[Assessment of sub-clinical thyroid disfunction in aged hospitalized patients in Limousin]

The aims of the study were to assess the prevalence of sub-clinical thyroid dysfunction in older patients and to analyze morphological and immunological thyroid abnormalities.

The effect of aging on thyroid function morphology and immunology was studied in 102 french patients (70 women and 32 men) with a mean age of 81.7 +/- 7.3 years (65-101 years). All patients were hospitalized with different pathological conditions but without any thyroid disease. Patients with treatment or iodine substance which could modify thyroid function were excluded. Serum Free thyroxine (FT4) and TSH levels were detected by RIA. Morphological thyroid study was performed by clinical evaluation and ultrasonography. Two sub-groups of patients were distinguished according to immunological detection tests: In group A (n = 64) immunological parameter was performed by antithyroid microsomal antibodies and in group B (N = 38) by thyroid peroxidase antibodies.

We found 4 hypothyroidisms (3.9%), 3 hyperthyroidisms (3%) and 4 marginal isolated high FT4 levels. Elevated levels of FT4 was observed in 3 patients and 1 care of low T4 was described. All patients with abnormal hormonal levels were female. Other patient had normal thyroid function: mean level FT4 was 11.2 +/- 2.2 pg/ml (N: 7-17) and mean level TSH was 1.6 +/- 0.8 mU/l (N: 0.2-4). These values are comparable to those observed in adult populations. Incidence of thyroid autoimmunity was very low (3.9%) in this series compared with previous data. From the morphological analysis, we found 32 morphological abnormalities (31.4%), without strong relation with thyroid dysfunction. Nodule prevalence was near 15% and goiter near 10%.