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The prevalence of thyroid dysfunction in a population with borderline iodine deficiency
Abstract
OBJECTIVE: We lack information on the influence of borderline iodine deficiency on the occurrence of thyroid dysfunction. Iodine deficiency has been reported to facilitate the development of toxic nodular goitre, whereas a high iodine intake may increase the prevalence of autoimmune hypothyroidism. SUBJECTS AND METHODS: In a cross‐sectional study of a random sample of the general population in our region with borderline iodine defficiency 2656 (65%) of 4073 men and women aged 41 to 71 years participated. Records were made of previous thyroidal illness. Blood samples were drawn for thyroid parameters and TPO Ab values. Iodine and creatinine was assessed in casual urine samples. RESULTS: Previous or present hyperthyroidism was reported by 1.4% of the participants whereas 0.6% had unknown biochemical hyperthyroidism. All cases of undiagnosed hyperthyroidism were among women. Previously diagnosed and treated hypothyroidism was reported by 1.0% and undiagnosed hypothyroidism was found in 0.4%. Subclinical hyperthyroidism was found in 1.3% and subclinical hypothyroidism in 0.7%. TPO Ab titres >200 kU/l were found in 16.9% of the women and 6.6% of the men, and 83% of participants with TSH >5 mU/l had TPO Ab titres >200 kU/l. Participants with TPO Ab titres between 100 and 200 kU/l had no increased frequency of thyroid dysfunction. The median iodine excretion rate was estimated as 103 μg/day. Serum TSH values were higher in women than in men and showed higher dispersion in women as well as in old age. Serum free T3 was found to be higher in women than in men and increased with age. Serum free T4 showed no sex difference but values increased with increasing age. CONCLUSION: In our region with borderline iodine deficiency more than 5% of the general population has clinical or subclinical thyroid dysfunction. We found a relatively high prevalence of hyperthyroidism, especially previously undiagnosed disease, but a low prevalence of hypothyroidism as would be expected in an area of iodine deficiency. Hypothyroidism was related to TPO Ab titres of >200 kU/l. Thyroid hormone levels varied with age and sex.
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“Studies in populations with iodine deficiency have failed to show an increase in TSH [91, 93–95].”
From Age-related variation in thyroid function – a narrative review highlighting important implications for research and clinical practice (2023) · cites this paper as [95]
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Metadata
- Authors
- Knudsen, N., Jørgensen, T., Rasmussen, S., Christiansen, E., & Perrild, H.
- Affiliations
- University of Copenhagen (DK)
- Bispebjerg Hospital (DK)
- Corresponding author
- Knudsen, Nils
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 1999-09
- Volume
- 51
- Issue
- 3
- Pages
- 361-367
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W1979170509
- Cited by
- 153
- References
- 17
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 4 · 2023: 4 · 2021: 3 · 2020: 5 · 2019: 9 · 2018: 6 · 2017: 8 · 2016: 4 · 2015: 6 · 2014: 2 · 2013: 12 · 2012: 4
- FWCI
- 4.54
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Keywords
- thyroid dysfunction, hyperthyroidism, hypothyroidism, subclinical hyperthyroidism, subclinical hypothyroidism, thyroid peroxidase antibodies, thyroid-stimulating hormone, iodine excretion, free thyroxine, free triiodothyronine, sex differences, age differences, autoimmune thyroid disease
- MeSH terms
- Adult, Aged, Antibodies, Cross-Sectional Studies, Denmark, Female, Follow-Up Studies, Humans, Hyperthyroidism, Hypothyroidism, Iodide Peroxidase, Iodine, Male, Middle Aged, Thyroid Diseases, Thyrotropin, Thyroxine, Triiodothyronine, Cohort Studies, Prevalence, Logistic Models, Statistics, Nonparametric
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