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Marwaha R.K.,Institute of Nuclear Medicine and Allied Sciences | Tandon N.,All India Institute of Medical Sciences | Ganie M.A.,B R Sur Homeopathy Medical College | Mehan N.,All India Institute of Medical Sciences | And 5 more authors.
Clinical Biochemistry | Year: 2013

Objectives: To generate thyroid hormone reference norms using electro-chemiluminescence technique. Design and methods: Cross sectional study on apparently normal 4349 Delhi adults (18-86. years). Predetermined exclusion criteria (goiter, hypoechogenicity or nodularity on ultrasound, elevated anti-thyroid peroxidase antibody, hypo or hyperthyroidism and family history of thyroid dysfunction) excluded 2433 subjects leaving 1916 (916 males and 1000 females) as the reference population. Results: Mean age and BMI of the reference population were 41.2±18.1years and 24.5±4.4kg/m2 respectively. Median urinary iodine excretion was 233.6μg/L (79-458;3rd-97th centile). The population was categorized into various age groups (18-30, 31-40, 41-50, 51-60, 61-70 and ≥70years). Overall FT3 and FT4 values in the reference population irrespective of age, ranged from 2.4-8.8 (mean 4.6±0.9) pmol/L and 10.1-24.8 (mean 15.40±2.0) pmol/L, respectively. Mean TSH value in the reference population was 2.2±0.9mIU/L which was significantly lower than that of total population (3.8±6.1; p<0.001). Conclusion: FT3 values were observed to be significantly higher in men than women (p=. 0.001). The centiles (3rd, 5th, 10th, 25th, 50th, 75th, 90th, 95th and 97th) of FT3, FT4 and TSH were derived for reference purposes in Indian adults. This community based study in Indian adults has established mean reference intervals for FT3, FT4 and TSH for different age groups for both sexes separately using strict exclusion criteria. These can be used as reference norms for Indian adults. © 2012 The Canadian Society of Clinical Chemists. Published by Elsevier Inc.

Marwaha R.K.,Institute of Nuclear Medicine and Allied Sciences | Tandon N.,Institute of Nuclear Medicine and Allied Sciences | Ganie M.A.,Institute of Nuclear Medicine and Allied Sciences | Kanwar R.,Institute of Nuclear Medicine and Allied Sciences | And 4 more authors.
Journal of Association of Physicians of India | Year: 2012

Objectives: The aim was to find impact of two decades of universal salt iodization on the prevalence of goiter, thyroid autoimmunity and thyroid dysfunction in Indian adults. Methods: This was a cross sectional study from Delhi, India. The subject population included 4409 adult members of resident welfare associations of 5 residential colonies, from 18-90 years of age, who participated in general health check-up camps. The subjects underwent a detailed evaluation including history, anthropometry, goiter grading, USG thyroid, thyroid auto-antibodies and thyroid function tests. All these subjects were regularly consuming iodized salt. Results: Overall, 9.6 % of subjects had clinical goiter (13.3% women and 3.3% in men). Prevalence of nodules on palpation was found to be in 1.6% which was lower in men. The nodule prevalence increased to 4.6% in men and 5.6 % in women on ultrasonography. Thyroid hypoechogenicity was seen in 30.6% of subjects with severe hypoechogenicity higher in women (5.7% men and 15.5 % women). TPO antibody was positive in 13.3% adults and it showed a positive correlation with age, female sex and hypothyroidism. Subclinical hypothyroidism was the commonest abnormality encountered and affected 19.3 % subjects (15.9% men; 21.4% women). Thyroid dysfunction showed a rising trend with age in both genders. Conclusions: Normal UIE and low goiter prevalence, especially in males, suggest success of the universal salt iodization program in the region under review. High prevalence of subclinical hypothyroidism was not correlated with either thyroid autoimmunity or iodine intake, as reflected in urinary iodine excretion. © JAPI.

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