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Valdés S, Maldonado-Araque C, Lago-Sampedro A, Lillo JA, Garcia-Fuentes E, Perez-Valero V, Gutierrez-Repiso C, Ocon-Sanchez P, Goday A, Urrutia I, Peláez L, Calle-Pascual A, Bordiú E, Castaño L, Castell C, Delgado E, Menendez E, Franch J, Gaztambide S, Girbés J, Ortega E, Lopez-Alba A, Chaves FJ, Vendrell J, Chacón MR, Soriguer F, Rojo-Martínez G. Population-Based National Prevalence of Thyroid Dysfunction in Spain and Associated Factors: Di@bet.es Study. Thyroid 2017; 27:156-166. [PMID: 27835928 DOI: 10.1089/thy.2016.0353] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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.
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Affiliation(s)
- Sergio Valdés
- 1 Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III , Madrid, Spain
- 2 Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga , Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Cristina Maldonado-Araque
- 1 Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III , Madrid, Spain
- 2 Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga , Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Ana Lago-Sampedro
- 1 Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III , Madrid, Spain
- 2 Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga , Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - J Antonio Lillo
- 3 UGC de Laboratorio (Bioquímica), Hospital Regional Universitario de Málaga , Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Eduardo Garcia-Fuentes
- 2 Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga , Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- 4 CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III , Madrid, Spain
| | - Vidal Perez-Valero
- 3 UGC de Laboratorio (Bioquímica), Hospital Regional Universitario de Málaga , Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Carolina Gutierrez-Repiso
- 1 Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III , Madrid, Spain
- 2 Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga , Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Pilar Ocon-Sanchez
- 3 UGC de Laboratorio (Bioquímica), Hospital Regional Universitario de Málaga , Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Albert Goday
- 5 Department of Endocrinology and Nutrition, Hospital del Mar , Barcelona, Spain
| | - Ines Urrutia
- 1 Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III , Madrid, Spain
- 6 Research Unit, Hospital Universitario Cruces-UPV-EHU , Baracaldo, Spain
| | - Laura Peláez
- 2 Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga , Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Alfonso Calle-Pascual
- 7 Department of Endocrinology and Nutrition, Hospital Universitario S. Carlos de Madrid , Madrid, Spain
| | - Elena Bordiú
- 8 Laboratorio de Bioquímica, Hospital Universitario S. Carlos de Madrid , Madrid, Spain
| | - Luis Castaño
- 1 Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III , Madrid, Spain
- 6 Research Unit, Hospital Universitario Cruces-UPV-EHU , Baracaldo, Spain
| | - Conxa Castell
- 9 Public Health Agency, Department of Health, Autonomous Government of Catalonia , Barcelona, Spain
| | - Elias Delgado
- 10 Department of Endocrinology and Nutrition, Hospital Central de Asturias , Oviedo, Spain
| | - Edelmiro Menendez
- 10 Department of Endocrinology and Nutrition, Hospital Central de Asturias , Oviedo, Spain
| | - Josep Franch
- 1 Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III , Madrid, Spain
- 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
| | - Sonia Gaztambide
- 1 Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III , Madrid, Spain
- 12 Department of Endocrinology and Nutrition, Hospital Universitario Cruces-UPV-EHU , Baracaldo, Spain
| | - Joan Girbés
- 13 Diabetes Unit, Hospital Arnau de Vilanova , Valencia, Spain
| | - Emilio Ortega
- 4 CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III , Madrid, Spain
- 14 Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Hospital Clínic de Barcelona , Barcelona, Spain
| | - Alfonso Lopez-Alba
- 15 Department of Endocrinology and Nutrition, Fundación Hospital de Jove , Gijón, Spain
| | - Felipe J Chaves
- 1 Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III , Madrid, Spain
- 16 Genotyping and Genetic Diagnosis Unit, Fundación de Investigación del Hospital Clínico de Valencia-INCLIVA , Valencia, Spain
| | - Joan Vendrell
- 1 Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III , Madrid, Spain
- 17 Department of Endocrinology and Nutrition, Hospital Universitario Joan XXIII , Institut d'Investigacions Sanitaries Pere Virgili, Tarragona, Spain
| | - Matilde R Chacón
- 1 Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III , Madrid, Spain
- 17 Department of Endocrinology and Nutrition, Hospital Universitario Joan XXIII , Institut d'Investigacions Sanitaries Pere Virgili, Tarragona, Spain
| | - Federico Soriguer
- 1 Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III , Madrid, Spain
- 2 Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga , Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Gemma Rojo-Martínez
- 1 Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III , Madrid, Spain
- 2 Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga , Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
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