Undiagnosed thyroid dysfunction, thyroid antibodies, and iodine excretion in a Mediterranean population

Area of Science:

• Endocrinology
• Public Health
• Epidemiology

Background:

• Thyroid dysfunction prevalence varies globally.
• Understanding local prevalence is crucial for public health initiatives.
• Mediterranean populations have unique demographic and environmental factors.

Purpose of the Study:

• To determine the prevalence of undiagnosed thyroid dysfunction and thyroid antibodies.
• To investigate the relationship between thyroid dysfunction, antibodies, and urine iodine excretion.
• To analyze prevalence in specific age groups (over 60) and by sex.

Main Methods:

• Cross-sectional study of 1,124 non-hospitalized Mediterranean adults in Catalonia, Spain.
• Measurement of free thyroxine, thyroid-stimulating hormone, thyroperoxidase antibodies, thyroglobulin antibodies, and urine iodine.
• Analysis of prevalence based on sex, age, and antibody status.

Main Results:

• Undiagnosed thyroid dysfunction found in 5.3% of adults (3.8% hypothyroidism), predominantly women.
• Total thyroid dysfunction (diagnosed + undiagnosed) was 8.9%, with 71.15% women.
• Thyroid antibody positivity was higher in women.
• No significant association between urine iodine levels and thyroid dysfunction or antibody status.
• In adults over 60, undiagnosed thyroid dysfunction was 9.8% and total dysfunction 13.61%, with similar prevalence in men and women.

Conclusions:

• A notable prevalence of undiagnosed thyroid dysfunction exists in this Mediterranean adult population.
• Thyroid dysfunction and antibody positivity are more common in women.
• Urine iodine levels were not associated with thyroid dysfunction or antibodies in this cohort.
• Aggressive case-finding for thyroid dysfunction is recommended for individuals over 60, regardless of sex.