Prevalence of Subclinical Thyroid Dysfunction and Its Relation to Socioeconomic Deprivation in the Elderly: A Community-Based Cross-Sectional Survey

Wilson, Sue; Parle, James; Roberts, Lesley; Roalfe, Andrea; Hobbs, FD Richard; Clark, Penny; Sheppard, M. C.; Gammage, Michael D.; Pattison, Helen; Franklyn, Jayne A.

doi:10.1210/jc.2006-1557

Cited by 102 publications

(99 citation statements)

References 34 publications

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“…For TPO antibodies, no comparison was made between the measurement methods used in HUNT 2 and HUNT 3, and changes in the prevalence of subclinical hypothyroidism by TPO antibody status should, therefore, be interpreted with caution. Few other studies have examined changes in the prevalence of untreated hypothyroidism, but similar to our study, a study among elderly patients in Birmingham, England, suggested that the prevalence of untreated subclinical hypothyroidism decreased from 6% in 1988-1989 to 3% around 2004 (11). More data are available on changes in thyroid hormone prescription.…”

Section: Huntsupporting

confidence: 84%

Changes in the prevalence of hypothyroidism: the HUNT Study in Norway

Åsvold

Vatten

Bjøro

2013

European Journal of Endocrinology

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Objective: Untreated hypothyroidism is common in iodine-replete areas. Frequent thyroid function testing and use of levothyroxine treatment for subclinical hypothyroidism suggest that the prevalence may have decreased. Therefore, in this study, we examined changes in the prevalence of hypothyroidism in a Norwegian county from 1995-1997 to 2006-2008 The corresponding decrease among men was 43% from 0.21 to 0.12% (PR 0.57; 95% CI 0.28-1.16). The prevalence of untreated subclinical hypothyroidism decreased by 64% from 3.0 to 1.1% in women (PR 0.36; 95% CI 0.31-0.42) and decreased by 54% from 2.1 to 1.0% in men (PR 0.46; 95% CI 0.38-0.56). Conversely, the prevalence of treated hypothyroidism among women increased by 60% from 5.0 to 8.0% (PR 1.60, 95% CI 1.50-1.71), and the corresponding prevalence in men doubled from 1.0 to 2.0% (PR 1.96; 95% CI 1.59-2.41). The prevalence of any form of hypothyroidism remained essentially similar at 9% in women and 3% in men. Conclusions: The prevalence of untreated hypothyroidism in this Norwegian county decreased strongly from 1995-1997 to 2006-2008. The findings suggest that the prevalence of untreated hypothyroidism in populations with easy access to thyroid function testing and levothyroxine treatment may now be low.

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Section: Huntsupporting

confidence: 84%

Changes in the prevalence of hypothyroidism: the HUNT Study in Norway

Åsvold

Vatten

Bjøro

2013

European Journal of Endocrinology

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“…Hypothyroidism is a common, potentially serious condition, which has been reported to increase along with increasing age [11]. Decrease of thyroid hormone reduces osteoblastic bone differentiation, resulting in the reduction of both bone formation and bone resorption.…”

Section: Discussionmentioning

confidence: 99%

“…Peak incidence rate ratio of bone fracture was found around the time of diagnosis, but increased fracture risk was also found up to 8 years prior to diagnosis, while fracture risk was found to return to normal more than 5 years after its diagnosis [9]. Subclinical hypothy-roidism may be defined as an abnormal serum thyrotropin (TSH) concentration in an asymptomatic patient with a normal serum free thyroxine (FT 4 ) concentration, and occurs in more than 10% of women older than 60 years [10,11]. Recent findings suggest that TSH is a negative regulator of skeletal remodeling by reducing both differentiation of osteoblasts and formation of osteoclasts [12].…”

mentioning

confidence: 99%

Subclinical Hypothyroidism is Related to Lower Heel QUS in Postmenopausal Women

et al. 2007

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Abstract. Recent findings suggest that thyroid stimulating hormone (TSH) is a negative regulator of skeletal remodeling by reducing both differentiation of osteoblasts and formation of osteoclasts. In addition, increased fracture risk in untreated hypothyroid patients has been reported to begin up to 8 years before diagnosis. The aim of the present study was to evaluate the effect of subclinical hypothyroidism on bone structure by using the heel QUS. Subjects were outpatients without any past or present history of thyroid disease. Among 210 postmenopausal women, 22 of 33 patients (Hypo), who had elevated serum TSH concentration (TSHõ4 µU/ml) with normal serum free thyroxine (FT 4 ) concentration, agreed to join to this study. We also randomly selected 24 control subjects (Cont) from 176 postmenopausal women with normal thyroid status. Calcaneus osteo sono assessment indices (OSI) of right feet were measured using the ultrasound bone densitometry AOS-100. Serum TSH concentrations in Hypo patients (5.31 ± 1.3 µU/ml) were higher than those in Cont patients (2.05 ± 1.1 µU/ml), and there was significant difference of FT 4 concentrations (Cont 1.33 ± 0.15 ng/dl; Hypo 1.19 ± 0.17 ng/dl). OSI and its Z-score in Hypo subjects (OSI, 2.138 ± 0.152; Z-Score -0.322 ± 0.504 SD, Mean ± SD) were significantly lower than those in Cont subjects (OSI, 2.347 ± 0.243; Z-Score 0.322 ± 0.91 SD, Mean ± SD). Simple regression statistical analysis showed that OSI decreased according to the increase of serum TSH concentration (n = 47, P<0.037). In addition, multiple regression analysis showed that the elevation of serum TSH concentration was associated with the decrease of OSI. These results suggest that the elevation of serum TSH concentration in subclinical hypothyroidism affects not bone turnover but bone structure as assessed by QUS.

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“…1 Subclinical hypothyroidism is the most common form of thyroid dysfunction in older people with a prevalence ranging between 3% and 18% in people aged >65 years, [2][3][4] and is more prevalent among older women than men. 4,5 A single TSH elevation has been shown to regress to euthyroidism in 2 years in 35% of older people, but this condition may also progress to overt hypothyroidism (in >2% per year).…”

Section: Introductionmentioning

confidence: 99%