The health status and the prevalence of metabolic disorders of adult endemic cretinism—An epidemiological study in China

Abstract

Background and aims: The cross-sectional survey aimed to characterize the health status of adult endemic cretinism patients in a severely iodine-deficient region, focusing on the prevalence of dyslipidemia, hyperglycemia, and hypertension. The study also sought to provide new epidemiological evidence for the association between endemic cretinism and lipid metabolism disorders, particularly hypercholesterolemia and hypertriglyceridemia. Methods and results: All surviving endemic cretinism patients (n = 31) and matched controls (n = 97) were investigated in December 2020. iodine concentration in urinary and serum, thyroid function parameters, lipid profile [total cholesterol (TC), triglyceride (TRIG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C)], fasting blood glucose (FBG), and blood pressure measurements [systolic blood pressure (SBP), diastolic blood pressure (DBP)] were assessed. Endemic cretinism patients exhibited significantly elevated thyroid-stimulating hormone (TSH) levels and a higher prevalence of hypothyroidism compared to controls. Serum TC and TRIG concentrations were markedly higher in endemic cretinism patients than in controls (5.27 mmol/L vs. 4.73 mmol/L, P = 0.009; and 1.65 mmol/L vs. 1.04 mmol/L, P < 0.001, respectively). The prevalence of hypercholesterolemia and hypertriglyceridemia was significantly higher in endemic cretinism patients (P = 0.001 and P < 0.001, respectively). Multivariate analysis revealed that endemic cretinism was an independent risk factor for both hypercholesterolemia [adjusted odds ratio (AOR) = 2.870, 95% confidence interval (CI): 1.129–7.298] and hypertriglyceridemia (AOR = 5.912, 95% CI: 2.261–15.455). Conclusion: Adult endemic cretinism patients demonstrate significantly elevated serum lipid levels and are more susceptible to hypercholesterolemia and hypertriglyceridemia, conditions closely associated with their underlying hypothyroidism. These findings highlight the importance of monitoring and managing metabolic parameters in adult endemic cretinism patients.