Increased prevalence of subclinical hypothyroidism in female hospitalized patients with depression
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ORIGINAL ARTICLE
Increased prevalence of subclinical hypothyroidism in female hospitalized patients with depression Shuai Zhao
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Zhilu Chen1 Xumiao Wang1 Zhijian Yao1,2,3 Qing Lu2,4 ●
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Received: 19 May 2020 / Accepted: 31 August 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Backgrounds Sex differences in depressive disorder (DD) and subclinical hypothyroidism (SCH) have been well recognized. However, few studies focus on the sex differences in DD patients with SCH. The purpose of this study is to address the sex differences in DD inpatients with SCH and further investigate the clinical characteristics and associations between DD and SCH among female and male depressed inpatients. Methods A total of 1787 hospitalized patients with a diagnosis of DD were recruited. Depression was assessed using the Hamilton Depression Rating Scale-17 items (HAMD), and anxiety was assessed using the Hamilton Anxiety Rating Scale. Blood test, including serum thyroid hormone levels, was measured. According to different genders, associations between DD and the presence of SCH were estimated using binary logistic regression. Results In the 1787 hospitalized patients with DD, the prevalence of SCH was 11.8%; the prevalence of SCH in female depressed inpatients is approximately two times that of male inpatients (14.6 vs. 7.4%, P < 0.05). Logistic regression showed that recurrent episodes and high BMI were associated with SCH in female inpatients (both P < 0.05). Spearman correlation analysis showed that thyroid stimulating hormone levels were associated with BMI (P < 0.05), total cholesterol levels (P < 0.05), and low-density lipoprotein cholesterol levels (P < 0.05) in female inpatients. Conclusions Our present study showed that the prevalence of SCH among female hospitalized patients with depression is approximately two times that of male inpatients. Recurrent and high-BMI female depressed inpatients are at high risk to develop SCH. More attention should be paid to the thyroid function of female inpatients with DD in future clinical work. Keywords Depressive disorders Subclinical hypothyroidism Sex differences ●
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Introduction
* Zhijian Yao [email protected] * Qing Lu [email protected] 1
Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, People’s Republic of China
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School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210096, People’s Republic of China
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Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing 210093, People’s Republic of China
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Child Development and Learning Science, Key Laboratory of Ministry of Education, Southeast University, Nanjing 210096, People’s Republic of China
Subclinical hypothyroidism (SCH) is a highly prevalent condition in depressed patients with prevalence estimates ranging from 9.4 to 60.6% [1, 2]. Evidence suggested that abnormal thyroid stimulating hormone (TSH) or thyroxine is associated with lifetime of depression [3
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