Navigating Thyroid Dysfunction and Comorbidities Among University Students in Abbottabad, Pakistan – A Cross-Sectional Evaluation of Screening Tool for Thyroid Dysfunction

Figures & data

Table 1 Students’ Demographics (n=1032)

Demographic variables	Frequency, n (%)
Age in years
15–20	474 (45.93)
21–25	523 (50.67)
26–30	32 (3.10)
31–35	3 (0.29)
Gender
Male	707 (68.5)
Female	325 (31.5)
Residence
Urban	670 (64.9)
Rural	362 (35.1)
Family income in PKR
<25,000 (Average)	156 (15.1)
25,000–50,000 (Higher)	521 (50.5)
>50,000 (Lower)	355 (34.4)

Table 2 Comorbidities of Students (n=1032)

Comorbidities	Frequency, n (%)
No disease	810 (78.5)
High BP	63 (6.1)
High cholesterolemia	33 (3.2)
Angina	35 (3.4)
DM	9 (0.9)
Cancer	5 (0.5)
BP+ cholesterol	42 (4.1)
BP+ angina	17 (1.6)
BP+ DM	1 (0.1)
BP+ Cholesterol+ angina	4 (0.4)
BP+ Cholesterol +cancer	3 (0.3)
High BP+ Angina+ cancer	2 (0.2)
High cholesterolemia + Diabetic	6 (0.6)
DM+ Angina+ cancer	1 (0.1)
Heart disease+ DM	1 (0.1)

Abbreviations: BP, Blood Pressure; DM, Diabetes Mellitus.

Figure 1 Comorbidities among respondents according to gender.

Figure 2 Combination of comorbidities according to gender.

Table 3 Signs and Symptoms Persist for More Than 05 Weeks in Students (n=1032)

Signs/Symptoms	Frequency n (%) Yes	Frequency n (%) No
Palpitations (rapid or forceful heartbeat)	311 (30.1)	721 (69.9)
Poor concentration	380 (36.8)	652 (63.2)
Memory loss	335 (32.5)	697 (67.5)
Difficulty sleeping	334 (32.4)	698 (67.6)
Excessive need for sleep	435 (42.2)	597 (57.8)
Fatigue	364 (35.3)	668 (64.7)
Weak muscles	318 (30.8)	714 (69.2)
Sore muscles	248 (24)	784 (76)
Agitation/anxiety	337 (32.7)	695 (67.3)
Depression	347 (33.6)	685 (66.4)
Dry skin	323 (31.3)	709 (68.7)
Itchy skin	235 (22.8)	797 (77.2)
Unusual hair loss	442 (42.8)	590 (57.2)
Dry hair	424 (41.1)	608 (58.9)
Cracking nails	184 (17.8)	848 (82.2)
Infrequent bowel movements or hard stools	143 (13.9)	889 (86.1)
Frequent bowel movements or loose stools	142 (13.8)	890 (86.2)
Unexplained weight gain	199 (19.3)	833 (80.7)
Unexplained weight loss	157 (15.2)	875 (84.8)
Persistent pain or swelling at the front of the neck	134 (13)	898 (87)
Hoarseness	120 (11.6)	912 (88.4)
The sensation of a lump in the throat	171 (16.6)	861 (83.4)
Eye pain or double vision	171 (16.6)	861 (83.4)
Swelling or protrusion of eyes	167 (16.2)	865 (83.8)
Change in facial appearance	220 (21.3)	812 (78.7)
Sweating	351 (34)	681 (66)
Difficulty tolerating cold	265 (25.7)	767 (74.3)
Difficulty tolerating heat	208 (20.2)	824 (79.8)
Hand tremor	157 (15.2)	875 (84.8)

Table 4 Thyroid Personal and Family History (n=1032)

Thyroid Problem History	Yes, n (%)	No, n (%)
Family members with diagnosed thyroid disease	91 (8.8)	941 (91.2)
Self-diagnosed with a thyroid disease	78 (7.6)	954 (92.4)
Any current treatment for thyroid disease	28 (2.7)	1004 (97.3)
Treated for thyroid disease in past	39 (3.8)	993 (96.2)
Herbal remedies or dietary supplements specifically to benefit thyroid	33 (3.2)	999 (96.8)

Figure 3 Types of thyroid disease among students.

Table 5 Estimation of Thyroid Dysfunction Risk Based on Physical Assessment

*Risk of Thyroid Dysfunction	n (%)
Low risk	406 (39.3)
Moderate risk	379 (36.7)
High risk	247 (23.9)

Notes: *As per the Thyroid foundation of Canada, Wayne’s Index, and Billewicz guidelines, the score was calculated.

Table 6 Association Between Students ‘Age and Gender in Relation to Thyroid Risk Levels

Variables	Number of Respondents	Low Risk	Moderate Risk	High Risk	P value
Age 15–20 Years	Respondents	158	168	148	<0.001
	% in age group	33.3%	35.4%	31.2%
	% in risk levels	38.9%	44.3%	59.9%
21–25 Years	Respondents	235	192	96
	% in age group	57.9%	50.7%	18.4%
	% in risk levels	44.9%	36.7%	38.9%
26–30 Years	Respondents	10	19	03
	% in age group	31.3%	5.0%	9.4%
	% in risk levels	2.5%	59.4%	1.2%
31–35 Years	Respondents	03	0	0
	% in age group	100.0%	0.0%	0.0%
	% in risk levels	0.7%	0.0%	0%
Total	Count	406	379	247
	% in age group	39.3%	36.7%	23.9%
	% in risk levels	100.0%	100.0%	100.0%
Gender Male	Respondents	306	240	161	<0.001
	% in gender	43.3%	33.9%	22.8%
	% in risk levels	75.4%	63.3%	65.2%
Female	Respondents	100	139	86
	% in gender	30.8%	42.8%	26.5%
	% in risk levels	24.6%	36.7%	34.8%
Total	Count	406	379	247
	% in gender	39.3%	36.7%	23.9%
	% in risk levels	100.0%	100.0%	100.0%

Figure 4 Association between comorbidities and thyroid risk levels.

Figure 5 Association between consumption of herbal medicine versus risk levels of thyroid.

Table 7 Regression Results of Thyroid Risk with Some Demographic Features of Students

Model	Unstandardized Coefficients		t	p-value	95.0% CI for B
	B	Std. Error			Lower Bound	Upper Bound
(Constant)	20.423	2.373	8.605	<0.001	15.766	25.080
Age	−1.772	0.274	−6.475	<0.001	−2.309	−1.235
Gender	0.886	0.329	2.690	0.007	0.240	1.532
Area of residence	−1.120	0.312	−3.583	<0.001	−1.733	−0.507
Monthly income	−0.196	0.218	−898	0.369	−0.625	0.232
Presence of comorbidities	0.099	0.082	1.201	0.230	−0.063	0.260
Family member diagnosed with thyroid?	−1.685	0.551	−3.058	0.002	−2.767	−0.604
Currently taking treatment for thyroid	−2.016	1.097	−1.838	0.066	−4.168	0.136
Ever treated for thyroid	−0.960	0.964	−0.996	0.319	−2.852	0.931
Consumption status of herbal medicine	0.172	0.960	0.179	0.858	−1.712	2.056