Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
PLoS One. 2020 Nov 25;15(11):e0242795. doi: 10.1371/journal.pone.0242795. eCollection 2020.
Thyroid hormone plays a pivotal role in human metabolism. In epidemiologic studies, adequate registration of thyroid disorders is warranted. We examined the prevalence of thyroid disorders, reported thyroid medication use, thyroid hormone levels, and validity of thyroid data obtained from questionnaires in the Lifelines Cohort Study.
We evaluated baseline data of all 152180 subjects (aged 18-93 years) of the Lifelines Cohort Study. At baseline, participants were asked about previous thyroid surgery and current and previous thyroid hormone use. At follow-up (n = 136776, after median 43 months), incident thyroid disorders could be reported in an open, non-structured question. Data on baseline thyroid hormone measurements (TSH, FT4 and FT3) were available in a subset of 39935 participants.
Of the 152180 participants, mean (±SD) age was 44.6±13.1 years and 58.5% were female. Thyroid medication was used by 4790 participants (3.1%); the majority (98.2%) used levothyroxine, and 88% were females. 59.3% of levothyroxine users had normal TSH levels. The prevalence of abnormal TSH levels in those not using thyroid medication was 10.8%; 9.4% had a mildly elevated (4.01-10.0 mIU/L), 0.7% had suppressed (<0.40 mIU/L), while 0.7% had elevated (>10.0 mIU/L) TSH levels. Over 98% of subjects with TSH between 4 and 10 mIU/L had normal FT4. Open text questions allowing to report previous thyroid surgery and incident thyroid disorders proved not to be reliable and severely underestimated the true incidence and prevalence of thyroid disorders.
Undetected thyroid disorders were prevalent in the general population, whereas the prevalence of thyroid medication use was 3.1%. Less than 60% of individuals using levothyroxine had a normal TSH level. The large group of individuals with subclinical hypothyroidism (9.4%) offers an excellent possibility to prospectively follow the natural course of this disorder. Both structured questions as well as linking to G.P.'s and pharmacists' data are necessary to improve the completeness and reliability of Lifelines' data on thyroid disorders.
甲状腺激素在人体代谢中起着关键作用。在流行病学研究中，需要对甲状腺疾病进行充分的登记。我们研究了莱夫兰斯队列研究中甲状腺疾病的患病率、报告的甲状腺药物使用情况、甲状腺激素水平以及问卷调查获得的甲状腺数据的有效性。
我们评估了莱夫兰斯队列研究中所有 152180 名受试者（年龄 18-93 岁）的基线数据。在基线时，参与者被问及以前的甲状腺手术以及目前和以前的甲状腺激素使用情况。在随访时（n=136776，中位随访时间为 43 个月），可以在一个开放的、非结构化的问题中报告新发甲状腺疾病。39935 名参与者的基线甲状腺激素测量（TSH、FT4 和 FT3）数据可用。
在 152180 名参与者中，平均（±SD）年龄为 44.6±13.1 岁，58.5%为女性。有 4790 名（3.1%）参与者使用甲状腺药物；大多数（98.2%）使用左甲状腺素，其中 88%为女性。59.3%的左甲状腺素使用者 TSH 水平正常。未使用甲状腺药物者的 TSH 异常水平患病率为 10.8%；9.4%有轻度升高（4.01-10.0 mIU/L），0.7%有抑制（<0.40 mIU/L），0.7%有升高（>10.0 mIU/L）TSH 水平。98%以上 TSH 在 4-10 mIU/L 之间的患者 FT4 正常。允许报告既往甲状腺手术和新发甲状腺疾病的开放文本问题证明不可靠，并严重低估了甲状腺疾病的真实发病率和患病率。
未被发现的甲状腺疾病在普通人群中很常见，而甲状腺药物的使用患病率为 3.1%。不到 60%使用左甲状腺素的患者 TSH 水平正常。亚临床甲状腺功能减退症（9.4%）的患者人数众多，为前瞻性观察该疾病的自然病程提供了极好的机会。结构良好的问题以及与全科医生和药剂师的数据链接对于改善莱夫兰斯关于甲状腺疾病的数据的完整性和可靠性是必要的。
