liu.seSearch for publications in DiVA
Change search
ReferencesLink to record
Permanent link

Direct link
Thyroid function tests, serum lipids and gender interrelations in a middle-aged population
Linköping University, Department of Medicine and Health Sciences, Primary Care . Linköping University, Faculty of Health Sciences.
2Department of Internal Medicine, Helsingborg Hospital, Sweden.
2001 (English)In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, Vol. 19, no 3, 183-185 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To study the value of screening for thyroid function in a screening program for hyperlipidaemia.

DESIGN: A screening study in primary health care.

SETTING: All individuals in a defined rural area, Söderåkra, Sweden, aged 40-59 years were invited to a screening programme at the local primary health care centre.

PARTICIPANTS: 782 individuals were invited for screening. Blood samples were obtained from 88% of the invited males and from 92% of the females.

MAIN OUTCOME MEASURES: Thyroid function tests (thyroid stimulating hormone (TSH) and free T4), serum lipids (total-cholesterol, HDL-cholesterol, LDL-cholesterol and s-triglycerides), b-glucose and body anthropometry (body mass index and waist to hip circumference) were measured.

RESULTS: 0.57% of males and 1.13% of females showed evidence of hypothyroidism as defined by a TSH value greater than 3.75 mU/l of those with s-cholesterol concentration above 7 mmol/l. In addition, higher TSH values in females were associated with higher s-cholesterol, s-LDL-cholesterol and s-triglycerides.

CONCLUSION: It seems appropriate to screen for hypothyroidism in females with s-cholesterol above 7.0 mmol/l.

Place, publisher, year, edition, pages
2001. Vol. 19, no 3, 183-185 p.
Keyword [en]
Free, T4, Serum, Lipids, Gender, Primary-CARE, Thyroid; Function, Tsh
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-17688DOI: 10.1080/028134301316982432PubMedID: 11697562OAI: diva2:211310
Available from: 2009-04-14 Created: 2009-04-14 Last updated: 2009-04-14Bibliographically approved
In thesis
1. Screening for Cardiovascular Risk and Diabetes in Primary Health Care: The Söderåkra Risk Factor Screening Study
Open this publication in new window or tab >>Screening for Cardiovascular Risk and Diabetes in Primary Health Care: The Söderåkra Risk Factor Screening Study
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Screening för hjärtkärlrisk och diabetes i primärvården : Söderåkrastudien
Abstract [en]

Background: Cardiovascular disease (CVD) has been the predominant cause of morbidity and mortality for many decades in Sweden. Preventive work in primary health care through individual approach and community-based programmes has shown some success. Still, we need better risk assessment tools and health strategies to lessen the burden of CVD in our population.

Methods: This thesis is based on four studies that explore the cardiovascular risk factor pattern and its development to CVD morbidity and mortality in the middle-aged (40-59 years) population in Söderåkra, southern Sweden, 1989-2006. At a single physician consultation in 1989-1990 the participants provided information about lifestyle in a self-administered questionnaire, underwent a physical examination and received medical advice after a laboratory investigation. The laboratory tests consisted mainly of blood glucose, serum lipids and thyroid function tests. Blood samples were also frozen for later analyses. A telephone interview on self-reported lifestyle changes was conducted ten years later. In 2006, primary health care medical records were studied for incident diabetes and also for impaired glucose tolerance (IGT). Finally, national registers were studied for incident fatal or nonfatal cardiovascular disease until 2006. Cardiovascular risk assessments using three separate risk algorithms were applied on the population.

Results: The participation rate was high with 90% attendance. The conclusion of this cross-sectional baseline analysis was that it is meaningful to check for a secondary cause of hyperlipidemia, hypothyroidism, in women with a cholesterol value above 7.0 mmol/L. After 10 years follow-up women reported significantly more lifestyle changes than men, odds ratio (OR) 1.56 (95% CI: 1.11- 2.18; p= 0.010). Men with a history of smoking or CVD at baseline and women with treated hypertension at baseline made successful lifestyle changes, OR 4.77 (95% CI: 2.18-10.5; p<0.001 and OR 1.84 (95% CI: 1.12-3.02; p= 0.016), respectively, than those without these characteristics. Until 2006, 38 participants had developed diabetes and four subjects IGT out of 664 participants, excluding 10 with diabetes at baseline. A low level of IGFBP-1 at baseline was associated with the development of type 2 diabetes/IGT, hazard ratio (HR) 3.54 (95% CI: 1.18-10.6, p=0.024). This was independent of abdominal obesity or inflammation (CRP). After excluding 16 participants with prevalent CVD at baseline, 71 first fatal or nonfatal CVD events in 689 men and women were registered. Several known risk factors and risk markers were applied on this population.

Those that turned out to be significantly associated with development of incident CVD in univariate Cox´s regression proportional hazard analyses where used in three different risk assessment models: the consultation model, SCORE and the extensive model. A non-laboratory-based risk assessment model, including variables easily obtained during one consultation visit to a general practitioner (GP), predicted cardiovascular events as accurately, HR 2.72; (CI 95% 2.18-3.39, p<0.001), as the established SCORE algorithm, HR 2.73; (CI 95% 2.10-3.55, p<0.001), which requires laboratory testing. Furthermore, adding laboratory measurements covering lipids, inflammation and endothelial dysfunction, did not confer any additional value to the prediction of CVD risk, HR 2.72; (CI 95% 2.19-3.37, p<0.001). The c-statistics for the consultation model (0.794; CI 95% 0.762-0.823) was not significantly different from SCORE (0.767; CI 95% 0.733-0.798, p=0.12) or the extended model (0.806; CI 95% 0.774-0.835, p=0.55).

Conclusions: Our study showed that it is worth searching for hypothyroidism, in women with a cholesterol value above 7 mmol/L. The study identified female gender, previous CVD, hypertension and smoking as predictors of positive lifestyle change during follow-up. A low level of IGFBP-1 predicted future diabetes/IGT in this population as did increased waist and CRP. Finally, data on nonlaboratory risk factors obtained during one GP visit predicted future cardiovascular risk as accurately as SCORE or a laboratory-based risk algorithm.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2009. 70 p.
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1110
National Category
Medical and Health Sciences
urn:nbn:se:liu:diva-17692 (URN)978-91-7393-673-6 (ISBN)
Public defence
2009-04-29, Aulan, Hälsans Hus (ingång 16), Campus US, Linköpings Universitet, Linköping, 13:00 (Swedish)
Available from: 2009-04-14 Created: 2009-04-14 Last updated: 2009-08-21Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMedLink to Ph.D. Thesis

Search in DiVA

By author/editor
Petersson, Ulla
By organisation
Primary Care Faculty of Health Sciences
In the same journal
Scandinavian Journal of Primary Health Care
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 74 hits
ReferencesLink to record
Permanent link

Direct link