Is Thyroid Autoimmunity per se a Determinant of Quality of Life in Patients with Autoimmune Hypothyroidism?
Open accessAbstract
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.
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In patients with autoimmune hypothyroidism, TPO-Ab levels (but not TSH, FT4, or FT3) are related to goiter symptoms, depressivity, and anxiety.
“A cross-sectional study among patients with autoimmune hypothyroidism observed that TPO-Ab levels (but not TSH, FT4, or FT3) are related to goiter symptoms, depressivity, and anxiety [67].”
From T4+T3 Combination Therapy: An Unsolved Problem of Increasing Magnitude and Complexity (2021) · cites this paper as [67]
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- Authors
- Watt, T., Hegedüs, L., Bjorner, J. B., Groenvold, M., Bonnema, S. J., Rasmussen, Å. K., & Feldt-Rasmussen, U.
- Affiliations
- University of Copenhagen (DK)
- 5Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark
- 2Institute of Public Health, University of Copenhagen
- Venue
- European Thyroid Journal
- Publisher
- Bioscientifica
- Published
- 2012-09-28
- Volume
- 1
- Issue
- 3
- Pages
- 186-192
- ISSN
- 2235-0640 (ISSN-L)
- 2235-0802
- PMC
- PMC3821477
- OpenAlex
- W2112887358
- Cited by
- 75
- References
- 35
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 4 · 2023: 9 · 2022: 8 · 2021: 10 · 2020: 5 · 2019: 2 · 2018: 6 · 2017: 4 · 2016: 4 · 2015: 5 · 2014: 10 · 2012: 1
- FWCI
- 4.11
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- European Thyroid Journal (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion)
- Funders
- Novo Nordisk Fonden
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Pathology and Forensic Medicine › Ophthalmology and Eye Disorders
- Keywords
- autoimmune hypothyroidism, health-related quality of life, thyroid autoimmunity, thyroid peroxidase antibodies, thyroid volume, thyroid function, depression, anxiety, emotional vulnerability, social functioning
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