The prevalence and correlation between subclinical hypothyroidism and gall stone disease in Baghdad teaching hospital

Background

Gall stones are the most common biliary pathology. Subclinical hypothyroidism is not a common problem in the population with thyroid disease, several explanations for a possible relation between hypothyroidism and lipid metabolism, gall stone formation proved that prevalence of gall stones is increased in patients with hypothyroidism disease.

Objective

To find the prevalence and correlation between the subclinical hypothyroidism and gall stone disease.

Methods

This cross-sectional study in Baghdad teaching hospital which done over the period of January 2015 till December 2015 where 103 patients presented with gall stones as an in and outpatients. All the patients were assessed and prepared for cholecystectomy by detailed history, clinical examination, thyroid function test and abdominal ultrasound.

Results

Among 103 patients, the majority them were in 36-50 years age group, 84 (81.6%) of them were females and 19 (18.4%) were males. Of the total number of patients, eight of them (7.8%) found to have subclinical hypothyroidism and 95 (92.2%) of them found to be euthyroid, most of patients in the subclinical hypothyroid group were showing female gender predominance with 81.6%. While the prevalence among males were found 18.4%, most patients with subclinical hypothyroidism were found to had positive family history (75%), and (25%) of them found to had negative family history.

Conclusion

There is gender specific relationship between subclinical hypothyroidism and gall stone disease as this study sharing statistically increasing in prevalence of the subclinical hypothyroidism among females in age group ≥ 40 years, positive family history, and single abdominal US gall stone. This subset of patients should be assessed for thyroid dysfunction.

Hypothyroid Patients Encoding Combined MCT10 and DIO2 Gene Polymorphisms May Prefer L-T3 + L-T4 Combination Treatment - Data Using a Blind, Randomized, Clinical Study

OBJECTIVES

In previous studies, around half of all hypothyroid patients preferred levo-thyroxine (L-T4) + levo-triiodothyronine (L-T3) combination therapy, 25% preferred T4, and 25% had no preference. The reason for this is yet to be explored.

METHODS

A total of 45 overtly autoimmune, hypothyroid patients - now euthyroid on ≥6 months' L-T4 therapy - participated in a prospective, double-blind, cross-over study. The patients were randomized into 2 groups of either 3 continuous months' L-T4 therapy followed by 3 months' combination therapy or vice versa. In all periods, 50 μg L-T4 was blindly replaced by either (identical) 50 μg L-T4 or by 20 μg T3. L-T4 was hereafter adjusted to obtain normal serum TSH values. We investigated 3 single nucleotide polymorphisms (SNPs) on the type II iodothyronine deiodinase (DIO2) gene (rs225014 (Thr92Ala), rs225015, and rs12885300 (ORFa-Gly3Asp)) and 1 SNP on the cellular membrane transport-facilitating monocarboxylate transporter (MCT10) gene (rs17606253), and asked in which of the 2 treatment periods patients felt better (i.e., which treatment was preferred).

RESULTS

27 out of 45 patients (60%) preferred the combination therapy. Two polymorphisms (rs225014 (DIO2, Thr92Ala) and rs17606253 (MCT10)) were combined yielding 3 groups: none vs. 1 of 2 vs. both SNPs present, and 42 vs. 63 vs. 100% of our patients in the 3 groups preferred the combined treatment (Jongheere-Terpstra trend test, p = 0.009).

CONCLUSION

The present study indicates that the combination of polymorphisms in DIO2 (rs225014) and MCT10 (rs17606253) enhances hypothyroid patients' preference for L-T4 + L-T3 replacement therapy. In the future, combination therapy may be restricted or may be even recommended to individuals harbouring certain polymorphisms.