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Watt T, Hegedüs L, Bjorner JB, et al. Is Thyroid Autoimmunity per se a Determinant of Quality of Life in Patients with Autoimmune Hypothyroidism?. Eur Thyroid J. 2012;1(3):186-92doi: 10.1159/000342623.
Watt, T., Hegedüs, L., Bjorner, J. B., Groenvold, M., Bonnema, S. J., Rasmussen, A. K., & Feldt-Rasmussen, U. (2012). Is Thyroid Autoimmunity per se a Determinant of Quality of Life in Patients with Autoimmune Hypothyroidism?. European thyroid journal, 1(3), 186-92. https://doi.org/10.1159/000342623
Watt, Torquil, et al. "Is Thyroid Autoimmunity per se a Determinant of Quality of Life in Patients with Autoimmune Hypothyroidism?." European thyroid journal vol. 1,3 (2012): 186-92. doi: https://doi.org/10.1159/000342623
Watt T, Hegedüs L, Bjorner JB, Groenvold M, Bonnema SJ, Rasmussen AK, Feldt-Rasmussen U. Is Thyroid Autoimmunity per se a Determinant of Quality of Life in Patients with Autoimmune Hypothyroidism?. Eur Thyroid J. 2012 Oct;1(3):186-92. doi: 10.1159/000342623. Epub 2012 Sep 29. PMID: 24783018; PMCID: PMC3821477.
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Eur Thyroid J. 2012 Oct;1(3):186-92. doi: 10.1159/000342623. Epub 2012 Sep 29.

Is Thyroid Autoimmunity per se a Determinant of Quality of Life in Patients with Autoimmune Hypothyroidism?.

European thyroid journal

Torquil Watt, Laszlo Hegedüs, Jakob Bue Bjorner, Mogens Groenvold, Steen Joop Bonnema, Ase Krogh Rasmussen, Ulla Feldt-Rasmussen

Affiliations

  1. Department of Endocrinology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark ; Institute of Public Health, University of Copenhagen, Copenhagen, Denmark.
  2. Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark.
  3. Institute of Public Health, University of Copenhagen, Copenhagen, Denmark ; National Research Centre for the Working Environment, Copenhagen, Denmark.
  4. Institute of Public Health, University of Copenhagen, Copenhagen, Denmark ; Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen, Denmark.
  5. Department of Endocrinology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.

PMID: 24783018 PMCID: PMC3821477 DOI: 10.1159/000342623

Abstract

PURPOSE: To evaluate the relationship between thyroid variables and health-related quality of life (QoL) in patients with autoimmune hypothyroidism, using the thyroid-specific QoL questionnaire ThyPRO.

METHODS: In a cross-sectional study, responses to the ThyPRO from 199 outpatients with autoimmune hypothyroidism were analyzed in relation to thyroid volume, thyroid function and markers of thyroid autoimmunity. Based on a classical QoL framework, we hypothesized that physiological dysfunction caused specific physical and psychological symptoms, which affected functioning and well-being, and consequently participation in life and QoL. These hypotheses were tested through multiple regression and multivariate path analysis models.

RESULTS: None of the thyroid function tests were associated with QoL scores. However, in the pairwise regression, the thyroid peroxidase antibody (TPOAb) level was associated with several QoL outcomes: Goitre Symptoms (p = 0.024), Depressivity (p = 0.004), Anxiety (p = 0.004), Emotional Susceptibility (p = 0.005) and Impaired Social Life (p = 0.047). In the multivariate model, the TPOAb level was related to Goitre Symptoms (r = 0.17, p = 0.019), Depressivity (r = 0.24, p = 0.001), and Anxiety (r = 0.23, p = 0.002), but no longer to Emotional Susceptibility or Impaired Social Life, indicating that the effect on these were mediated through an effect on the symptom scales (i.e. Goitre Symptoms, Depressivity and Anxiety).

CONCLUSION: Health-related QoL, evaluated with state-of-the-art QoL methodology, was related to TPOAb level but not to thyroid function. This raises the hypothesis that autoimmunity, independent of thyroid function, impacts on QoL in patients with autoimmune hypothyroidism, especially in terms of psychological symptoms. Longitudinal studies, in initially untreated patients, are needed to test this hypothesis.

Keywords: Autoimmune hypothyroidism; Autoimmunity; Clinical variables; Quality of life

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