Sergio Valdés1,2, Cristina Maldonado-Araque1,2, Ana Lago-Sampedro1,2, J Antonio Lillo3, Eduardo Garcia-Fuentes2,4, Vidal Perez-Valero3, Carolina Gutierrez-Repiso1,2, Pilar Ocon-Sanchez3, Albert Goday5, Ines Urrutia1,6, Laura Peláez2, Alfonso Calle-Pascual7, Elena Bordiú8, Luis Castaño1,6, Conxa Castell9, Elias Delgado10, Edelmiro Menendez10, Josep Franch1,11, Sonia Gaztambide1,12, Joan Girbés13, Emilio Ortega4,14, Alfonso Lopez-Alba15, Felipe J Chaves1,16, Joan Vendrell1,17, Matilde R Chacón1,17, Federico Soriguer1,2, Gemma Rojo-Martínez1,2. 1. 1 Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III , Madrid, Spain . 2. 2 Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga , Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain . 3. 3 UGC de Laboratorio (Bioquímica), Hospital Regional Universitario de Málaga , Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain . 4. 4 CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III , Madrid, Spain . 5. 5 Department of Endocrinology and Nutrition, Hospital del Mar , Barcelona, Spain . 6. 6 Research Unit, Hospital Universitario Cruces-UPV-EHU , Baracaldo, Spain . 7. 7 Department of Endocrinology and Nutrition, Hospital Universitario S. Carlos de Madrid , Madrid, Spain . 8. 8 Laboratorio de Bioquímica, Hospital Universitario S. Carlos de Madrid , Madrid, Spain . 9. 9 Public Health Agency, Department of Health, Autonomous Government of Catalonia , Barcelona, Spain . 10. 10 Department of Endocrinology and Nutrition, Hospital Central de Asturias , Oviedo, Spain . 11. 11 EAP Raval Sud, Institut Català de la Salut, Red GEDAPS, Primary Care, Unitat de Suport a la Recerca (IDIAP-Fundació Jordi Gol) , Barcelona, Spain . 12. 12 Department of Endocrinology and Nutrition, Hospital Universitario Cruces-UPV-EHU , Baracaldo, Spain . 13. 13 Diabetes Unit, Hospital Arnau de Vilanova , Valencia, Spain . 14. 14 Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Hospital Clínic de Barcelona , Barcelona, Spain . 15. 15 Department of Endocrinology and Nutrition, Fundación Hospital de Jove , Gijón, Spain . 16. 16 Genotyping and Genetic Diagnosis Unit, Fundación de Investigación del Hospital Clínico de Valencia-INCLIVA , Valencia, Spain . 17. 17 Department of Endocrinology and Nutrition, Hospital Universitario Joan XXIII , Institut d'Investigacions Sanitaries Pere Virgili, Tarragona, Spain .
Abstract
BACKGROUND: The aim of this study was to investigate the national prevalence of thyroid dysfunction in Spain and its association with various clinical, environmental, and demographic variables. METHODS: The study included 4554 subjects (42.4% men) with a mean age of 50 years (range 18-93 years), who were participants in a national, cross-sectional, population-based survey conducted in 2009-2010. Data gathered included clinical and demographic characteristics, physical examination, and blood sampling. Thyrotropin, free thyroxine, free triiodothyronine, and thyroid peroxidase antibody (TPOAb) concentrations were analyzed by electrochemiluminescence. Urinary iodine (UI) levels were measured in an isolated urine sample. RESULTS: The prevalence of treated hypothyroidism, untreated subclinical hypothyroidism, and untreated clinical hypothyroidism was 4.2% [confidence interval (CI) 3.6-4.9%], 4.6% [CI 4.0-5.2%], and 0.3% [CI 0.1-0.5%], respectively. The prevalence of total hypothyroidism (including all fractions) was 9.1% [CI 8.2-10.0%]. The prevalence of total hyperthyroidism was 0.8% [CI 0.6-1.1]. A total of 7.5% [CI 6.7-8.3%] of the population tested positive for TPOAbs (≥50 IU/mL). In multivariate logistic regression models, TPOAbs were strongly associated with both hypothyroidism (p < 0.001) and hyperthyroidism (p = 0.005), whereas high UI levels (>200 μg/g creatinine) were associated with hypothyroidism (p < 0.001). The positive association between UI and hypothyroidism remained for both treated (p < 0.001) and untreated (p < 0.05) hypothyroidism, whereas it was especially significant for non-autoimmune (TPOAbs negative) forms (p < 0.001). At UI levels ≥200 μg/g, there was a positive correlation between UI and thyrotropin levels (β = 0.152, p < 0.001) and a negative correlation between UI and free triiodothyronine levels (β = -0.134, p = 0.001). CONCLUSION: According to the data, a large proportion (10%) of the Spanish population has some evidence of thyroid dysfunction. High TPOAb concentrations were associated with both hypo- and hyperthyroidism, whereas high UI concentrations were associated with hypothyroidism.
BACKGROUND: The aim of this study was to investigate the national prevalence of thyroid dysfunction in Spain and its association with various clinical, environmental, and demographic variables. METHODS: The study included 4554 subjects (42.4% men) with a mean age of 50 years (range 18-93 years), who were participants in a national, cross-sectional, population-based survey conducted in 2009-2010. Data gathered included clinical and demographic characteristics, physical examination, and blood sampling. Thyrotropin, free thyroxine, free triiodothyronine, and thyroid peroxidase antibody (TPOAb) concentrations were analyzed by electrochemiluminescence. Urinary iodine (UI) levels were measured in an isolated urine sample. RESULTS: The prevalence of treated hypothyroidism, untreated subclinical hypothyroidism, and untreated clinical hypothyroidism was 4.2% [confidence interval (CI) 3.6-4.9%], 4.6% [CI 4.0-5.2%], and 0.3% [CI 0.1-0.5%], respectively. The prevalence of total hypothyroidism (including all fractions) was 9.1% [CI 8.2-10.0%]. The prevalence of total hyperthyroidism was 0.8% [CI 0.6-1.1]. A total of 7.5% [CI 6.7-8.3%] of the population tested positive for TPOAbs (≥50 IU/mL). In multivariate logistic regression models, TPOAbs were strongly associated with both hypothyroidism (p < 0.001) and hyperthyroidism (p = 0.005), whereas high UI levels (>200 μg/g creatinine) were associated with hypothyroidism (p < 0.001). The positive association between UI and hypothyroidism remained for both treated (p < 0.001) and untreated (p < 0.05) hypothyroidism, whereas it was especially significant for non-autoimmune (TPOAbs negative) forms (p < 0.001). At UI levels ≥200 μg/g, there was a positive correlation between UI and thyrotropin levels (β = 0.152, p < 0.001) and a negative correlation between UI and free triiodothyronine levels (β = -0.134, p = 0.001). CONCLUSION: According to the data, a large proportion (10%) of the Spanish population has some evidence of thyroid dysfunction. High TPOAb concentrations were associated with both hypo- and hyperthyroidism, whereas high UI concentrations were associated with hypothyroidism.
Authors: Peter N Taylor; Diana Albrecht; Anna Scholz; Gala Gutierrez-Buey; John H Lazarus; Colin M Dayan; Onyebuchi E Okosieme Journal: Nat Rev Endocrinol Date: 2018-03-23 Impact factor: 43.330
Authors: L Dal Maso; C Panato; A De Paoli; V Mattioli; D Serraino; R Elisei; G Zoppini; C Gobitti; E Borsatti; E Di Felice; F Falcini; S Ferretti; S Francisci; P Giorgi Rossi; S Guzzinati; G Mazzoleni; D Pierannunzio; S Piffer; S Vaccarella; M Vicentini; M Zorzi; S Franceschi; U Fedeli Journal: J Endocrinol Invest Date: 2021-01-18 Impact factor: 4.256
Authors: Cristina Maldonado-Araque; Sergio Valdés; Ana Lago-Sampedro; Juan Antonio Lillo-Muñoz; Eduardo Garcia-Fuentes; Vidal Perez-Valero; Carolina Gutierrez-Repiso; Albert Goday; Ines Urrutia; Laura Peláez; Alfonso Calle-Pascual; Luis Castaño; Contxa Castell; Elias Delgado; Edelmiro Menendez; Josep Franch-Nadal; Sonia Gaztambide; Joan Girbés; Emilio Ortega; Joan Vendrell; Matilde R Chacón; Felipe J Chaves; Federico Soriguer; Gemma Rojo-Martínez Journal: Sci Rep Date: 2018-04-26 Impact factor: 4.379