Predictors of Improvement in Quality of Life When Treating Hypothyroidism

Journal of Thyroid Research

Filip Krag Knop¹  Martin Krakauer²  Torquil Watt³  Jeppe Lerche la Cour³  Luba Freja Michaelsson³  Bjarke Borregaard Medici⁴  Jens Faber⁵  Birte Nygaard⁵ 

[1] Center for Clinical Metabolic Research, University of Copenhagen, Gentofte Hospital, Kildegårdsvej 28, Opgang 7, 3. Sal, Hellerup 2900, Denmark, ku.dk;Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Nørre Allé 20, Copenhagen 2200, Denmark, ku.dk;Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, ku.dk;Department of Clinical Physiology and Nuclear Medicine, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte Hospitalsvej 2, 1. Sal, th, Hellerup, Denmark, ku.dk;Department of Medicine, Herlev and Gentofte Hospital, University of Copenhagen, Herlev Ringvej 75, Herlev 2730, Denmark, ku.dk;Department of Medicine, Herlev and Gentofte Hospital, University of Copenhagen, Herlev Ringvej 75, Herlev 2730, Denmark, ku.dk;Center for Clinical Metabolic Research, University of Copenhagen, Gentofte Hospital, Kildegårdsvej 28, Opgang 7, 3. Sal, Hellerup 2900, Denmark, ku.dk;Department of Medicine, Herlev and Gentofte Hospital, University of Copenhagen, Herlev Ringvej 75, Herlev 2730, Denmark, ku.dk;Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Nørre Allé 20, Copenhagen 2200, Denmark, ku.dk;

DOI  :  10.1155/2021/5577217

来源: Hindawi Publishing Corporation

【 摘 要 】

Background. Primary hypothyroidism is characterized by reduced quality of life (QoL). Although thyrotropin (TSH) is utilized as the primary indicator of thyroid disease and treatment adequacy, no simple correlation between QoL and TSH has been shown. This study aimed to investigate changes in clinically relevant predictors during initiation of levothyroxine (L-T4) therapy and their ability to predict improvement in QoL. Method. Quality of life was measured in patients with newly diagnosed hypothyroidism, during the initial 12 months of L-T4 therapy, by the thyroid-related patient-reported outcome questionnaire, ThyPRO-39. The main outcome measures were the Composite QoL scale and the Tiredness and Emotional Susceptibility subscales (0–100, higher scores worse). Clinical variables (resting energy expenditure (REE), body composition, thyroid function, L-T4 dose, and cognitive function tests) were evaluated as predictors of improvement in QoL by univariate and multiple regression analysis. Results. Thirty-seven hypothyroid patients with a baseline median TSH of 30 mU/l and a median QoL score of 29 were included. After twelve months of L-T4 treatment, the ThyPRO-39 QoL score had significantly improved to a median score of 14, while REE per kg fat-free mass (FFM) increased significantly from a mean of 26.5 to 28.7 kcal/day/kg (p<0.001). Change in ThyPRO-39 was not associated with a change in REE/FFM (unstandardized coefficient (USC): 0.09 with confidence interval (CI): −1.93 to 2.11, p=0.93) but was positively predicted by baseline body mass index (BMI) (USC: 1.54 with CI: 0.59 to 2.49, (p=0.002), without association with weight loss (USC: 0.33 with CI: −1.21 to 1.27, p=0.96). Conclusion. Improvement in QoL as measured by ThyPRO-39 after initiation of L-T4 therapy for hypothyroidism was not associated with changes in REE. High baseline BMI, but not weight loss during therapy, was associated with improvement in QoL. This trail is registered with www.Clinicaltrials.gov (registration no. https://clinicaltrials.gov/ct2/show/NCT02891668).

【 授权许可】

CC BY