Population-based national incidence of thyroid dysfunction in Spain

Thyroid dysfunction is a common health disorder. However, data on its incidence remain scarce and geographically limited. This study aimed to assess the incidence of thyroid dysfunction in the Spanish adult population and factors associated with its onset. A nationwide observational population‑based cohort study was conducted, including 1,629 euthyroid individuals (not receiving levothyroxine/thionamides, and TSH levels of 0.2-5.0mIU/mL) at baseline (2008-2010), who were re-evaluated in 2016-2017. Multivariable logistic regression analysis assessed the association between incident thyroid dysfunction and potential exposure factors. ROC analysis identified optimal TPOAb and TSH cut-offs for predicting incident hypothyroidism. The age- and sex-adjusted incidence of hypothyroidism was 13.38cases/1,000persons-year (CI95% 10.52-16.25) for TSH ≥ 5mIU/mL, and 6.78cases/1,000persons-year (CI95% 4.73-8.83) for TSH ≥ 10mIU/mL. The incidence of hyperthyroidism was 2.65cases/1,000persons-year (CI95% 1.46-3.83). Female sex, age between 30 and 40 and > 60 years, TPOAb > 20mIU/L and TSH > 2.8mIU/mL were independently associated with new cases of hypothyroidism. The presence of obesity, diabetes or urinary iodine levels were not associated with the incidence of thyroid disease. Baseline TPOAb and TSH cut-offs best predicting hypothyroidism were 9.1mIU/L (AUC 0.654; CI95% 0.583-0.725; p < 0.001), and 2.03mIU/mL (AUC 0.702; CI95% 0.639-0.766; p < 0.001) respectively. This study provides data on incidence rates and risk factors of thyroid dysfunction in the adult Spanish population.