Thyroid abnormality in patients with psoriasis: prevalence and association with severity

Abstract Background: Psoriasis is associated with several comorbidities and its association with thyroid abnormality has been hypothesized. Objective: To assess the prevalence of thyroid abnormality in Brazilian patients with psoriasis and to analyze its association with severity, presence of psoriatic arthritis and immunobiological treatment. Additionally, to compare results with literature as a control. Methods: In this observational study, clinical and laboratory data of patients followed from January 2018 to December 2019 were analyzed. Thyroid abnormality was assessed through the current history of thyroid disease and laboratory tests - thyrotropin (TSH), free thyroxine (FT4), antithyroid peroxidase (anti-TPO) and antithyroglobulin (anti-TG) antibodies. Patients were classified according to psoriasis severity - Psoriasis Area and Severity Index (PASI), presence of psoriatic arthritis, and current treatment. Subsequently, the results were compared with a control group selected from the literature review. Results: Of the 250 included patients, 161 were eligible. The prevalence of thyroid abnormality was 28.57% and of hypothyroidism, 14.91%. The mean age was 55 years and the median PASI was 2.2. There was no association between thyroid abnormality and PASI (p = 0.8), presence of psoriatic arthritis (p = 0.87), or use of immunobiological therapy (p = 0.13). The literature control group included 6,227 patients and there was a statistically significant difference for the hypothyroidism variable (p < 0.0001).

Thyroid abnormality in patients with psoriasis: prevalence and association with severity.

BACKGROUND: Psoriasis is associated with several comorbidities and its association with thyroid abnormality has been hypothesized. OBJECTIVE: To assess the prevalence of thyroid abnormality in Brazilian patients with psoriasis and to analyze its association with severity, presence of psoriatic arthritis and immunobiological treatment. Additionally, to compare results with literature as a control. METHODS: In this observational study, clinical and laboratory data of patients followed from January 2018 to December 2019 were analyzed. Thyroid abnormality was assessed through the current history of thyroid disease and laboratory tests - thyrotropin (TSH), free thyroxine (FT4), antithyroid peroxidase (anti-TPO) and antithyroglobulin (anti-TG) antibodies. Patients were classified according to psoriasis severity - Psoriasis Area and Severity Index (PASI), presence of psoriatic arthritis, and current treatment. Subsequently, the results were compared with a control group selected from the literature review. RESULTS: Of the 250 included patients, 161 were eligible. The prevalence of thyroid abnormality was 28.57% and of hypothyroidism, 14.91%. The mean age was 55 years and the median PASI was 2.2. There was no association between thyroid abnormality and PASI (p=0.8), presence of psoriatic arthritis (p=0.87), or use of immunobiological therapy (p=0.13). The literature control group included 6,227 patients and there was a statistically significant difference for the hypothyroidism variable (p<0.0001). STUDY LIMITATIONS: Absence of a control group from the same center. CONCLUSION: This was one of the first Brazilian studies on the prevalence of thyroid abnormality in patients with psoriasis.

Perfil das participantes do projeto de extensão "Viver Melhor - Assistência Integral às Mulheres no Climatério" / Profile of the participants of the "Living Better – Integral Care of Menopausal Women" extension project

O climatério, transição entre o período reprodutivo e o não-reprodutivo, é marcado por mudanças hormonais, físicas e psíquicas, que muitas vezes são acompanhadas de sintomas desagradáveis às mulheres. O projeto Viver Melhor - Assistência Integral às Mulheres no Climatério do HU/CAS-UFJF tem como função prestar educação em saúde a essa população. A fim de aperfeiçoar o trabalho do grupo e auxiliar na promoção da saúde dessas mulheres, o perfil delas foi analisado. Para isso utilizamos o Questionário de Saúde da Mulher, composto por 37 questões, aplicado a 36 participantes do projeto, selecionadas em amostra acidental. Como resultados, observou-se pontuação baixa (sintomas mais graves) no questionário para sintomas somáticos, vasomotores e de memória e concentração; e pontuação alta (sintomas mais leves) para depressão, atratividade e sintomas menstruais. Conclui-se, portanto, que a alta prevalência e a relativa gravidade de alguns desses sintomas podem ter influências negativas na qualidade de vida das mulheres climatéricas. Desta forma, iniciativas de educação em saúde devem ser incentivadas, estimulando o esclarecimento e o acesso ao serviço de saúde para a população em período de climatério.

Menopause, the transition period between childbearing age and non-reproductive age, is characterized by hormonal, physical and psychic changes, which frequently lead to unpleasant symptoms. The "Living Better - Integral Care of Menopausal Women", an extension project developed at the University Hospital / Health Care Center of the Federal University of Juiz de Fora, Brazil, aims to provide menopausal women with health education. The participants' profile was assessed, in order to improve the work developed and help with health education initiatives. The Women's Health Questionnaire, composed of 37 questions, was applied to 36 participants randomly selected. Lower scores (more severe symptoms) were observed for somatic, vasomotor, memory and concentration symptoms, while higher scores (milder symptoms) were observed for depression, attractiveness and menstrual symptoms. The high prevalence and relative severity of some of these symptoms may adversely affect the quality of life of menopausal women. Health education initiatives must be supported so as to increase the menopausal population's knowledge about and access to health care services.