Clinical Spectrum and Autoimmune Profiles in a Libyan Clinical Cohort with Thyroid Disorders: A Pilot Study from Bani Waleed, Libya

Despite being one of the largest countries in North Africa, Libya lacks sufficient data on the frequencies of thyroid diseases and autoimmune thyroid disorders (AITDs), particularly Hashimoto's thyroiditis and Graves' disease. This study aimed to investigate the frequency and patterns of thyroid dysfunction and autoimmune markers in a clinical cohort of patients with thyroid disorders. In this pilot cross-sectional study, 130 patients with thyroid disorders were recruited between March and September 2023. Children and pregnant women were excluded. Demographic data, including sex, age, weight, height, family history, hypertension, diabetes mellitus, and type of thyroid medication, were collected via a questionnaire. Blood samples were also obtained from all subjects to measure thyroid hormones (T3 [nmol/L], T4 [nmol/L], and thyroid-stimulating hormone [TSH] [µIU/mL]) and thyroid antibodies (antithyroid peroxidase [anti-TPO] and anti-thyroglobulin [anti-TG] levels). Anti-TPO ≥ 40 IU/mL and anti-TG ≥ 104 ng/mL were defined as positive. Data analysis (SPSS v23) employed descriptive statistics, comparative tests (t-tests, analysis of variance, chi-square), and binary logistic regression to identify predictors of autoimmunity. A p-value of < 0.05 was considered significant. The participants consisted of 108 females (83.1%) and 22 males (16.9%), with a mean age of 42.41 ± 14.44 years (range, 18–70 years). The percentage of overt hypothyroidism and subclinical hypothyroidism was 35.4% (46/130) and 13.1% (17/130), respectively. The proportion of overt hyperthyroidism and subclinical hyperthyroidism was 9.2% (12/130) and 5.4% (7/130), respectively. Additionally, treated hypothyroidism was observed in 30.8% (40/130) and treated hyperthyroidism in 6.2% (8/130) of the participants. The mean and standard deviations of TSH, T3, and T4 were 7.51 ± 15.11 µIU/mL, 4.90 ± 28.33 nmol/L, and 90.29 ± 86.26 nmol/L, respectively. The overall frequency of AITDs was 49.2% (64/130) of our sample. Specifically, the frequency of positive anti-TPO and anti-TG antibodies was 43.1% (56/130) and 22.3% (29/130), respectively, with 12.3% (16/130) of the patients testing positive for both antibodies. Body mass index showed a significant association with thyroid disorders (p = 0.014) and with anti-TPO positivity (p = 0.03). Positive anti-TG antibodies were significantly more frequent in females (p = 0.01). This pilot study highlights a high frequency of thyroid dysfunction and autoimmunity among patients presenting for routine investigations in private clinics. While the findings are not generalizable to the wider Libyan population due to sample size and selection bias, they emphasize the importance of routine thyroid antibody testing and provide groundwork for larger, population-based studies.