Laurberg P, Bülow Pedersen I, Pedersen K M, Vestergaard H
Department of Endocrinology and Medicine, Aalborg Hospital, Denmark.
Thyroid. 1999 Jan;9(1):33-8. doi: 10.1089/thy.1999.9.33.
In areas with relatively high iodine intake, the incidence rate of hypothyroidism is several-fold higher than that of hyperthyroidism. Recently, we found a similarly high prevalence rate of subclinical hypothyroidism compared with hyperthyroidism in a high iodine intake area, while a relatively low prevalence of subclinical hypothyroidism was observed in a low iodine intake area. In the present study we compared the incidence rate (newly diagnosed in primary care and at hospital) of overt hypothyroidism with that of hyperthyroidism in a well-defined geographical area in Jutland, Denmark, with an iodine intake around 60 microg/day. The number of personsxyears studied was 569,108. Data on hyperthyroidism have been published previously. The overall incidence of hypothyroidism was 13.5/100,000 per year (F/M 22.9/3.6), hyperthyroidism 38.7/100.000 per year (F/M 63.0/13.0). The incidence of hypothyroidism was steadily increasing with age up to 80/100,000 per year in subjects older than 70 years of age, but apart from congenital hypothyroidism it was lower than that of hyperthyroidism at all ages. The majority of patients (79%) was diagnosed to have spontaneous autoimmune hypothyroidism (16% with goiter, 84% with no thyroid visible or palpable). In conclusion, in an area with moderately low iodine intake, hypothyroidism was considerably less common than hyperthyroidism. This is in contrast to findings in high iodine intake areas. The iodine intake of an area seems to be of major importance for the pattern of thyroid disorders observed.
在碘摄入量相对较高的地区，甲状腺功能减退症的发病率比甲状腺功能亢进症高出几倍。最近，我们发现在高碘摄入地区，亚临床甲状腺功能减退症的患病率与甲状腺功能亢进症同样高，而在低碘摄入地区，亚临床甲状腺功能减退症的患病率相对较低。在本研究中，我们比较了丹麦日德兰半岛一个明确地理区域（碘摄入量约为60微克/天）中显性甲状腺功能减退症与甲状腺功能亢进症的发病率（在初级保健机构和医院新诊断的病例）。研究对象的人数为569,108人。关于甲状腺功能亢进症的数据此前已发表。甲状腺功能减退症的总体发病率为每年13.5/100,000（女性/男性为22.9/3.6），甲状腺功能亢进症为每年38.7/100,000（女性/男性为63.0/13.0）。甲状腺功能减退症的发病率随年龄稳步上升，70岁以上人群中高达每年80/100,000，但除先天性甲状腺功能减退症外，各年龄段的发病率均低于甲状腺功能亢进症。大多数患者（79%）被诊断为自身免疫性自发性甲状腺功能减退症（16%伴有甲状腺肿，84%甲状腺不可见或触不到）。总之，在碘摄入量适度偏低的地区，甲状腺功能减退症的发病率远低于甲状腺功能亢进症。这与高碘摄入地区的研究结果相反。一个地区的碘摄入量似乎对所观察到的甲状腺疾病模式至关重要。
