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Age-specific thyrotropin references decrease over-diagnosis of hypothyroidism in elderly patients in iodine-excessive

Yingchai Zhang1, Yu Sun1,2, Zhiwei He1

  • 1Department of Endocrinology and Metabolism, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, P.R. China.

Clinical Endocrinology
|September 29, 2021
PubMed
Summary
This summary is machine-generated.

High iodine intake in elderly populations can affect thyroid function. Using age-specific TSH ranges significantly reduced diagnosed overt and subclinical hypothyroidism, preventing over-treatment.

Keywords:
elderly populationiodine‐excessive areasovert hypothyroidismsubclinical hypothyroidismurine iodine concentration

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Area of Science:

  • Endocrinology
  • Public Health
  • Environmental Health

Background:

  • Excess iodine exposure poses risks to thyroid health.
  • Elderly populations may be particularly vulnerable to iodine's effects on thyroid function.
  • Accurate diagnosis of hypothyroidism is crucial for appropriate management.

Purpose of the Study:

  • To determine the prevalence of overt hypothyroidism (OH) and subclinical hypothyroidism (SCH) in elderly individuals with chronic excess iodine exposure.
  • To identify risk factors associated with hypothyroidism in this population.
  • To evaluate the impact of age-specific thyroid-stimulating hormone (TSH) reference ranges on prevalence estimates.

Main Methods:

  • A cross-sectional study involving 2559 adults in Jiangsu Province with high iodine intake.
  • Measurement of urinary iodine concentration (UIC) and serum TSH levels.
  • Logistic regression analysis to identify risk factors and assess the effect of age-specific TSH ranges.

Main Results:

  • Median UIC was 307.3 µg/L, indicating significant iodine exposure.
  • Prevalence of OH decreased from 2.37% to 1.78% and SCH from 29.59% to 2.96% when using age-specific TSH ranges.
  • Advanced age, female gender, and high UIC were identified as risk factors for hypothyroidism.

Conclusions:

  • Age-specific TSH reference ranges significantly lower the diagnosed prevalence of OH and SCH in elderly populations with high iodine intake.
  • Implementing age-specific ranges can prevent over-diagnosis and unnecessary treatment of hypothyroidism.
  • This approach ensures more accurate thyroid disorder assessment in iodine-exposed elderly individuals.