Prevalence of Metabolic Syndrome among Adult Filipino Patients with Thyroid Disease in an Outpatient Clinic in Cebu City, Philippines from 2004–2015

Background: The Metabolic Syndrome (MetS) is a cluster of cardiovascular risk factors, which increases the risk for cardiovascular disease and stroke. In recent studies, thyroid disorder (TD) is associated with cardiovascular disease due to the effect of its hormones on the functions of the heart and should thus be considered an independent cardiovascular risk factor. The concurrence of MetS in persons with thyroid dysfunction may further increase their risk for cardiovascular events. In the Philippines, there is limited data regarding the prevalence of metabolic syndrome in patients with thyroid dysfunction, and at present no available local guidelines on the optimal time to screen patients with thyroid disorder for metabolic syndrome. We aimed to determine the prevalence of MetS and its components among adult Filipino patients with thyroid disorder. Methods: This is a retrospective cross sectional study of 870 randomly selected patients previously diagnosed with thyroid disease in an outpatient clinic in Cebu City from year 2004 until 2015. Clinical data were obtained using an electronic medical search database. Anthropometric measures and BMI were recorded. Laboratory parameters including total cholesterol, triglycerides, HDL, LDL and fasting blood glucose were reviewed. Those patients who did not have any blood evaluations for metabolic parameters were excluded. Only 487 patients were included in the final analysis. Statistical analysis of the data was analyzed using the IBM SPSS Software version 21 and Chi square test of independence with 2x2 Fisher exact test adjustment wherein a p-value of <0.05 alpha was considered significant. Findings: The overall prevalence of MetS in our patient population with diagnosed thyroid disease was 46%. MetS was noted in 54% of patients presenting with nontoxic goiter, 40% of patients presenting with thyrotoxicosis and only 6% in patients with hypothyroidism. The presence of MetS was more common among women (81%) with thyroid disorder than in men (19%), and more prevalent in the age group between 40 to 60 years of age. The components of MetS noted in our patient population were dyslipidemia (91%), diabetes (88%), obesity (75%) and hypertension (67%). There was no difference between genders with regard to the components of the MetS except the HDL and triglyceride levels. Conclusion: In our study population, MetS was prevalent among patients presenting with thyroid disorder, especially in the female population above the age of 40. Screening for components of MetS is therefore advised on all patients seen in the outpatient setting for thyroid disorder. Our study has a valid clinical implication as undiagnosed components of metabolic syndrome will have poor long term prognosis in terms of morbidity and mortality. Early diagnosis and treatment of MetS, especially in patients with thyroid disorder who remain asymptomatic can result in better long term outcome.