Screening for thyroid dysfunction in older French hospitalized patients

The aims of the study were to assess the prevalence of sub-clinical thyroid dysfunction in older patients and to analyze morphological and immunologic al thyroid abnormalities. Subjects and Methods The effect of aging on thyroid function morphology and immunology was studi ed in 102 french patients (70 women and 32 men) with a mean age of 81.7 +/- 7.3 years (65-101 years). All patients were hospitalized with different pa thological conditions but without any thyroid disease. Patients with treatm ent or iodine substance which could modify thyroid function were excluded. Serum Free thyroxine (FT4) and TSH levels were detected by RIA. Morphologic al thyroid study was performed by clinical evaluation and ultrasonography. Two sub-groups of patients were distinguished according to immunological de tection tests: In group A (n =64) immunological parameter was performed by antithyroid microsomal antibodies and in group B (N = 38) by thyroid peroxi dase antibodies. Results We found 4 hypothyroidisms (3.9 %), 3 hyperthyroidisms (3 %) and 4 marginal isolated high FT4 levels. Elevated levels of FT4 was observed in 3 patient s and 1 care of low T-4 was described. All patients with abnormal hormonal levels were female. Other patient had normal thyroid function : mean level FT4 was 11.2 +/- 2.2 pg/ml (N : 7-17) and mean level TSH was 1.6 +/- 0.8 mU /l (N: 0.2-4). These values are comparable to those observed in adult popul ations. Incidence of thyroid autoimmunity was very low (3.9 %) in this seri es compared with previous data. From the morphological analysis, we found 3 2 morphological abnormalities (31.4 %), without strong relation with thyroi d dysfunction. Nodule prevalence was near 15 % and goiter near 10 %. Conclusion The prevalence of sub-clinical thyroid dysfunction was 8 %. No male subject was affected. The prevalence of nodule was close to 15 %. Contrary to the literature, we have not found high incidence of immunological abnormalities in this old population.