Clinic of Endocrinology and Metabolism, University Hospital Alexandrovska, 1, G. Sofiyski Str., 1431, Sofia, Bulgaria.
Department of Internal Medicine, Faculty of Medicine, Medical University Sofia, Sofia, Bulgaria.
Hormones (Athens). 2020 Dec;19(4):477-484. doi: 10.1007/s42000-020-00203-z. Epub 2020 Apr 23.
This review attempts to summarize data on the prevalence of thyroid pathology in the Bulgarian population over a period of 20 years. Thyroid dysfunction was studied in two population-based studies (2006 and 2012). In the first, hypothyroidism was found in 6.3% and hyperthyroidism in 3.7% of the participants. The second study found overt and subclinical hypothyroidism in 3.2% and 4.5%, respectively, of females, and in 1.1% and 2% of males. TPOAb levels were elevated in 23% of females and in 9.6% of males. Nodules were found using ultrasound (US) in 23.4% of the participants in the 2006 study (in 30.1% of females and 15.0% of males), while the 2012 study showed 24.4% (32.1% of females and 15.7% of males). Recent data regarding prevalence of thyroid carcinoma in the Bulgarian population are lacking. Between 4 and 6% of thyroid biopsies produce results which have markers for malignancy. Four studies were carried out to address urinary iodine excretion levels in schoolchildren and three for those in pregnant women. Although median urinary iodine was in the iodine-sufficient range, a rising proportion of women had low urinary excretion. In the studies involving schoolchildren, excessive iodine excretion was also observed. The major strength of this review is the combination of data from different publications to give an overall baseline of thyroid epidemiology in Bulgaria. Further work is needed to map the recent trends regarding thyroid pathology in Bulgaria and the complete epidemiological dataset.
这篇综述试图总结 20 年来保加利亚人群中甲状腺疾病的流行数据。在两项基于人群的研究（2006 年和 2012 年）中研究了甲状腺功能障碍。在第一项研究中，参与者中有 6.3%患有甲状腺功能减退症，3.7%患有甲状腺功能亢进症。第二项研究发现，女性分别有 3.2%和 4.5%存在显性和亚临床甲状腺功能减退症，男性分别有 1.1%和 2%存在显性和亚临床甲状腺功能减退症。女性中 TPOAb 水平升高的比例为 23%，男性为 9.6%。在 2006 年的研究中，使用超声（US）发现 23.4%的参与者存在结节（女性为 30.1%，男性为 15.0%），而 2012 年的研究显示，24.4%的参与者存在结节（女性为 32.1%，男性为 15.7%）。最近缺乏保加利亚人群甲状腺癌流行率的数据。4-6%的甲状腺活检结果有恶性标志物。进行了四项研究来评估学龄儿童和三项研究来评估孕妇的尿碘排泄水平。尽管中位数尿碘处于碘充足范围，但具有低尿碘排泄的女性比例在增加。在涉及学龄儿童的研究中，也观察到了过量的碘排泄。本综述的主要优势在于结合了来自不同出版物的数据，为保加利亚的甲状腺流行病学提供了总体基线。需要进一步的工作来描绘保加利亚甲状腺病理最近的趋势以及完整的流行病学数据集。
