Clinical Epidemiology & Public Health
Public health | Online ISSN 3068-4587
1
Citations
7.7k
Views
16
Articles
Volume 3 Number 1 2025
RESEARCH ARTICLE (Open Access)
Demographic Patterns in Thyroid Dysfunction: Age and Gender Associations from a 7-Year Clinical Cohort in Ibb, Yemen
Mohammed A.M.Y. Al-Hetar 1,2,3* , Norasiykin A. Wahab1,4, Malak Mohammed Al-Hetar2, Nabil Al-joma’ai5, Abdullah Ahmed Faleh2, Adnan Taha Al-jaberi6, Abdullah Almatary3, Mohammad Ebraheem Alezzy2, Eshtiak Mohammed2, Ahd Hamoud Haidar2
Clinical Epidemiology & Public Health 3 (1) 1-8 https://doi.org/10.25163/health.3110535
Submitted: 15 October 2025 Revised: 14 December 2025 Accepted: 19 December 2025 Published: 21 December 2025
Abstract
Background: Thyroid disorders, including overt and subclinical forms, are a major public health concern. Accurate biochemical classification is essential for early detection and effective management, particularly in population-based screening.
Objective: To estimate the prevalence and distribution of thyroid dysfunction and examine age and sex associations using comprehensive hormone profiling.
Methods: We conducted a retrospective cross-sectional study of 4,081 individuals evaluated at a tertiary endocrine center in Ibb, Yemen (August 2018–July 2025). Thyroid status was classified using FT3, FT4, and TSH. Subclinical hypothyroidism was defined as elevated TSH with normal FT3/FT4; subclinical hyperthyroidism as suppressed TSH with normal FT3/FT4. Abnormal TSH defined overt hypo and hyperthyroidism with concordant FT3/FT4 changes. Analyses used SPSS v26 and Pearson’s chi-square tests. The cohort comprised 92.4% females, with the majority aged 30–49 years.
Results: Normal thyroid function was observed in 89.3% of participants. Subclinical hypothyroidism was present in 10.7%, subclinical hyperthyroidism in 2.7%, overt hypothyroidism in 0.8%, and overt hyperthyroidism in 1.7%. Females were disproportionately represented (92.4%), and the 30–49year age group was most affected. Age showed a significant association with TSH in females (χ² = 10.303, df = 4, p = 0.036) and borderline significance in the total population (χ² = 9.418, df = 4, p = 0.051). FT3 and FT4 showed no consistent age associations. Sex did not consistently influence hormone profiles.
Conclusion: Approximately 13.4% of the population exhibited subclinical thyroid dysfunction. Age was a significant determinant of TSH variation, particularly among women, underscoring the importance of agestratified screening and integrated FT3–FT4–TSH classification in endocrine surveillance.
Keywords: Thyroid dysfunction, subclinical hypothyroidism, subclinical hyperthyroidism, overt hypothyroidism, age association, gender, epidemiology, Ibb-Yemen.
References
Al Eidan, E., Ur Rahman, S., Al Qahtani, S., Al Farhan, A. I., & Abdulmajeed, I. (2018). Prevalence of subclinical hypothyroidism in adults visiting primary healthcare settings in Riyadh. Journal of Community Hospital Internal Medicine Perspectives, 8(1), 11–15. https://doi.org/10.1080/20009666.2017.1422672
Alexander, E. K., Pearce, E. N., Brent, G. A., Brown, R. S., Chen, H., Dosiou, C., Grobman, W. A., Laurberg, P., Lazarus, J. H., Mandel, S. J., Peeters, R. P., & Sullivan, S. (2017). 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease during Pregnancy and the Postpartum. Thyroid, 27(3), 315–389. https://doi.org/10.1089/thy.2016.0457
Alhajri A M, S. A. S. A. I. H. et al. (2025). Prevalence and Risk Factors of Subclinical and Overt Hypothyroidism in Saudi Arabia: A Systematic Review. Cureus, 17(6).
Ane Garmendia Madariaga, S. S. P. F.-G. J. C. G. (2014). The Incidence and Prevalence of Thyroid Dysfunction in Europe: A Meta-Analysis. JCEM, 99(3).
Baretella, O., Blum, M. R., Abolhassani, N., Alwan, H., Wildisen, L., Giovane, C. Del, Tal, K., Moutzouri, E., Åsvold, B. O., Cappola, A. R., Gussekloo, J., Iacoviello, M., Iervasi, G., Imaizumi, M., Weiler, S., Razvi, S., Sgarbi, J. A., Völzke, H., Brown, S. J., … Rodondi, N. (2025). Associations Between Subclinical Thyroid Dysfunction and Cardiovascular Risk Factors According to Age and Sex. Journal of Clinical Endocrinology and Metabolism, 110(5), e1315– e1322. https://doi.org/10.1210/clinem/dgae860
Carla Moran, N. S. D. H. S. O. (2024). Approach to the Patient with Raised Thyroid Hormones and Nonsuppressed TSH. The Journal of Clinical Endocrinology & Metabolism, 109(4), 1094–1108.
Chen, J., Zhang, L., & Zhang, X. (2024). Overall, sex-and race/ethnicity-specific prevalence of thyroid dysfunction in US adolescents aged 12–18 years. Frontiers in Public Health, 12. https://doi.org/10.3389/fpubh.2024.1366485
Coste, J., Mandereau-Bruno, L., Bertagna, X., & Wémeau, J.-L. (2025). Prevalence of treated hyper- and hypo-thyroidism and sociodemographic and geographic disparities in France in 2020. European Thyroid Journal, 14(3). https://doi.org/10.1530/etj-25-0041
Dillon, C. F., Weisman, M. H., Leung, A. M., Brent, G. A., & Miller, F. W. (2025a). Autoimmune Thyroid Disease in the United States: Population Prevalence, Diagnosis Rates, and Trends. Journal of the Endocrine Society, 9(10). https://doi.org/10.1210/jendso/bvaf120
Dillon, C. F., Weisman, M. H., Leung, A. M., Brent, G. A., & Miller, F. W. (2025b). Autoimmune Thyroid Disease in the United States: Population Prevalence, Diagnosis Rates, and Trends. Journal of the Endocrine Society, 9(10). https://doi.org/10.1210/jendso/bvaf120
Fiammetta Battheu, C. C. S. C. & C. M. (2025). Differences in autoimmune thyroid diseases between females and males: the result of a complex interconnection of factors. Endocrine, 29, 665–679.
Garber, J. R., Cobin, R. H., Gharib, H., Hennessey, J. V., Klein, I., Mechanick, J. I., Pessah-Pollack, R., Singer, P. A., & Woeber, K. A. (2012). Clinical practice guidelines for hypothyroidism in adults: Cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. In Endocrine Practice (Vol. 18, Issue 6). American Association of Clinical Endocrinologists. https://doi.org/10.4158/ep12280.gl
Kargar, S., Tabatabaei, S. M., Okati-Aliabad, H., & Rad, H. I. (2024a). Prevalence of Thyroid Dysfunction Disorders among Adult Populations in the Middle East: A Systematic Review and Meta-analysis. The Open Public Health Journal, 17(1). https://doi.org/10.2174/0118749445317174240827052511
Kargar, S., Tabatabaei, S. M., Okati-Aliabad, H., & Rad, H. I. (2024b). Prevalence of Thyroid Dysfunction Disorders among Adult Populations in the Middle East: A Systematic Review and Meta-analysis. The Open Public Health Journal, 17(1). https://doi.org/10.2174/0118749445317174240827052511
Krishnamurthy, H., Suresh, C., Siriwardhane, T., Krishna, K., Song, Q., Jayaraman, V., Wang, T., Bei, K., & Rajasekaran, J. J. (2025). Association between thyroid dysfunction and insulin resistance: a retrospective cohort study. BMJ Open, 15(1). https://doi.org/10.1136/bmjopen-2023-076397
Malaysian Endocrine & Metabolic Society. (2019). CLINICAL PRACTICE GUIDELINES MANAGEMENT OF THYROID DISORDERS. http://www.moh.gov.my
Manso, J. (2025). Special Issue “Thyroid Dysfunctions: Molecular Mechanisms Underlying Clinical Consequences.” International Journal of Molecular Sciences, 26(24), 11967. https://doi.org/10.3390/ijms262411967
Mark P. J. Vanderpump. (2011). The epidemiology of thyroid disease. British Medical Bulletin, 99(1).
Moran, C., Schoenmakers, N., Halsall, D., Oddy, S., Lyons, G., van den Berg, S., Gurnell, M., & Chatterjee, K. (2024). Approach to the Patient with Raised Thyroid Hormones and Nonsuppressed TSH. Journal of Clinical Endocrinology and Metabolism, 109(4), 1094–1108. https://doi.org/10.1210/clinem/dgad681
NICE GUIDELINE. (2019). Thyroid disease: assessment and management NICE guideline. www.nice.org.uk/guidance/ng145
Pearce, S. H. S., Brabant, G., Duntas, L. H., Monzani, F., Peeters, R. P., Razvi, S., & Wemeau, J.-L. (2014). 2013 ETA Guideline: Management of Subclinical Hypothyroidism. European Thyroid Journal, 2(4), 215–228. https://doi.org/10.1159/000356507
Peter Laurberg, C. C. (2010). Iodine intake as a determinant of thyroid disorders in populations. Science Direct, 24(1), 13–27.
Razvi, S. (2024). Thyroid-function reference ranges in the diagnosis of thyroid dysfunction in adults. Nat Rev Endocrinol, 20, 253–254. https://doi.org/https://doi.org/10.1038/s41574-024-00972-2
Siying Liu, C. L. L. H. Z. S. W. T. Y. L. and T. L. (2024). Thyroid®: Vitamin E Intake and Prevalence Rates of Thyroid Dysfunction and Autoimmune Thyroiditis: A Cross-Sectional Analysis of NHANES Data. Thyroid® (Official Journal of the American Thyroid Association, 34(5), 789– 798.
Sohn, S. Y., Inoue, K., Rhee, C. M., & Leung, A. M. (2024). Risks of Iodine Excess. In Endocrine Reviews (Vol. 45, Issue 6, pp. 858–879). Endocrine Society. https://doi.org/10.1210/endrev/bnae019
Sun Y. Lee, M. Ms. E. N. P. M. Ms. (2023). Hyperthyroidism: A Review. JAMA, 330(15), 1472-1483.
Taylor, P. N., Albrecht, D., Scholz, A., Gutierrez-Buey, G., Lazarus, J. H., Dayan, C. M., & Okosieme, O. E. (2018). Global epidemiology of hyperthyroidism and hypothyroidism. In Nature Reviews Endocrinology (Vol. 14, Issue 5, pp. 301–316). Nature Publishing Group. https://doi.org/10.1038/nrendo.2018.18
Taylor, P. N., Lansdown, A., Witczak, J., Khan, R., Rees, A., Dayan, C. M., & Okosieme, O. (2023). Age-related variation in thyroid function – a narrative review highlighting important implications for research and clinical practice. In Thyroid Research (Vol. 16, Issue 1). BioMed Central Ltd. https://doi.org/10.1186/s13044-023-00149-5
Unnikrishnan, A., & Menon, U. (2011). Thyroid disorders in India: An epidemiological perspective. Indian Journal of Endocrinology and Metabolism, 15(6), 78. https://doi.org/10.4103/2230- 8210.83329
Vargas-Uricoechea, H. (2023). Molecular Mechanisms in Autoimmune Thyroid Disease. In Cells(Vol. 12, Issue 6). MDPI. https://doi.org/10.3390/cells12060918
Wessam Mansour Filfilan. (2023). Thyroid Hormones Regulate the Thermoregulatory Mechanisms of the Body: Review. Pakistan Journal of Biological Sciences, 26(9), 453–457.
Yamamoto, K., Nakano, Y., Soejima, Y., Suyama, A., Oguni, K., Hasegawa, K., & Otsuka, F. (2025). Is subclinical hypothyroidism associated with cardiovascular disease in the elderly? In Endocrine Connections (Vol. 14, Issue 5). BioScientifica Ltd. https://doi.org/10.1530/EC-24-0601
Yang, W., Jin, C., Wang, H., Lai, Y., Li, J., & Shan, Z. (2023). Subclinical hypothyroidism increases insulin resistance in normoglycemic people. Frontiers in Endocrinology, 14. https://doi.org/10.3389/fendo.2023.1106968
Yoo, W. S., & Chung, H. K. (2021). Subclinical hypothyroidism: Prevalence, health impact, and treatment landscape. Endocrinology and Metabolism, 36(3), 500–513. https://doi.org/10.3803/ENM.2021.1066
Zimmermann, M. B., & Andersson, M. (2021). Global perspectives in endocrinology: Coverage of iodized salt programs and iodine status in 2020. In European Journal of Endocrinology (Vol. 185, Issue 1, pp. R13–R21). BioScientifica Ltd. https://doi.org/10.1530/EJE-21-0171
Article metrics
View details
0
Downloads
0
Citations
11
Views
0
Save
Save
0
Citation
Citation
11
View
View
0
Share
Share