Endocrine Abstracts

There are few valid data that describe the frequency of comorbidity in primary hypothyroidism patients seen in family practice. This study aimed to investigate the prevalence of comorbidities and their association with elevated (≥4.0%) thyroid-stimulating hormone (TSH) using a large sample of hyhpothyroidism patients from primary care practices.

Materials and methods: A cross-sectional study in which multivariate logistic regression was applied to explore the association of comorbidities with elevated TSH. Altogether, 925 patients with hypothyroidism were under observation.

Results: In total 759 (82.1%) participants had comorbidity. The mean number of comorbidities was 1.7 (SD 1.02). Diseases of the circulatory system were the most common (689, 74.5%), followed by endocrine and metabolic diseases (322, 34.8%), and diseases of the musculoskeletal system and connective tissue (165, 17.8%). After adjustment for age and sex, the number of comorbidities was significantly associated with TSH. The higher the number of comorbidities, the higher TSH level. Patients with obesity, and those with dyslipidaemia and ischaemic heart disease were more likely to have increased TSH. The prevalence of physicians’ inertia was statistically significantly and negatively associated with the number of comorbidities (Mann–Whitney U test, Z=–12.36; P<0.005; r=–0.14).

Conclusion: There is a high prevalence of comorbidity among hypothyroidism patients in primary care. A positive association of number of comorbidities and TSH is probably moderated by physicians’ inertia in treatment of hypothyroidism strictly according to guidelines.