Epidemiology of subtypes of hyperthyroidism in Denmark: a population-based study

被引:129
作者
Carle, Allan [1 ]
Pedersen, Inge Bulow [1 ]
Knudsen, Nils [2 ]
Perrild, Hans [2 ]
Ovesen, Lars [3 ]
Rasmussen, Lone Banke [4 ]
Laurberg, Peter [1 ]
机构
[1] Aarhus Univ Hosp, Aalborg Hosp, Dept Endocrinol & Internal Med, DK-9000 Aalborg, Denmark
[2] Bispebjerg Hosp, Endocrine Unit, Med Clin 1, DK-2400 Copenhagen, Denmark
[3] Slagelse Hosp, Dept Internal Med, DK-4200 Slagelse, Denmark
[4] Tech Univ Denmark, Natl Food Inst, Dept Nutr, DK-2860 Copenhagen, Denmark
关键词
MULTINODULAR TOXIC GOITER; LOW IODINE INTAKE; GRAVES-DISEASE; THYROID-DYSFUNCTION; NODULAR GOITER; THYROTOXICOSIS; HYPOTHYROIDISM; ICELAND; SUPPLEMENTS; PREVALENCE;
D O I
10.1530/EJE-10-1155
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: Few population-based studies have described the epidemiology of subtypes of hyperthyroidism. Design: A prospective population-based study, monitoring two well-defined Danish cohorts in Aalborg with moderate iodine deficiency (nZ311 102) and Copenhagen with only mild iodine deficiency (nZ227 632). Methods: A laboratory monitoring system identified subjects with thyroid function tests suggesting overt hyperthyroidism (low s-TSH combined with high s-thyroxine or s-triiodothyronine). For all subjects, we collected information on medical history, thyroid scintigraphy and thyroid hormone receptor antibody (TRAb) measurement. Information was used to disprove or verify primary overt hyperthyroidism and to subclassify hyperthyroidism into nosological disorders. Results: From 1997 to 2000 (2 027 208 person-years of observation), we verified 1682 new cases of overt hyperthyroidism. The overall standardized incidence rate (SIR) per 100 000 person-years was 81.6, and was higher in Aalborg compared with Copenhagen (96.7 vs 60.0, P<0.001), giving an SIR ratio (SIRR (95% confidence interval (CI))) between moderate versus mild iodine-deficient areas of 1.6 (1.4-1.8). Nosological types of hyperthyroidism (percentage/SIRR (95% CI)): multinodular toxic goitre (MNTG) 44.1%/1.9 (1.6-2.2), Graves' disease (GD) 37.6%/1.2 (0.99-1.4), solitary toxic adenoma (STA) 5.7%/2.4 (1.3-3.5), 'mixed type' hyperthyroidism (TRAb-positive, scintigraphicly multinodular) 5.4%/6.0 (3.0-12), subacute thyroiditis 2.3%/0.9 (0.4-1.4), postpartum thyroid dysfunction 2.2%/1.6 (0.8-3.0), amiodarone-associated hyperthyroidism 0.8%/7.1 (1.1-65), hyperthyroidism after thyroid radiation 0.7%/12.3 (0.8-50), lithium-associated hyperthyroidism 0.7%/0.97 (0.4-4.8) and hyperthyroidism caused by various other factors 0.7%. Lifetime risk for overt hyperthyroidism was 10.5%/6.5%/2.4% (females/all/males). Conclusion: Hyperthyroidism was common in Denmark with MNTG and GD as dominating entities. The higher incidence of hyperthyroidism in the most iodine-deficient region was caused by higher frequency of MNTG, 'mixed-type', STA and amiodarone-associated hyperthyroidism.
引用
收藏
页码:801 / 809
页数:9
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