Thyroid function testing is underused in adults with recently diagnosed hyperlipidemia, according to a study published online in the Nov. 11 issue of JAMA Internal Medicine. Despite current guidelines, only half of patients with newly diagnosed hyperlipidemia are screened for thyroid dysfunction. Given the push toward guidelines-compliant medical practice, this represents an area where adherence to guidelines may actually drive test volumes, given the U.S. Centers for Disease Control and Prevention’s findings that more than one-third of U.S. adults have high levels of “bad” cholesterol or low-density lipoprotein (LDL). The National Cholesterol Education Program, the American Association of Clinical Endocrinologists, and the American Thyroid Association all currently recommend screening for hypothyroidism in patients with newly diagnosed hyperlipidemia prior to commencing lipid-lowering therapy. In this study, researchers retrospectively reviewed charts from 8,795 adult patients (mean age, 53 years; 55 percent women; 45 percent African American; 24 percent white; 16 percent Hispanic) initially diagnosed with new hyperlipidemia (total serum cholesterol level of at least 200 mg/dL or LDL cholesterol level of at least 160 mg/dL) from 2003 to 2011 at Boston Medical Center’s general internal medicine or family medicine clinics. The proportion of patients with serum thyroid function testing conducted within six […]
Thyroid function testing is underused in adults with recently diagnosed hyperlipidemia, according to a study published online in the Nov. 11 issue of JAMA Internal Medicine. Despite current guidelines, only half of patients with newly diagnosed hyperlipidemia are screened for thyroid dysfunction.
Given the push toward guidelines-compliant medical practice, this represents an area where adherence to guidelines may actually drive test volumes, given the U.S. Centers for Disease Control and Prevention’s findings that more than one-third of U.S. adults have high levels of “bad” cholesterol or low-density lipoprotein (LDL).
The National Cholesterol Education Program, the American Association of Clinical Endocrinologists, and the American Thyroid Association all currently recommend screening for hypothyroidism in patients with newly diagnosed hyperlipidemia prior to commencing lipid-lowering therapy.
In this study, researchers retrospectively reviewed charts from 8,795 adult patients (mean age, 53 years; 55 percent women; 45 percent African American; 24 percent white; 16 percent Hispanic) initially diagnosed with new hyperlipidemia (total serum cholesterol level of at least 200 mg/dL or LDL cholesterol level of at least 160 mg/dL) from 2003 to 2011 at Boston Medical Center’s general internal medicine or family medicine clinics. The proportion of patients with serum thyroid function testing conducted within six months of the initial diagnosis of high cholesterol was determined.
The researchers found that thyroid functioning was evaluated within about six months in just under half of those with a hyperlipidemia diagnosis (49.5 percent). These testing rates were significantly higher among white patients (58 percent) compared to other races or ethnicities (range, 45 percent to 59 percent). Subsequent thyroid function testing was also significantly higher among women than men (60 percent versus 37 percent). Serum thyroid-stimulating hormone levels were elevated in 5.2 percent of those tested within six months, similar quantities to previously published studies.
“We conclude that the low rate of thyroid function testing in patients with new-onset hyperlipidemia demonstrates the need for more awareness of current guidelines,” write the authors, led by Devina Willard, M.D., from Boston Medical Center in Massachusetts. “Future studies are needed to better understand reasons for low thyroid function screening rates among patients with hyperlipidemia and cost-effectiveness of hypothyroidism screening and treatment among these patients.”
