Estimation of the prevalence of thyroid dysfunction in Catalonia through two different registries: Pharmaceutical dispensing and diagnostic registration

Abstract

Summary Background Population studies on the prevalence of thyroid dysfunctions are costly. The pharmacy dispensing (PDR) and diagnosis (DR) registers allow us to study the epidemiology of these pathologies in a simpler way. Our aims: 1/Estimate the prevalence of thyroid dysfunction in Catalonia based on data from the PDR and the DR, 2/to evaluate the concordance of the results obtained by both strategies. Methods The population studied was the one registered with the public health system in Catalonia(Catsalut). In the PDR analysis, the information obtained through the Pharmaceutical Provision file (during 2012, 2013, 2014) was used regarding the number of patients under treatment (NPT) (levothyroxine and antithyroid medication). The DR analysis (2014) was performed by ICD‐9 codes (hyperthyroidism 242 and hypothyroidism 243, 244). Results According to the NPT in the PDR analysis, the prevalence of treated hypothyroidism increased over 3 years: 2.81%(2012), 2.92%(2013) and 3.07%(2014) (P < .00001). The prevalence of hyperthyroidism in treatment was 0.14%(2012), 0.13%(2013) and 0.14%(2014). According to the DR analysis in 2014, the prevalence of hypothyroidism was 2.54% and 0.35% for hyperthyroidism. The PDR analysis estimated a higher hypothyroidism prevalence compared to that estimated by the DR (P < .0001) and vice versa in the case of hyperthyroidism. Conclusion Both PDR and DR prevalence estimations of thyroid dysfunction show some degree of discordance probably due to undercoding bias in the case of DR and the absence of subclinical pathology in the case of PDR. However, both approaches are valid and complementary for estimating the prevalence of thyroid dysfunction.

Description of thyroid disorders the year before conception: a population-based study

“…did, the percentage of hypothyroidism is 4.8%, which is higher. In the case of hyperthyroidism, the results obtained in this study are similar to the range identified by Torrejón for women aged between 30 and 50 years old (0.54%) ( 13 ).…”

“…The epidemiology of thyroid disorders depends on multiple factors such as nutritional iodine intake and thyroid autoimmunity. However, the Catalan population fulfils the iodine intake of WHO recommended standards ( 1 , 5 , 13 – 15 ). Although the TPOAb prevalence detected was relatively high in the UTD group (16.92%), it could be associated with an adequate level of iodine status in the population ( 16 ), which is very similar to that obtained in Catalan women by Vila et al.…”

Increased incidence of Graves' disease during the SARS‐CoV2 pandemic

“… 18 Unfortunately, we have a lack of knowledge on the incidence of GD in Spain and only have data about the estimated prevalence of 0.8% 19 of the population being diagnosed with hyperthyroidism and 0.14% receiving antithyroid treatment. 20 …”

“…This variability responds to the strong genetic component in the likelihood of developing GD, which is estimated at 79%, 16 but many other risk factors have been associated with autoimmune thyroid disorders involving T‐cell dysfunction, among which smoking stands out with an odds ratio of 1.9, 17 or iodine intake 18 . Unfortunately, we have a lack of knowledge on the incidence of GD in Spain and only have data about the estimated prevalence of 0.8% 19 of the population being diagnosed with hyperthyroidism and 0.14% receiving antithyroid treatment 20 …”

“…18 Unfortunately, we have a lack of knowledge on the incidence of GD in Spain and only have data about the estimated prevalence of 0.8% 19 of the population being diagnosed with hyperthyroidism and 0.14% receiving antithyroid treatment. 20 During the COVID-19 pandemic thyroid gland alteration/ dysfunction has been emerged as a possible endocrine complication. 21 Compared with pre-pandemic, the post-SARS-CoV-2 era patients presented some differences from a clinical and epidemiological point of view, with a more severe thyrotoxicosis, an increase in the levels of FT4 and an even greater gender gap than traditionally described, of up 10 times higher in females; in fact, only one man presented GD with the possibility that it was triggered by a history of vaccination.…”