Prevalence of Hypothyroidism in a Large Sample of Patients with Obesity Hypoventilation Syndrome

Ahmed S BaHammam; Salih Aleissi; Awad H Olaish; Aljohara S Almeneessier; Anwar A Jammah

doi:10.2147/NSS.S263959

Prevalence of Hypothyroidism in a Large Sample of Patients with Obesity Hypoventilation Syndrome

Nat Sci Sleep. 2020 Sep 16:12:649-659. doi: 10.2147/NSS.S263959. eCollection 2020.

Authors

Ahmed S BaHammam^{1

2}, Salih Aleissi¹, Awad H Olaish¹, Aljohara S Almeneessier^{1

3}, Anwar A Jammah⁴

Affiliations

¹ University Sleep Disorders Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
² Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, Riyadh, Saudi Arabia.
³ Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
⁴ Endocrinology Unit, Thyroid Diseases Section, Department of Medicine, King Saud University, Riyadh, Saudi Arabia.

Abstract

Purpose: Data on hypothyroidism in patients with obesity hypoventilation syndrome (OHS) are scarce. This study assessed the prevalence of hypothyroidism among a large group of patients with OHS.

Patients and methods: This was a prospective observational study of 308 consecutive patients with OHS seen between January 2002 and December 2018. Serum thyroid-stimulating hormone (TSH) and free-thyroxine (FT4) levels were measured in all patients. The OHS patients were compared with 445 patients with obstructive sleep apnoea (OSA) matched for age, sex, and body mass index (BMI).

Results: The OHS patients had a mean age of 55.1 ± 13.8 years and a BMI of 43.9 ± 14.8 kg/m²; apnoea hypopnea index was ≥30 events/hr in 222 (72%). Clinical hypothyroidism was diagnosed in 58 (18.8%) of the OHS patients; only two cases (0.6%) were diagnosed in the sleep disorders clinic (newly diagnosed cases). Subclinical hypothyroidism was diagnosed in 19 (6.2%) of the OHS patients based on elevated TSH and normal FT4 levels; all cases were newly diagnosed. A logistic regression model identified female sex as the only predictor of clinical hypothyroidism in OHS patients (odds ratio: 2.801 [1.386-5.662], p = 0.004). There was no significant difference in clinical hypothyroidism prevalence between the OHS and OSA patients; however, subclinical hypothyroidism was more common in OHS than in OSA patients (6.2% vs 2.9%, respectively, p = 0.03).

Conclusion: Clinical hypothyroidism was prevalent among patients with OHS; however, newly diagnosed cases of clinical hypothyroidism were relatively low. Female sex was the only predictor of clinical hypothyroidism.

Keywords: TSH; menopause; obstructive sleep apnoea; subclinical hypothyroidism; thyroxine.