title: Screening of Undiagnosed Hypothyroidism in Elderly Persons with Diabetes according to Age-Specific Reference Intervals for Serum Thyroid Stimulating Hormone and the Impact of Antidiabetes Drugs.
abstract: Background. Studies have suggested that hypothyroidism is more frequent in the elderly with diabetes mellitus. However, an adaptation of TSH levels to age should be considered in this assessment. Some antidiabetes drugs reportedly interfere with TSH levels. The objectives of this study were to evaluate the prevalence of undiagnosed hypothyroidism in patients with diabetes and the influence of antidiabetes drugs. Material and Methods. 1160 subjects, 60 years and older (751 with diabetes), were studied; results were compared according to diabetes treatment and with persons without diabetes. TSH, FT4, antithyroperoxidase, fasting glucose, and HbA1c were measured. Results and Discussion. 6.4% of patients with diabetes had hypothyroidism, a higher prevalence compared with persons without diabetes (5.1%), but lower than observed in many studies. The use of age-specific TSH reference interval (RI) could explain this difference. Patients taking metformin (MTF) had TSH (showed in medians) slightly lower (2.8 mU/L) than those not on MTF (3.3 mU/L), p < 0.05. MTF doses influenced TSH levels. Conclusions. The use of specific TSH RI could avoid the misdiagnosis of hypothyroidism in elderly with diabetes. Patients in use of MTF as single drug had lower TSH than those using other medications and persons without diabetes.
authors.affiliation: Hospital Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, 20241260 Rio de Janeiro, RJ, Brazil; Diagnosticos da America SA, Rio de Janeiro, RJ, Brazil.
authors.forename: Rosita
authors.identifier: 0000-0002-2628-0886
authors.initials: R
authors.lastname: Fontes
authors.affiliation: Hospital Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, 20241260 Rio de Janeiro, RJ, Brazil.
authors.forename: Patricia de Fatima Dos Santos
authors.initials: Pde F
authors.lastname: Teixeira
authors.affiliation: Hospital Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, 20241260 Rio de Janeiro, RJ, Brazil.
authors.forename: Mario
authors.initials: M
authors.lastname: Vaisman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007037:Hypothyroidism / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D008403:Mass Screening; D008875:Middle Aged; D012016:Reference Values; D013972:Thyrotropin / Q000097:blood*
chemical_list: D007004:Hypoglycemic Agents; D013972:Thyrotropin