Prevalence of Hypothyroidism in a Large Sample of Patients with Obesity Hypoventilation Syndrome

Abstract

Purpose

Data on hypothyroidism in patients with obesity hypoventilation syndrome (OHS) are scarce. This study assessed the prevalence of hypothyroidism among a large group of patients with OHS.

Patients and Methods

This was a prospective observational study of 308 consecutive patients with OHS seen between January 2002 and December 2018. Serum thyroid-stimulating hormone (TSH) and free-thyroxine (FT4) levels were measured in all patients. The OHS patients were compared with 445 patients with obstructive sleep apnoea (OSA) matched for age, sex, and body mass index (BMI).

Results

The OHS patients had a mean age of 55.1 ± 13.8 years and a BMI of 43.9 ± 14.8 kg/m²; apnoea hypopnea index was ≥30 events/hr in 222 (72%). Clinical hypothyroidism was diagnosed in 58 (18.8%) of the OHS patients; only two cases (0.6%) were diagnosed in the sleep disorders clinic (newly diagnosed cases). Subclinical hypothyroidism was diagnosed in 19 (6.2%) of the OHS patients based on elevated TSH and normal FT4 levels; all cases were newly diagnosed. A logistic regression model identified female sex as the only predictor of clinical hypothyroidism in OHS patients (odds ratio: 2.801 [1.386–5.662], p = 0.004). There was no significant difference in clinical hypothyroidism prevalence between the OHS and OSA patients; however, subclinical hypothyroidism was more common in OHS than in OSA patients (6.2% vs 2.9%, respectively, p = 0.03).

Conclusion

Clinical hypothyroidism was prevalent among patients with OHS; however, newly diagnosed cases of clinical hypothyroidism were relatively low. Female sex was the only predictor of clinical hypothyroidism.

Keywords:

• menopause
• obstructive sleep apnoea
• subclinical hypothyroidism
• TSH
• thyroxine

Data Sharing Statement

Data are available upon request. However, releasing data needs IRB approval.

Ethics Statement

The study protocol was approved the Institutional Review Board (IRB) of the College of Medicine, King Saud University and Medical City. All participants had written informed consent.

Acknowledgments

This study was supported by a grant from the “Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia (08-MED511-02)”.

The authors thank Prof. Shahrokh Javaheri of the Bethesda North Hospital for his help in designing the study.

Author Contributions

All authors contributed to data analysis, drafting or revising the article, have agreed on the journal (Nature and Science of Sleep) to which the article was submitted, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest for this work.