Making sense of thyroid function tests

Background: Thyroid disorders are second only to diabetes mellitus among endocrine problems encountered in practice. Many patients with thyroid disorders tend to present with nonspecific symptoms to clinicians in different specialties, who are often quick to request for a thyroid function test. Although interpretation of the results of most thyroid function tests (TFTs) is straightforward, in a small number of situations the results seem to point in different directions, thereby producing clinical confusion. Knowledge of the different patterns of TFTs and their causes will help clinicians to properly manage their patients and avoid unnecessary, and often expensive further investigations.Objective: To highlight the causes of the different patterns of abnormal thyroid function tests seen in clinical practice and to provide a practical approach to the evaluation of patients with such results.Method: We searched PubMed, Google scholar and Medline for articles written in English on the interpretation and pattern of thyroid function tests.Result: Interpretation of the results of most TFTs is straightforward especially when combined measurements (TSH with T4 or T3 or both) are ordered. Careful clinical reassessment of thyroid status and consideration of possible confounding factors such as pregnancy, intercurrent (non-thyroidal) illness or drug therapy will readily identify the cause of such apparently discordant TFTs.Conclusion: A sound knowledge of the conditions that can be associated with different patterns of TFTs will go a long way in guiding the choice of additional investigations and allowing a correct diagnosis, thus avoiding inappropriate treatment.Keywords: Thyroid function tests (TFTs), patterns of abnormal TFTs, non-thyroidal illnes

Prevalence and risk factors for overweight and obesity among suburban semi-nomadic Fulani's of northwestern Nigeria

Background: Obesity is a major public health problem that is associated with increased cardiovascular morbidity and mortality. It is an important threat that is fast becoming an emerging epidemic globally, Nigeria inclusive. Although there are numerous studies on the prevalence of obesity in Nigeria, the semi-nomadic Fulani's have not been extensively studied. This study will, therefore, help to assist policymakers to plan effective strategies for combating the epidemic among neglected ethnic populations.Method: The study was a community-based cross-sectional study carried out in Kumbotso Local Government Area of Kano state, from June 2015 to December 2015. Anthropometric indices (Weight, height, waist and Hip circumferences) were measured for the subjects. Body mass index and waist hip ratio was also calculated. Serum blood glucose, lipid, and blood pressure were determined.Results:  The mean ±SD age of the subjects was 38.97±15/98 years, with a range of 18 – 90 years. There were 208 (39.1%) males and 324 (60.9%) females, p <0.001. Obesity was found in 9.21% of the subjects (4.32% of males, 13.58% of females). Overweight was found in 20.86% of the subjects, 15.38% of males and 13.58% of females respectively. Factors associated with overweight include advancing age and female gender. The odds ratio for developing obesity is higher in subjects > 50 years (2.319, 95% CI, 1.203-3.540).Conclusion: There is a relatively high prevalence of overweight and obesity among suburban semi-nomadic Fulani's. In view of this, there is the urgent need to initiate public health measures aimed at improving healthy lifestyle measures.Key words: Prevalence, overweight, obesity, risk factors and sub urban