Diagnostic Determinants of Thyroid Dysfunction in Southern Saudi Arabia: Identifying High-Risk Populations Through Integrated Risk Factor Analysis

Jalal H Abu Halimah,1 Mohammad A Jareebi,2 Zakaria Y Shubayli,3 Mohammad Y Shubayli,3 Mohammad A Zaeri,3 Khalid A Bakri,3 Ahmed Y Sabi,3 Abdulaziz F Zaylaee,3 Zuhair A Almunawwar,3 Eyad Z Omar,3 Rakan M Hakami,3 Abdullah A Khudier,3 Abdulaziz A Aqdi,3 Rayim A Oraybi,3 Khalid O Alyahyawi11Department of Surgery, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia; 2Department of Family and Community Medicine, Jazan University, Jazan, Saudi Arabia; 3Faculty of Medicine, Jazan University, Jazan, Saudi ArabiaCorrespondence: Mohammad A Jareebi, Email mjareebi@jazanu.edu.saBackground and Objectives: Early and accurate diagnosis of thyroid disorders remains challenging in resource-variable settings, with limited diagnostic algorithms tailored to regional populations. Understanding the constellation of risk factors for thyroid disease can enhance diagnostic accuracy and inform targeted screening strategies.Methods: We conducted a cross-sectional diagnostic study among 1,250 adults (≥ 18 years) in southern Saudi Arabia (May 2024) to identify diagnostic determinants of thyroid dysfunction. Participants completed structured assessments of demographic profiles, anthropometric measurements, family and medical histories, lifestyle factors, and current thyroid status. Statistical analyses included chi-square tests, Fisher’s exact tests, and independent-samples t-tests to establish diagnostic associations.Results: Self-reported physician-diagnosed thyroid disorders were reported by 10% of participants, with hypothyroidism predominating (7%). Diagnostic determinants showed distinct clustering patterns: hypothyroidism demonstrated the strongest associations with female sex (OR-equivalent difference: 81% vs 41%, p < 0.001), elevated BMI (30 ± 6.6 vs 26 ± 7.7 kg/m2, p < 0.001), advanced age (40 ± 11 vs 34 ± 13 years, p < 0.001), family history (p < 0.001), and prior radiation exposure (p < 0.001). Hyperthyroidism exhibited different diagnostic signatures, notably physical inactivity and hereditary factors (p < 0.001). One-quarter of diagnosed individuals presented with multiple concurrent thyroid pathologies, complicating diagnostic interpretation.Conclusion: This study identifies patterns of self-reported thyroid dysfunction and associated factors that may help guide future screening strategies integrating demographic, anthropometric, and clinical determinants to identify high-risk populations requiring thyroid function testing. The findings support development of risk-stratified diagnostic algorithms and may improve early detection rates in comparable settings.Keywords: diagnostic determinants, thyroid dysfunction, hypothyroidism, hyperthyroidism, risk factors, prevalence, Saudi Arabia, cross-sectional study, early detection