Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine, Cardiff, UK.
University Medicine Greifswald, Institute for Community Medicine, Greifswald, Germany.
Nat Rev Endocrinol. 2018 May;14(5):301-316. doi: 10.1038/nrendo.2018.18. Epub 2018 Mar 23.
Thyroid hormones are essential for growth, neuronal development, reproduction and regulation of energy metabolism. Hypothyroidism and hyperthyroidism are common conditions with potentially devastating health consequences that affect all populations worldwide. Iodine nutrition is a key determinant of thyroid disease risk; however, other factors, such as ageing, smoking status, genetic susceptibility, ethnicity, endocrine disruptors and the advent of novel therapeutics, including immune checkpoint inhibitors, also influence thyroid disease epidemiology. In the developed world, the prevalence of undiagnosed thyroid disease is likely falling owing to widespread thyroid function testing and relatively low thresholds for treatment initiation. However, continued vigilance against iodine deficiency remains essential in developed countries, particularly in Europe. In this report, we review the global incidence and prevalence of hyperthyroidism and hypothyroidism, highlighting geographical differences and the effect of environmental factors, such as iodine supplementation, on these data. We also highlight the pressing need for detailed epidemiological surveys of thyroid dysfunction and iodine status in developing countries.
甲状腺激素对生长、神经元发育、生殖和能量代谢调节至关重要。甲状腺功能减退症和甲状腺功能亢进症是常见的疾病，可能会对全球所有人群造成严重的健康后果。碘营养是甲状腺疾病风险的一个关键决定因素；然而，其他因素，如衰老、吸烟状况、遗传易感性、种族、内分泌干扰物以及新型治疗方法（包括免疫检查点抑制剂）的出现，也会影响甲状腺疾病的流行病学。在发达国家，由于广泛进行甲状腺功能检测以及治疗起始的门槛相对较低，未确诊甲状腺疾病的患病率可能正在下降。然而，在发达国家，特别是在欧洲，继续警惕碘缺乏仍然至关重要。在本报告中，我们回顾了全球甲状腺功能亢进症和甲状腺功能减退症的发病率和患病率，强调了地域差异以及碘补充等环境因素对这些数据的影响。我们还强调了在发展中国家详细调查甲状腺功能障碍和碘状况的迫切需要。
