Abstract
Background: There are scarce data on the prevalence of thyroid disorders and urinary iodine status among tribal populations of India, with no reported data from Kashmir valley.Objectives: To estimate the prevalence of thyroid disorders and evaluate urinary iodine concentration (UIC) and thyroid autoantibody status among Gujjar and Bakerwal tribes of Kashmir valley.Methods: This cross-sectional study recruited tribal subjects using multistage cluster sampling from 5 out of 22 districts of Jammu and Kashmir (J&K). Using a predesigned questionnaire, the details of past or current medical history and drug intake, including thyroid hormone medication etc. were recorded after obtaining an informed consent. Examination included anthropometry (height, weight, waist circumference), blood pressure measurement, and relevant general physical examination focusing on goiter palpation, while as laboratory assessment included estimation of serum thyroid hormone levels, antithyroid peroxidase antibody (anti-TPO Ab), and urinary iodine concentration.Results: A total of 763 subjects (56.4% women and 43.6% men) with a mean(±SD) age of 39.46 (±17.51) ranging from 10 to 85 years and mean(±SD) body mass index (BMI) of 21.28 (±4.16) kg/m2 were studied. Goiter was detected in 6.8%, while 33.2% subjects had some form of thyroid dysfunction (including 24.1% subclinical and 6.8% overt hypothyroidism). Subclinical and overt hyperthyroidism were observed in 1.3 and 0.9% of cases, respectively. Anti-TPO Ab was elevated in 13.6%, while the median [interquartile range (IQR)] for UIC was 154.50 (135) μg/L [156.13 (134) μg/L in men and 147.26 (136) μg/L in women]. A negative correlation was observed between UIC and anti-TPO Ab (r = −0.087, P = <0.05).Conclusion: These novel data on iodine and thyroid status among a tribal population of India generally inhabiting in remote sub-Himalayan belts demonstrate high prevalence of subclinical hypothyroidism (SCH) with persistent iodine deficiency. These preliminary data may warrant large well-designed studies to carry out comprehensive assessment of the problem in this high-risk and marginalized population.
Highlights
Thyroid disorders are highly prevalent endocrine diseases, with iodine deficiency remaining a common cause of thyroid dysfunction worldwide
The blood samples were allowed to settle for 15 min at room temperature before they were centrifuged at 1,100 g (Eppendorf 5804R, Hamburg, Germany) for 10 min at the study site, and the serum samples were transported in cold boxes (∼4◦) to the storage site (SKIMS) where samples were stored at −20◦C until the assay
Subclinical hypothyroidism (SCH) was diagnosed if serum T4 levels were normal and serum thyroid-stimulating hormone (TSH) elevated (>6.5 μIU/ml), while subclinical hyperthyroidism was diagnosed if TSH was low (
Summary
Thyroid disorders are highly prevalent endocrine diseases, with iodine deficiency remaining a common cause of thyroid dysfunction worldwide. A follow-up data in the same region 15 years later demonstrated a significant drop in the goiter prevalence, indicating effective implementation of the National Iodine Deficiency Disorders Control (NIDDC) program [6]. There are scarce data on the incidence and prevalence of thyroid disorders in the tribal population of India except small studies on incidence of iodine deficiency from Orissa and Kerala [9, 10]. No such studies have been conducted in the tribal population of J&K, which comprises around 10.9% of the country’s total tribal population. There are scarce data on the prevalence of thyroid disorders and urinary iodine status among tribal populations of India, with no reported data from Kashmir valley
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