Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Geriatrics
Published in: BMC Geriatrics 1/2024

Open Access 01-12-2024 | Research

Prevalence and risk factors for subclinical hypothyroidism in older patients with major depressive disorder

Authors: Min Li, Xiu-Wen Wang, Xiao-Qian Wang, Jian-Jun Zhang, Xiang-Yang Zhang

Published in: BMC Geriatrics | Issue 1/2024

Login to get access

Abstract

Background

Subclinical hypothyroidism (SCH) is highly correlated with major depressive disorder (MDD). However, the prevalence and risk factors for SCH in older patients with MDD have rarely been reported in China.

Methods

This cross-sectional study included 266 older MDD patients with SCH was performed. Clinical and anthropometric, biochemical, and thyroid function data were collected. Depression, anxiety, and psychotic symptoms were assessed using the Hamilton Depression Scale, the Hamilton Anxiety Scale, and the Positive and Negative Syndrome Scale positive subscale, respectively.

Results

Among older patients with MDD, the prevalence of SCH was 64.7% (172/266). Compared to patients without SCH, older MDD patients with SCH had a longer disease course and higher TSH, A-TG, A-TPO, HDL-C, LDL-C, TC, FPG, and systolic pressure levels (all P ≤ 0.002). Furthermore, disease progression (OR 1.082, 95% CI 1.020–1.147, P = 0.009), A-TG (OR 1.005, 95% CI 1.001–1.009, P = 0.017), TC (OR 2.024, 95% CI 1.213–3.377, P = 0.007), FPG (OR 2.916, 95% CI 1.637–5.194, P < 0.001), systolic pressure (OR 1.053, 95% CI 1.008–1.100, P = 0.022) were independently associated with SCH, in older patients with MDD.

Conclusions

Our findings suggest a high prevalence of SCH in older patients with MDD. Several demographic and clinical variables were independently associated with SCH in older patients with MDD.
Literature
1.
Li Z, Ruan M, Chen J, Fang Y. Major depressive disorder: advances in Neuroscience Research and Translational Applications. Neurosci Bull. 2021;37(6):863–80.PubMedCentralCrossRefPubMed
2.
Salk RH, Hyde JS, Abramson LY. Gender differences in depression in representative national samples: Meta-analyses of diagnoses and symptoms. Psychol Bull. 2017;143(8):783–822.PubMedCentralCrossRefPubMed
3.
Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, Rush AJ, Walters EE, Wang PS, National Comorbidity Survey R. The epidemiology of major depressive disorder: results from the National Comorbidity Survey replication (NCS-R). JAMA. 2003;289(23):3095–105.CrossRefPubMed
4.
Fielding R, Gu L, Xie J, Long J, Chen Q, Chen Q, Pan R, Yan Y, Wu G, Liang B et al. Epidemiology of major depressive disorder in Mainland China: a systematic review. PLoS ONE 2013, 8(6).
5.
Ferrari AJ, Somerville AJ, Baxter AJ, Norman R, Patten SB, Vos T, Whiteford HA. Global variation in the prevalence and incidence of major depressive disorder: a systematic review of the epidemiological literature. Psychol Med. 2013;43(3):471–81.CrossRefPubMed
6.
7.
Helfand M, U.S. Preventive Services Task Force. Screening for subclinical thyroid dysfunction in nonpregnant adults: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2004;140(2):128–41.CrossRefPubMed
8.
Javed Z, Sathyapalan T. Levothyroxine treatment of mild subclinical hypothyroidism: a review of potential risks and benefits. Ther Adv Endocrinol Metab. 2016;7(1):12–23.PubMedCentralCrossRefPubMed
9.
Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, Spencer CA, Braverman LE, Serum TSH. T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab. 2002;87(2):489–99.CrossRefPubMed
10.
Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado thyroid Disease prevalence study. Arch Intern Med. 2000;160(4):526–34.CrossRefPubMed
11.
Guan Yunfeng LZ, Jiang Peng P, Yi J, Xing S. The prevalence of hypothyroidism among adults in China: a systematic review. Chin J Endemiol. 2017;36(10):772–6.
12.
Baumgartner C, Blum M, Rodondi N. Subclinical hypothyroidism: summary of evidence in 2014. Swiss Med Wkly 2014.
13.
Tang R, Wang J, Yang L, Ding X, Zhong Y, Pan J, Yang H, Mu L, Chen X, Chen Z. Subclinical hypothyroidism and depression: a systematic review and Meta-analysis. Front Endocrinol. 2019;10:1–8.CrossRef
14.
15.
Prezioso G, Giannini C, Chiarelli F. Effect of thyroid hormones on neurons and neurodevelopment. Hormone Res Paediatrics. 2018;90(2):73–81.CrossRef
16.
17.
Pasqualetti G, Pagano G, Rengo G, Ferrara N, Monzani F. Subclinical hypothyroidism and cognitive impairment: systematic review and Meta-analysis. J Clin Endocrinol Metab. 2015;100(11):4240–8.CrossRefPubMed
18.
Ian Hickie BB, Mitchell P, Wilhelm K, Orlay W. Clinical and subclinical hypothyroidism in patients with chronic and treatment-resistant depression. Aust N Z J Psychiatry 1996:246–52.
19.
Bruce M, Cohen MD, Barbara PD, Sommer R, Alexander Vuckovic MD. Antidepressant-resistant depression in patients with comorbid subclinical hypothyroidism or high-normal TSH levels. Treat PSYCHIATRY. 2018;175(7):598–604.
20.
21.
Chueire VB, Romaldini JH, Ward LS. Subclinical hypothyroidism increases the risk for depression in the elderly. Arch Gerontol Geriatr. 2007;44(1):21–8.CrossRefPubMed
22.
Karakatsoulis GN, Tsapakis E-M, Mitkani C, Fountoulakis KN. Subclinical thyroid dysfunction and major depressive disorder. Hormones. 2021;20(4):613–21.CrossRefPubMed
23.
Kotwal A, Cortes T, Genere N, Hamidi O, Jasim S, Newman CB, Prokop LJ, Murad MH, Alahdab F. Treatment of thyroid dysfunction and serum lipids: a systematic review and Meta-analysis. J Clin Endocrinol Metab 2020, 105(12).
24.
Kus A, Kjaergaard AD, Marouli E, Del Greco MF, Sterenborg R, Chaker L, Peeters RP, Bednarczuk T, Asvold BO, Burgess S, et al. Thyroid function and Mood disorders: a mendelian randomization study. Thyroid. 2021;31(8):1171–81.CrossRefPubMed
25.
Liu YY, Brent GA. Thyroid hormone crosstalk with nuclear receptor signaling in metabolic regulation. Trends Endocrinol Metab. 2010;21(3):166–73.CrossRefPubMed
26.
Sridevi A, Vivekanand B, Giridhar G, Mythili A, Subrahmanyan KA. Insulin resistance and lipid alterations in subclinical hypothyroidism. Indian J Endocrinol Metab. 2012;16(Suppl 2):345–6.CrossRef
27.
28.
Razvi S, Jabbar A, Pingitore A, Danzi S, Biondi B, Klein I, Peeters R, Zaman A, Iervasi G. Thyroid hormones and Cardiovascular function and Diseases. J Am Coll Cardiol. 2018;71(16):1781–96.CrossRefPubMed
29.
Lin CH, Wang FC, Lin SC, Chen CC, Huang CJ. A comparison of inpatients with anxious depression to those with nonanxious depression. Psychiatry Res. 2014;220(3):855–60.CrossRefPubMed
30.
Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiat 1960.
31.
32.
Wu EL, Chien IC, Lin CH, Chou YJ, Chou P. Increased risk of hypothyroidism and hyperthyroidism in patients with major depressive disorder: a population-based study. J Psychosom Res. 2013;74(3):233–7.CrossRefPubMed
33.
Lang X, Hou X, Shangguan F, Zhang XY. Prevalence and clinical correlates of subclinical hypothyroidism in first-episode drug-naive patients with major depressive disorder in a large sample of Chinese. J Affect Disord. 2020;263:507–15.CrossRefPubMed
34.
Li X, Zhen D, Zhao M, Liu L, Guan Q, Zhang H, Ge S, Tang X, Gao L. Natural history of mild subclinical hypothyroidism in a middle-aged and elderly Chinese population: a prospective study. Endocr J. 2017;64(4):437–47.CrossRefPubMed
35.
Zhao M, Yang T, Chen L, Tang X, Guan Q, Zhang B, Zhang X, Zhang H, Wang C, Xu J, et al. Subclinical hypothyroidism might worsen the effects of aging on serum lipid profiles: a population-based case-control study. Thyroid. 2015;25(5):485–93.CrossRefPubMed
36.
Kornstein SG, Schneider RK. Clinical features of treatment-resistant depression. J Clin Psychiatry. 2001;62(Suppl):18–25.PubMed
37.
Shan Z, Chen L, Lian X, Liu C, Shi B, Shi L, Tong N, Wang S, Weng J, Zhao J, et al. Iodine status and prevalence of thyroid disorders after introduction of mandatory Universal Salt iodization for 16 years in China: a cross-sectional study in 10 cities. Thyroid. 2016;26(8):1125–30.CrossRefPubMed
38.
Li Y, Teng D, Ba J, Chen B, Du J, He L, Lai X, Teng X, Shi X, Li Y, et al. Efficacy and safety of long-term Universal Salt iodization on thyroid disorders: epidemiological evidence from 31 provinces of Mainland China. Thyroid. 2020;30(4):568–79.CrossRefPubMed
39.
Boucai L, Hollowell JG, Surks MI. An Approach for Development of Age-, Gender-, and ethnicity-specific Thyrotropin reference limits. Thyroid. 2011;21(1):5–11.PubMedCentralCrossRefPubMed
40.
Hennessey JV, Espaillat R. Subclinical hypothyroidism: a historical view and shifting prevalence. Int J Clin Pract. 2015;69(7):771–82.CrossRefPubMed
41.
42.
Huang X, Sun Y, Wu A, Zhang X-Y. Gender differences in the prevalence and clinical correlates of thyroid dysfunction in patients with first-episode and drug-naïve major depressive disorder with comorbid Suicide attempts: a large cross-sectional study. BMC Psychiatry. 2023;23(1):603–13.PubMedCentralCrossRefPubMed
43.
Detka J, Kurek A, Basta-Kaim A, Kubera M, Lason W, Budziszewska B. Elevated brain glucose and glycogen concentrations in an animal model of depression. Neuroendocrinology. 2014;100(2–3):178–90.CrossRefPubMed
44.
Jose de Leon PM, Lorraine Maw, Margaret T, Susce M, Mercedes Perez-Rodriguez. Enrique Baca-Garcia: lack of replication of the association of low serum cholesterol and attempted Suicide in another country raises more questions. Ann Clin Psychiatry. 2011;23(3):163–70.PubMed
45.
Liu W, Wu Z, Sun M, Zhang S, Yuan J, Zhu D, Yan G, Hou K. Association between fasting blood glucose and thyroid stimulating hormones and suicidal tendency and Disease severity in patients with major depressive disorder. Bosn J Basic Med Sci. 2022;22(4):635–42.PubMedCentralPubMed
46.
Peng YF, Zhong SM, Qin YH. The relationship between major depressive disorder and glucose parameters: a cross-sectional study in a Chinese population. Adv Clin Exp Med. 2017;26(4):665–9.CrossRefPubMed
47.
Rodondi N, Bauer DC. Subclinical hypothyroidism and Cardiovascular Risk: how to end the controversy. J Clin Endocrinol Metabolism. 2013;98(6):2267–9.CrossRef
48.
Garduño-Garcia JJ, Alvirde-Garcia U, López-Carrasco G, Padilla Mendoza ME, Mehta R, Arellano-Campos O, Choza R, Sauque L, Garay-Sevilla ME, Malacara JM, et al. TSH and free thyroxine concentrations are associated with differing metabolic markers in euthyroid subjects. Eur J Endocrinol. 2010;163(2):273–8.CrossRefPubMed
49.
Maratou E, Hadjidakis DJ, Kollias A, Tsegka K, Peppa M, Alevizaki M, Mitrou P, Lambadiari V, Boutati E, Nikzas D, et al. Studies of insulin resistance in patients with clinical and subclinical hypothyroidism. Eur J Endocrinol. 2009;160(5):785–90.CrossRefPubMed
50.
Pesic MM, Radojkovic D, Antic S, Kocic R, Stankovic-Djordjevic D. Subclinical hypothyroidism: association with cardiovascular risk factors and components of metabolic syndrome. Biotechnol Biotechnol Equip. 2014;29(1):157–63.PubMedCentralCrossRefPubMed
51.
Tan KC, Shiu SW, Kung AW. Plasma Cholesteryl Ester transfer protein activity in Hyper- and hypothyroidism. J Clin Endocrinol Metab. 1998;83:140–3.PubMed
52.
Susan E, Tsutakawa HJ, Morikawa k. Recognition of a TG mismatch: the Crystal structure of very short Patch Repair Endonuclease in Complex with a DNA duplex. Cell. 1999;99:615–23.
53.
Liu W, Wu Z, Sun M, Zhang S, Yuan J, Zhu D, Yan G, Hou K. Association between fasting blood glucose and thyroid stimulating hormones and suicidal tendency and Disease severity in patients with major depressive disorder. Bosnian J Basic Med Sci. 2022;22(4):635–42.
54.
Maleki N, Kazerouni F, Hedayati M, Rahimipour A, Maleki H. Assessment of cardiovascular risk factors in patients with subclinical hypothyroidism. Acta Cardiol. 2017;71(6):691–7.CrossRef
55.
Wei Z-X, Xie G-J, Mao X, Zou X-P, Liao Y-J, Liu Q-S, Wang H, Cheng Y. Exosomes from patients with major depression cause depressive-like behaviors in mice with involvement of mir-139-5p-regulated neurogenesis. Neuropsychopharmacology. 2020;45(6):1050–8.PubMedCentralCrossRefPubMed
56.
Liang JQ, Liao HR, Xu CX, Li XL, Wei ZX, Xie GJ, Cheng Y. Serum exosome-derived mir-139-5p as a potential biomarker for major depressive disorder. Neuropsychiatr Dis Treat. 2020;16:2689–93.PubMedCentralCrossRefPubMed
Metadata
Title
Prevalence and risk factors for subclinical hypothyroidism in older patients with major depressive disorder
Authors
Min Li
Xiu-Wen Wang
Xiao-Qian Wang
Jian-Jun Zhang
Xiang-Yang Zhang
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2024
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-023-04584-9

Other articles of this Issue 1/2024

BMC Geriatrics 1/2024 Go to the issue

Research

Exploring the impact of information and communication technologies on loneliness and social isolation in community-dwelling older adults: a scoping review of reviews

Research

Elderly patients with non-specific complaints at the emergency department have a high risk for admission and 30-days mortality

Research

Sleep quality and psychological health in patients with pelvic and acetabulum fractures: a cross-sectional study

Research

Incorporating preoperative frailty to assist in early prediction of postoperative pneumonia in elderly patients with hip fractures: an externally validated online interpretable machine learning model

Research

Measuring the effects of nurse-led frailty intervention on community-dwelling older people in Ethiopia: a quasi-experimental study

Research

Improving diagnostics using extended point-of-care testing during in-home assessments of older adults with signs of emerging acute disease: a prospective observational non-randomised pilot and feasibility study
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine
Image Credits