Correlation between overt hyperthyroid and subclinical hyperthyroid and cognitive impairment in Dr. Sardjito General Hospital, Yogyakarta, Indonesia
Berkat Hia Pernodjo Dahlan Abdul Ghofir
(1*)
(1) 
(*) Corresponding Author
Abstract
Hyperthyroidism is a metabolic imbalance resulting from excessive production of thyroid hormones. Overt or subclinical hyperthyroid prevalence has reached 20%. The differences in thyroid status induce apoptosis in adult cerebral cortex. Triiodothyroxine (T3) acts directly on the cerebral cortex mitochondria and induces the release of cytochrome-c which leads to apoptosis. The increase of hormone levels encountered in hyperthyroidism which is associated with an increase in necrotic death of neurons and oxidative stress has a negative effect on cognition. Several studies demonstrated the significant association of hyperthyroidism with cognitive impairment, despite remaining as controversial results. The study aimed to evaluate the correlation between overt hyperthyroid and subclinical hyperthyroid and cognitive impairment in hyperthyroidism patients. This was a cross-sectional study involving 68 patients of hyperthyroidism who were treated in Endocrine Clinic of Dr. Sardjito General Hospital, Yogyakarta. The inclusion criteria were hyperthyroidism based on anamnesis, clinical examination and laboratory tests, age of 20- 60 years, symptoms of hyperthyroidism, and minimum education of elementary school. The relationship of hyperthyroidism and cognitive impairment, and multivariate analysis was analyzed by Chi-square and logistic regression tests, respectively. The results were considered as statistically significant if the value of p was <0.05. The results showed that overt hyperthyroidism had significantly associated with cognitive impairment (p = 0.021). Another variable associated with cognitive impairment was female gender (p = 0.019). In a multivariate analysis, the variables of overt hyperthyroidism (p = 0.024) and sex (p = 0.025) had independent association with cognitive impairment. In conclusion, this study found that overt hyperthyroidism had a significant association with incidence of cognitive impairment compared to subclinical hyperthyroidism.
Keywords: hyperthyroidism - overt - subclinical - cognitive - mini-mental state examination
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