Health Related Quality of Life in Hypothyroidism - A Population-based study, the WHO MONICA Project.

To explore health related quality of life (HRQoL) among subjects with hypothyroidism compared to subjects without hypothyroidism in the general population. HRQoL is important in clinical practice. Hypothyroidism is prevalent, mainly found in women, and increasing with age.Women and men, n=414, (39-78 years) from the WHO MONICA project, Gothenburg, Sweden, participated. Hypothyroidism was defined as subjects having levothyroxine supplementation or serum thyroid stimulating hormone (S-TSH) >4.2 mU/l.HRQoL was measured with Psychological General Well-Being Index (PGWB), Nottingham Health Profile (NHP), Short Form-36 Health Survey (SF-36), a single item self-rated health scale (0-100), and stress was rated 1-6. The results were adjusted for age, sex and comorbidity using Analysis of Covariance (ANCOVA).Hypothyroidism was found in 70 subjects (17%). They scored worse HRQoL than controls regarding Sleep (33.2 ± 31.4 vs. 18.9 ± 25.6, p<0.001) and Social isolation (10.0 ± 19.3 vs. 4.8 ± 14.2, p<0.05) in NHP, and had more medication in general 2.7 ± 2.5 vs. 1.8 ± 2.1, p<0.05. Subjects with levothyroxine (n=40) showed similar results as the total hypothyroid group. Subjects with elevated S-TSH (n=30) showed lower HRQoL in Sleep (p<0.001) and Pain (p<0.05) in NHP. HRQoL was similar in subjects with and without positive thyroperoxidase antibodies (TPO-Ab) ether in those with hypothyroidism (44% TPO-Ab) or controls (9% TPO-Ab).Men and women with hypothyroidism in the general population reported having more issues with Sleep and Social isolation than those without hypothyroidism irrespective of TPO-Ab. Scores were similar in all of the other HRQoL domains measured.

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Authors: Lotta Ellegård, Emily Krantz, Penelope Trimpou, Kerstin Landin-Wilhelmsen