scotland :the thyroid epidemiology and research study. J. Cli. Endocrinol. Metab., 98(3): 1147-1153.
Veeramuthumari, P.; Isabel W. and Kannan, K. (2011). A study on the level of T3, T4, TSH and the association of A/G polymorphism with CTLA-4 gene in Graves’ Hyperthyroidism among south Indian population. Ind. J. Clin. Biochem., 26(1): 66–69.
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2019-06-30
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Hasan, R. I., & Raziq, A. H. (2019). Studying the Frequency of Autoimmune Thyroid Diseases in Duhok Province. Science Journal of University of Zakho, 7(2), 45–49. https://doi.org/10.25271/sjuoz.2019.7.2.587
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