Evaluation of insulin resistance, anxiety and nutritional status of adults diagnosed with hypothyroidism, subclinical hypothyroidism and euthyroid

This study was conducted to evaluate the insulin resistance levels, anxiety and nutritional status of adult individuals diagnosed with primary hypothyroidism, subclinical hypothyroidism and euthyroidism. The study was carried out with 120 individuals, aged 18-64 years, who applied to Aksaray University Education and Research Hospital Internal Medicine Outpatient Clinic between December 2019 and August 2021. Individuals were divided into two groups as 60 patients (PG) diagnosed with hypothyroidism and 60 controls (CG). Patient group was divided into three different subgroups, equal in number, as primary hypothyroidism group (PHG), subclinical hypothyroidism group (SHG) and euthyroidism group (EG). A questionnaire was applied by the researcher in order to determine the general characteristics, health information and nutritional habits of the individuals. In order to determine the daily energy and nutrient intakes, food consumption records were taken with the 24-hour reminder method. The Beck Anxiety Inventory (BAI) was used to assess the anxiety states of individuals and the Mindful Eating Questionnare (MEQ) was used to examine the eating attitudes. Anthropometric measurements were taken by the researcher. Average age of individuals in PG is 36.33±11.50 years, and those in CG are 30.63±10.06 years (p>0.05). In PHG, the ratio of daily energy from carbohydrates (%51.00±11.20) was found to be higher than CG (%44.30±7.87) (p<0.05). Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) was 2.13±1.27 μU/mL in PHG, 2.41±2.16 μU/mL in SHG, 1.97±0.90 μU/mL in EG and 1.79±0.58 μU/mL in CG (p>0.05). No relationship was found between dietary energy, carbohydrate, fat, protein, fiber and HOMA-IR levels (p>0.05). There was no correlation between individuals' HOMA-IR levels and serum TSH levels (p>0.05). A negative correlation was found between serum TSH levels and iodine intake in CG (r=-0.315, p=0.014). A positive correlation was observed between serum TSH levels and saturated fat intake in EG (r=0.619, p=0.004). It has been detected that when the serum vitamin D level increases by one unit, the risk of disease decreases by 1% (OR=0.990, p=0.023). BAI scores of PG (PHG:14.10±8.10, SHG:13.35±9.66, EG:14.75±9.54) were found higher than CG (7.23±5.68) (p=0.000). MEQ scores were similar in PG and CG (p>0.05). It has been determined that the level of anxiety is higher in individuals diagnosed with primary hypothyroidism, subclinical hypothyroidism and euthyroidism and thyroid hormone levels can be affected by nutritional status. Keywords: Anxiety, hypothyroidism, insulin resistance, nutritional status, thyroid hormones