MULTIMORBIDITY AND ITS ASSOCIATED RISK FACTORS AMONG ADULTS WITH THYROID NODULES

Imad R. Musa*

ABSTRACT

Background: Multimorbidity is a complex phenomenon and a growing global health challenge. Therefore, this study aimed to investigate the prevalence of multimorbidity and its associated risk factors among adults with thyroid nodules (TNs) in the eastern region of the Kingdom of Saudi Arabia (KSA). Methods: A retrospective study was conducted at the Royal Commission Hospital, Eastern KSA, from January 1, 2015 to December 31, 2021. Participants’ sociodemographic characteristics were assessed. Multimorbidity was defined as having more than one condition, such as diabetes mellitus (DM), hypertension, obesity, hypothyroidism, hyperthyroidism, anaemia and bronchial asthma. Multivariate regression analyses were conducted to identify any potential risk factors in multimorbid patients. Results: 391 adult participants with TNs were recruited in this study: The median (IQR) age was 46.00 (20.0) years of age, the majority of participants were females (84.9%) and the median (IQR) body mass index (BMI) was 30.27 (7.71) kg/m2. A total of 208 adults (53.2%) had multimorbidity: 117 (29.9%), 51 (13.0%), 33 (8.4%), and 6 (1.5%) 1 (0.3%) had two, three, four, five and six morbidities, respectively. The remaining 54 (13.8%) and 129 (33.0%) patients had no morbidity and one morbidity, respectively. In a univariate analysis, increasing age, white blood cell count (WBCc), platelet, thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4) and total cholesterol were positively associated with multimorbidity, whereas gender, low-density lipoprotein, high-density lipoprotein, triglyceride, 25-hydroxyvitamin D (25[OH)] D) levels and the outcome of thyroid ultrasound findings were not associated with multimorbidity. In a multivariate analysis, increasing age (adjusted odds ratio [AOR] = 1.057, 95% CI = 1.039 ‒1.075), elevated WBCc (AOR = 1.144, 95% CI 1.028 ‒1.274) and high FT3, (AOR = 0.703, 95% CI = 0.505 ‒ 0.978) were associated with multimorbidity. Conclusion: Multimorbidity is a major public health problem among adults with TNs in the KSA. Increasing age, elevated WBCc and FT3 are significantly associated with multimorbidity.

Keywords: Multimorbidity, hypertension, diabetes mellitus, obesity, anaemia, bronchial asthma, hypothyroidism, hyperthyroidism, thyroid nodules.