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[Asymptomatic thyroid dysfunction. Routine detection using the free thyroxine index].

J L Schlienger, D Heist, C Demangeat

    Presse Medicale (Paris, France : 1983)
    |January 22, 1983
    PubMed
    Summary
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    Routine thyroid function tests in hospital patients revealed a significant prevalence of subclinical hyperthyroidism and hypothyroidism. Investigating older patients and using free T4 assays can improve diagnostic efficiency and reduce costs for detecting thyroid dysfunction.

    Area of Science:

    • Endocrinology
    • Clinical Chemistry
    • Internal Medicine

    Context:

    • Routine thyroid function testing is crucial for hospitalized patients.
    • Thyroid dysfunction can be present without overt clinical signs or history.
    • Prevalence of subclinical thyroid disease in a general hospital population.

    Purpose:

    • To determine the prevalence of subclinical thyroid dysfunction in hospitalized patients.
    • To evaluate the diagnostic utility of free plasma thyroxine index (FT4I) and triiodothyronine (T3) levels.
    • To assess the cost-effectiveness of screening strategies for thyroid disorders.

    Summary:

    • 1862 patients without thyroid history were tested; 16.3% had abnormal total thyroxine (T4), 7.5% abnormal FT4I, and 23% low T3.
    • Subclinical hyperthyroidism was found in 1.66% and hypothyroidism in 0.75% of patients.

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  • Abnormal FT4I on repeat testing indicated hyperthyroidism in 72% and hypothyroidism in 74% of cases.

    • Impact:

    • Subclinical thyroid dysfunction is more prevalent than previously thought in hospitalized patients.
    • Screening individuals over 50 years old and utilizing free T4 assays can optimize diagnostic yield and reduce costs.
    • Early detection of thyroid dysfunction can prevent long-term complications and improve patient outcomes.