Undiagnosed thyroid dysfunction, thyroid antibodies, and iodine excretion in a Mediterranean population

Abstract

The prevalence of thyroid dysfunction varies in different populations. The aim of this cross-sectional study was to analyze the prevalence of undiagnosed thyroid dysfunction and thyroid antibodies and their relationship with urine iodine excretion in a representative sample of 1,124 (55.5% women; mean age: 44.8 ± 15.2 years) non-hospitalized Mediterranean adults, in Catalonia (Spain). Free thyroxine, thyroid-stimulating hormone, thyroperoxidase and thyroglobulin antibodies, and urine iodine were measured. Undiagnosed thyroid dysfunction was 5.3% (hypothyroidism 3.8%; 56.66% of these subjects were women). The total (diagnosed + undiagnosed) thyroid dysfunction was 8.9% (71.15% women). Thyroperoxidase antibodies were positive in 2.4% of men and 9.4% of women and thyroglobulin antibodies, in 1.3% of men and 3.8% of women. No differences were observed in urine iodine between groups with thyroid dysfunction and euthyroidism, or between subjects with positive or negative antibodies. In subjects over 60, undiagnosed thyroid dysfunction was 9.8% (hypothyroidism 6.9%, hyperthyroidism 3.3%; 36.36% women) and total thyroid dysfunction 13.61% (53.12% women). Women and men over 60 had similar thyroid dysfunction prevalence. Thus, aggressive case-finding should be recommended in both, over 60.

Prevalence of Undiagnosed Hypothyroidism in Europe: A Systematic Review and Meta-Analysis

“…The sample size of selected studies varied between 307 [34] and 80,490 [35]. The studies included sample populations from Austria [35], Belgium [36], Bulgaria [37], Denmark [38], Germany [39, 40], Italy [16, 18, 41], Norway [15, 42], Spain [17, 19, 34, 43], The Netherlands [44, 45], the UK [46, 47], and Turkey [48]. …”

“…The estimates can vary between 0.1 and 12.5%, depending on the definition used [15, 16]. For example, some studies evaluated the prevalence of undiagnosed and untreated subclinical and/or overt hypothyroidism [17-19], while others addressed previously diagnosed and treated hypothyroidism [20, 21]. Patients with undiagnosed hypothyroidism are not treated for the disease and therefore might be at higher risk of developing long-term complications, such as serious and even fatal cardiovascular diseases, diabetes, or others [22-25].…”

Thyroid Disease and Oral Lichen Planus as Comorbidity: A Prospective Case-Control Study

“…The prevalence of thyroid dysfunction varies within different populations and countries, occurring most frequently in aging women [34]. Many countries in central Europe have endemic multinodular goiter with prevalences between 3 and 6% [35].…”

Untitled

“…Another survey in Italy found an overall prevalence of thyroid functional autonomy (i. e., subnormal TSH concentrations and normal concentration of FT3 and FT4) of 4.6 %. Finally, the overall prevalence of subclinical hyperthyroidism was lower in Spain (1.3 %) [24] and higher in Denmark (9.7 %) [25].…”