A Hong1,2, B Stokes3, P Otahal3, D Owens2,4, J R Burgess1,2. 1. Department of Diabetes & Endocrinology, Royal Hobart Hospital, Hobart, Tasmania. 2. School of Medicine, University of Tasmania, Hobart, Tasmania. 3. Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania. 4. Diagnostic Services Pty Ltd, Hobart, Tasmania.
Abstract
CONTEXT: Tasmania is an island state of the Australian Commonwealth with a well-documented history of mild iodine deficiency. Between 2001 and 2009, Tasmania experienced two incremental phases of iodine fortification. OBJECTIVE: To examine trends in thyroid-stimulating hormone (TSH) and thyroid peroxidase antibody (ATPO) testing and their relationship to different phases of iodine nutrition in the Tasmanian population between 1995 and 2013. DESIGN: Retrospective longitudinal study. SETTING AND PARTICIPANTS: The major primary care and largest public hospital pathology providers in Tasmania submitted data for all TSH and ATPO tests performed between 1995 and 2013. Data linkage methodology was used to determine trends in TSH and ATPO testing. RESULTS: A total of 1.66 million TSH assessments, involving 389,910 individual patients, were performed in Tasmania between 1995 and 2013. There was approximately a fourfold increase in the overall rate of TSH testing during this period with the rate of incident TSH assessment remaining relatively stable over the study period. The incidence of overt suppression and elevation of TSH (TSH≤0.1 mIU/L and ≥10 mIU/L) declined 62.3% and 59.7%, respectively, with a trend for increased incidence of borderline TSH elevation ≥4.0 mIU/L. The incidence of thyroid autoimmunity as determined by the proportion of abnormal ATPO results remained stable, with the absolute number of positive test results increasing during the study period. CONCLUSION: Iodine supplementation of this mildly iodine-deficient population was not associated with an obvious increase in incidence of overt thyroid dysfunction or autoimmunity. Whilst the volume of TSH testing increased over the study period, the increase was driven by patients undergoing follow-up TSH assessments.
CONTEXT: Tasmania is an island state of the Australian Commonwealth with a well-documented history of mild iodine deficiency. Between 2001 and 2009, Tasmania experienced two incremental phases of iodine fortification. OBJECTIVE: To examine trends in thyroid-stimulating hormone (TSH) and thyroid peroxidase antibody (ATPO) testing and their relationship to different phases of iodine nutrition in the Tasmanian population between 1995 and 2013. DESIGN: Retrospective longitudinal study. SETTING AND PARTICIPANTS: The major primary care and largest public hospital pathology providers in Tasmania submitted data for all TSH and ATPO tests performed between 1995 and 2013. Data linkage methodology was used to determine trends in TSH and ATPO testing. RESULTS: A total of 1.66 million TSH assessments, involving 389,910 individual patients, were performed in Tasmania between 1995 and 2013. There was approximately a fourfold increase in the overall rate of TSH testing during this period with the rate of incident TSH assessment remaining relatively stable over the study period. The incidence of overt suppression and elevation of TSH (TSH≤0.1 mIU/L and ≥10 mIU/L) declined 62.3% and 59.7%, respectively, with a trend for increased incidence of borderline TSH elevation ≥4.0 mIU/L. The incidence of thyroid autoimmunity as determined by the proportion of abnormal ATPO results remained stable, with the absolute number of positive test results increasing during the study period. CONCLUSION:Iodine supplementation of this mildly iodine-deficient population was not associated with an obvious increase in incidence of overt thyroid dysfunction or autoimmunity. Whilst the volume of TSH testing increased over the study period, the increase was driven by patients undergoing follow-up TSH assessments.
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