Abstract
BACKGROUND: Hypothyroidism remains a significant public health issue in India, with autoimmune thyroid disease (AITD) increasingly recognized as a major contributor despite the nationwide success of iodized salt programs in addressing iodine deficiency. Identifying autoimmune associations in hypothyroidism is critical for improving diagnostic and management strategies. OBJECTIVE: This study aimed to assess the prevalence of AITD and its association with other autoimmune conditions among patients with hypothyroidism. METHODS: A cross-sectional study was conducted at the Department of Medicine, Hakeem Abdul Hameed Centenary Hospital, New Delhi, between June 2023 and May 2024. A total of 165 adult patients (≥18 years) with overt or subclinical hypothyroidism were enrolled. Clinical history, demographic data, anthropometric measurements, and biochemical investigations were obtained. Thyroid profiles, anti-thyroid peroxidase (anti-TPO) antibodies, and anti-tissue transglutaminase (anti-TTG) antibodies were assessed. Data were analyzed using SPSS v21.0. Statistical significance was defined at p<0.05. RESULTS: Of 165 participants, 124 (75.2%) were female and 41 (24.8%) were male, with a female-to-male ratio of approximately 3:1. The predominant age group was 41-60 years (41.2%). Elevated anti-TPO antibodies were detected in 130 patients (78.8%), confirming AITD as the leading etiology. A statistically significant correlation was observed between autoimmune disorders and anti-TPO positivity (p<0.001). Additionally, 15.4% of subjects were anti-TTG positive, all of whom also exhibited elevated anti-TPO antibodies (p=0.008). CONCLUSION: AITD accounted for the majority of hypothyroidism cases in this study, with a significant association observed between hypothyroidism and other autoimmune conditions, including celiac disease. These findings underscore the importance of screening hypothyroid patients for autoimmunity and highlight the need for prospective studies to establish causal pathways and long-term outcomes.