Socio-Behavioral Risk Factors for Neurological Complications in Residents of the Pre-Aral Area with Primary Hypothyroidism

Abstract

Socio-behavioral factors play an important role in the course of primary hypothyroidism and may contribute to the development of neurological complications, especially in ecologically unfavorable regions. This study aimed to assess socio-behavioral risk factors for neurological complications among residents of the Pre-Aral Area with primary hypothyroidism. The research was conducted at the Khorezm Regional Multidisciplinary Medical Center during 2023–2025 and included 143 participants divided into four groups: patients with primary hypothyroidism living in the Pre-Aral Area with neurological complications, patients with primary hypothyroidism living in the same region without neurological complications, patients with primary hypothyroidism living outside ecologically unfavorable territories, and practically healthy controls. Socio-behavioral factors such as education level, dietary habits, use of iodized salt, adherence to levothyroxine replacement therapy, regular medical follow-up, physical activity, harmful habits, occupational exposures, chronic stress, comorbidity, and disease duration were assessed. Clinical-neurological examination and thyroid status evaluation were performed in all participants. Statistical analysis was conducted using IBM SPSS Statistics 27.0, including correlation analysis and multivariate logistic regression.

The results showed that residents of the Pre-Aral Area had a less favorable socio-behavioral profile, characterized by insufficient use of iodized salt, low consumption of fish, seafood, vegetables, and fruits, a higher prevalence of comorbid conditions, metabolic disorders, chronic stress, and occupational hazards. The most unfavorable combination of risk factors was observed in patients with primary hypothyroidism and neurological complications. Regular use of iodized salt and iodine-rich foods was lower among residents of the Pre-Aral Area, while dyslipidemia, arterial hypertension, chronic stress, and professional exposure to dust or chemicals were more common in the main group. These findings indicate that socio-behavioral and environmental factors may aggravate the course of primary hypothyroidism and increase the risk of neurological complications. The results support the need to include nutritional correction, iodine prophylaxis, metabolic risk reduction, stress assessment, and regular medical monitoring in early prevention programs for residents of the Pre-Aral Area with primary hypothyroidism.