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Female vulnerability for thyroid function abnormality in bipolar disorder: role of lithium treatment

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Author
Özerdem, Ayşegül
Tunca, Zeliha
Çımrın, Dilek
Hıdıroğlu, Ceren
Ergör, Gül
Type
Article
Date
2014-02
Language
en_US
Metadata
Show full item record
Abstract
BackgroundPrevious studies have provided evidence of subtle thyroid hormone metabolism abnormalities in patients with mood disorders. Although these studies are informative, the precise role of the hypothalamic-pituitary-thyroid axis in bipolar disorder, especially in women, remains unclear. We sought to further corroborate thyroid function in patients with bipolar disorder in comparison to patients with other psychiatric, as well as non-psychiatric, diagnoses. MethodsIn this retrospective, cross-sectional, naturalistic study, serum thyroid-stimulating hormone (TSH) levels in a total sample of 3,204 patients were compared. The study sample included patients with bipolar disorder (n=469), unipolar depression (n=615), and other psychiatric diagnoses (n=999), patients from endocrinology clinics (n=645), and patients from dermatology clinics (n=476). Analyses were completed using two different normal ranges for TDH: a high normal range (0.4-5.0 IU/mL) and a low normal range (0.3-3.0 IU/mL). ResultsPatients with bipolar disorder showed significantly higher serum TSH levels compared to all other groups. In women, the rate of above normal range TSH was highest in patients with bipolar disorder for both high (5.0IU/mL; 12.1%) and low (3.0IU/mL; 30.4%) upper normal limits. In patients with bipolar disorder, serum TSH levels did not differ significantly between different mood states. In the lithium-treated patients (n=240), a significantly lower percentage of women (55.9%) compared to men (71.2%) fell within the 0.3-3.0IU/mL normal TSH window (p=0.016). For the high normal range (0.4-5.0IU/mL), serum lithium levels above 0.8mmol/L were associated with a significantly lower proportion of female patients (59.2%) falling within the normal range than male patients (88.9%). Non-lithium treatment was not associated with a gender difference. ConclusionsOur findings show a higher rate of TSH abnormality in patients with bipolar disorder, particularly those taking lithium, compared to those with other psychiatric and medical conditions. Lithium-associated thyroid dysregulation occurs more frequently in female patients. Using the low normal range TSH values at follow-up can increase sensitivity in recognizing hyperthyroidism in lithium-treated female patients, and help in preventing the development of subclinical hypothyroidism and an adverse course of illness.
Subject
bipolar disorder
female
gender difference
lithium
thyroid function
High-Dose Thyroxine
Treated Patients
Autoimmune-Thyroiditis
Antithyroid Antibodies
Reference Intervals
National-Health
United-States
Depression
Hypothyroidism
Thyrotropin
URI
https://doi.org/10.1111/bdi.12163
https://hdl.handle.net/11413/2245
Collections
  • Makaleler / Articles [147]
  • Pubmed Publications [149]
  • Scopus Publications [724]
  • WoS Publications [1016]

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İstanbul Kültür University

Hakkında |Politika | Kütüphane | İletişim | Send Feedback | Admin

Istanbul Kültür University, Ataköy Campus E5 Karayolu Üzeri Bakırköy 34158, İstanbul / TURKEY
Copyright © İstanbul Kültür University

Creative Commons Lisansı
IKU Institutional Repository, Creative Commons Alıntı-GayriTicari-Türetilemez 4.0 Uluslararası Lisansı ile lisanslanmıştır.

Designed by  UNIREPOS