Prevalence of thyroid autoimmunity in sporadic idiopathic hypoparathyroidism in comparison to type 1 diabetes and premature ovarian failure

Context: Thyroid autoimmunity is the most common coexistent endocrinopathy in type 1 diabetes (T1D), Addison's disease, and premature ovarian failure (POF). Although the role of autoimmunity is being investigated in patients with sporadic idiopathic hypoparathyroidism (SIH), there is little information on coexistent thyroid autoimmunity. Objective: Our objective was to assess the prevalence of thyroid peroxidase autoantibodies (TPOAb) and thyroid dysfunction in patients with SIH and its comparison with that in T1D, POF, and Hashimoto's thyroiditis (HT) and age- and sex-matched healthy controls (for SIH). Design and Setting: We conducted a case control study in a tertiary care setting. Patients and Methods: Subjects were consecutive patients with SIH (n = 87), T1D (n = 100), POF (n = 58), and HT (n = 47) and healthy controls (100 females and 64 males). Serum free T3, free T4, TSH, and TPOAb (normal ≤ 34 IU/ml) were measured by electrochemiluminescence assay. Subjects with 1) serum TSH at least 5 μ U/ml along with TPOAb more than 34 IU/ml; 2) TSH at least 10 μ U/ml but normal TPOAb titers; or 3) Graves' disease were considered to have thyroid dysfunction. Results: TPOAb positivity (>34 IU/ml) in females was 14.6% in SIH, 24.1% in POF, and 42.1% in T1D compared with 76.6% in HT and 9% in healthy controls. The frequencies of TPOAb positivity and thyroid dysfunction in patients with SIH were comparable to those in control and POF groups, but significantly less than in T1D and HT groups. Conclusion: The frequencies of TPOAb and thyroid dysfunction were not significantly higher in patients with SIH than in healthy controls, unlike in patients with T1D and POF

Prevalence of vitamin D deficiency and its relationship with thyroid autoimmunity in Asian Indians: a community-based survey

25-Hydroxy vitamin D (25(OH)D) deficiency is linked with predisposition to autoimmune type 1 diabetes and multiple sclerosis. Our objective was to assess the relationship between serum 25(OH)D levels and thyroid autoimmunity. Subjects included students, teachers and staff aged 16-60 years (total 642, 244 males, 398 females). Serum free thyroxine, thyroid-stimulating hormone (TSH), and thyroid peroxidase autoantibodies (TPOAb), intact parathyroid hormone and 25(OH)D were measured by electrochemiluminescence and RIA, respectively. Thyroid dysfunction was defined if (1) serum TSH ≥ 5 μ U/ml and TPOAb>34 IU/ml or (2) TSH ≥ 10 μ U/ml but normal TPOAb. The mean serum 25(OH)D of the study subjects was 17.5 (SD 10.2) nmol/l with 87 % having values ≤ 25 nmol/l. TPOAb positivity was observed in 21 % of subjects. The relationship between 25(OH)D and TPOAb was assessed with and without controlling for age and showed significant inverse correlation (r - 0.08, P = 0.04) when adjusted for age. The prevalence of TPOAb and thyroid dysfunction were comparable between subjects stratified according to serum 25(OH)D into two groups either at cut-off of ≤ 25 or >25 nmol/l or first and second tertiles. Serum 25(OH)D values show only weak inverse correlation with TPOAb titres. The presence of such weak association and narrow range of serum 25(OH)D did not allow us to interpret the present results in terms of quantitative cut-off values of serum 25(OH)D. Further studies in vitamin D-sufficient populations with wider range of serum 25(OH)D levels are required to substantiate the findings of the current study

Relationship of body fat and its distribution with bone mineral density in Indian population

Obesity has been associated with increased Bone Mineral Density (BMD). There is evidence of differential effect of regional fat on BMD. Hence, we undertook this study to evaluate the correlation between total body fat and its distribution with BMD in nonobese (mean body mass index: 25.0 ± 4.7 kg/m²) Indian adult volunteers. A total of 2347 participants (men: 39.4% and women: 60.6%) included in this cross-sectional study were divided according to sex and age. Fasting blood samples were drawn for biochemical parameters. Percent total body, truncal and leg fat and BMD at lumbar spine, femur and forearm were measured by dual-energy X-ray absorptiometry. The BMD at all sites (radius, femur and spine) increased from lowest to highest quartiles of percent body fat. Percent truncal fat was positively correlated with BMD at all sites in both sexes, except for femoral neck in men, where it had negative correlation. Percent leg fat was positively related with BMD at all sites in premenopausal women, and spine and radius BMD in postmenopausal women. However, in men, it had negative correlation with femoral neck BMD. On multiple regression analysis, regional fat had positive association with BMD at all sites after adjusting for age, sex, lean mass index, 25-hydroxyvitamin D and intact parathyroid hormone levels. Leg-to-total body fat ratio was negatively associated with BMD at all sites in men and pre- and post-menopausal women. Percent total body and regional fat have positive association with BMD at all sites in men and women

Height velocity in apparently healthy north Indian school children

Objective: Linear growth is best estimated by serial anthropometric data or height velocity (HV). In the absence of recent data on growth velocity, we undertook to establish normative data in apparently healthy North Indian children. Materials and Methods: Prospective longitudinal study in a representative sample of 7710 apparently healthy children, aged 3–17 years from different regions of Delhi. Height was measured at baseline and at 12 months while pubertal examination was performed at baseline in a subset of children. Results: The data on HV and puberty were available in 5635 participants (73.08%; 2341 boys and 3294 girls) and 1553 participants (622 boys; and 931 girls), respectively. The mean peak height velocity (PHV) was 7.82 ± 2.60 cm in boys seen at 12–12.9 years and 6.63 ± 1.81 cm in girls at 10–10.9 years Although late maturing boys had a greater HV than early or normal maturers, it did not vary with the age of pubertal maturation in girls. HV correlated with parental height in prepubertal boys, girls, and pubertal boys (P < 0.01) while no correlation was seen in girls. Conclusions: The study presents normal height velocities in North Indian children. A secular trend was observed in achieving PHV in both boys and girls

Status of thyroid function in Indian adults: two decades after universal salt iodization

Objectives: The aim was to find impact of two decades of universal salt iodization on the prevalence of goiter, thyroid autoimmunity and thyroid dysfunction in Indian adults. Methods: This was a cross sectional study from Delhi, India. The subject population included 4409 adult members of resident welfare associations of 5 residential colonies, from 18-90 years of age, who participated in general health check-up camps. The subjects underwent a detailed evaluation including history, anthropometry, goiter grading, USG thyroid, thyroid auto-antibodies and thyroid function tests. All these subjects were regularly consuming iodized salt. Results: Overall, 9.6 % of subjects had clinical goiter (13.3% women and 3.3% in men). Prevalence of nodules on palpation was found to be in 1.6% which was lower in men. The nodule prevalence increased to 4.6% in men and 5.6 % in women on ultrasonography. Thyroid hypoechogenicity was seen in 30.6% of subjects with severe hypoechogenicity higher in women (5.7% men and 15.5% women). TPO antibody was positive in 13.3% adults and it showed a positive correlation with age, female sex and hypothyroidism. Subclinical hypothyroidism was the commonest abnormality encountered and affected 19.3% subjects (15.9% men; 21.4% women). Thyroid dysfunction showed a rising trend with age in both genders. Conclusions: Normal UIE and low goiter prevalence, especially in males, suggest success of the universal salt iodization program in the region under review. High prevalence of subclinical hypothyroidism was not correlated with either thyroid autoimmunity or iodine intake, as reflected in urinary iodine excretion

Reference range of thyroid function (FT3, FT4 and TSH) among Indian adults

Objectives: To generate thyroid hormone reference norms using electro-chemiluminescence technique. Design and methods: Cross sectional study on apparently normal 4349 Delhi adults (18–86 years). Predetermined exclusion criteria (goiter, hypoechogenicity or nodularity on ultrasound, elevated anti-thyroid peroxidase antibody, hypo or hyperthyroidism and family history of thyroid dysfunction) excluded 2433 subjects leaving 1916 (916 males and 1000 females) as the reference population. Results: Mean age and BMI of the reference population were 41.2 &#177; 18.1 years and 24.5 &#177; 4.4 kg/m2 respectively. Median urinary iodine excretion was 233.6 &#956;g/L (79–458;3rd–97th centile). The population was categorized into various age groups (18–30, 31–40, 41–50, 51–60, 61–70 and &#8805; 70 years). Overall FT3 and FT4 values in the reference population irrespective of age, ranged from 2.4–8.8 (mean 4.6 &#177; 0.9) pmol/L and 10.1–24.8 (mean 15.40 &#177; 2.0) pmol/L, respectively. Mean TSH value in the reference population was 2.2 &#177; 0.9 mIU/L which was significantly lower than that of total population (3.8 &#177; 6.1; p &#60; 0.001). Conclusion: FT3 values were observed to be significantly higher in men than women (p = 0.001). The centiles (3rd, 5th, 10th, 25th, 50th, 75th, 90th, 95th and 97th) of FT3, FT4 and TSH were derived for reference purposes in Indian adults. This community based study in Indian adults has established mean reference intervals for FT3, FT4 and TSH for different age groups for both sexes separately using strict exclusion criteria. These can be used as reference norms for Indian adults