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甲状腺功能减退症患病率的变化:挪威 HUNT 研究。

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

机构信息

Department of Public Health, Faculty of Medicine, Norwegian University of Science and Technology, Postboks 8905, N-7491 Trondheim, Norway.

出版信息

Eur J Endocrinol. 2013 Oct 1;169(5):613-20. doi: 10.1530/EJE-13-0459. Print 2013 Nov.

Abstract

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.

DESIGN

Population surveys of 33,917 individuals in 1995-1997 and 49,180 individuals in 2006-2008 were carried out.

METHODS

We compared the prevalence of untreated overt, untreated subclinical, and treated hypothyroidism between 1995-1997 and 2006-2008.

RESULTS

The prevalence of untreated overt hypothyroidism among women decreased by 84% from 1995-1997 (0.75%) to 2006-2008 (0.12%) (prevalence ratio (PR) 0.16; 95% CI 0.10-0.26). 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.

摘要

目的

在碘充足的地区,未经治疗的甲状腺功能减退症很常见。频繁的甲状腺功能检测和使用左甲状腺素治疗亚临床甲状腺功能减退症表明,患病率可能已经下降。因此,在这项研究中,我们检查了 1995-1997 年至 2006-2008 年期间挪威一个县甲状腺功能减退症的患病率变化。

设计

对 1995-1997 年的 33917 人和 2006-2008 年的 49180 人进行了人群调查。

方法

我们比较了 1995-1997 年和 2006-2008 年未经治疗的显性、亚临床和治疗性甲状腺功能减退症的患病率。

结果

女性未经治疗的显性甲状腺功能减退症的患病率从 1995-1997 年的 0.75%下降到 2006-2008 年的 0.12%(患病率比 (PR) 0.16;95%置信区间 (CI) 0.10-0.26)。男性的相应下降幅度为 43%,从 0.21%降至 0.12%(PR 0.57;95%CI 0.28-1.16)。女性未经治疗的亚临床甲状腺功能减退症的患病率从 3.0%下降到 1.1%(PR 0.36;95%CI 0.31-0.42),男性从 2.1%下降到 1.0%(PR 0.46;95%CI 0.38-0.56)。相反,女性接受治疗的甲状腺功能减退症的患病率从 5.0%上升到 8.0%(PR 1.60,95%CI 1.50-1.71),男性的相应患病率则翻了一番,从 1.0%上升到 2.0%(PR 1.96;95%CI 1.59-2.41)。女性任何形式的甲状腺功能减退症的患病率保持在 9%,男性为 3%,基本相似。

结论

在挪威的这个县,未经治疗的甲状腺功能减退症的患病率从 1995-1997 年到 2006-2008 年之间急剧下降。这一发现表明,在容易获得甲状腺功能检测和左甲状腺素治疗的人群中,未经治疗的甲状腺功能减退症的患病率可能已经较低。

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