Centro de Pesquisa Clínica e Epidemiológica, Universidade de São Paulo, São Paulo, SP, Brasil.
Divisão de Endocrinologia, Faculdade de Medicina de Marília, Marília, SP, Brasil.
Arch Endocrinol Metab. 2021 Nov 3;65(4):468-478. doi: 10.20945/2359-3997000000348. Epub 2021 Apr 12.
To evaluate incidence of subclinical and overt hyperthyroidism and hypothyroidism.
The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) is a prospective cohort study of 15,105 civil servants, examined at baseline and over a 4-year follow-up. This analysis included 9,705 participants with normal thyroid function at baseline, follow-up information about thyroid function and with no report of using drugs that may interfere in the thyroid function. Thyroid function was defined by TSH/FT4 levels or routine use of thyroid hormones/anti-thyroid medications. Annual and cumulative (over 4-year) incidence rates were presented as percentages (95% Confidence Intervals).
The incidence of all overt and subclinical thyroid disease was 6.7% (1.73%/year): 0.19% for overt hyperthyroidism (0.048%/year), 0.54% for subclinical hyperthyroidism (0.14%/year), 1.98% for overt hypothyroidism (0.51%/year), and 3.99% for subclinical hypothyroidism (1.03%/year). The incidence of all thyroid diseases was higher in women, when compared to men, with a low women:men ratio (1.36). For Blacks the highest incidence was for overt hyperthyroidism, while for Whites, the highest incidence was for overt hypothyroidism. However, the highest incidence of overt hyperthyroidism was detected in Asian descendants. The presence of antithyroperoxidase antibodies at baseline was associated with higher incidence of overt thyroid diseases.
These results showed a high incidence of hypothyroidism, which is compatible with a country with a more-than-adequate iodine intake. The low women:men ratio of the incidence of thyroid dysfunction highlights the importance of the diagnosis of thyroid diseases among men in Brazil.
评估亚临床和显性甲状腺功能亢进和甲状腺功能减退症的发病率。
巴西纵向成人健康研究（ELSA-Brasil）是一项针对 15105 名公务员的前瞻性队列研究，在基线和 4 年随访期间进行检查。本分析包括 9705 名基线甲状腺功能正常、随访甲状腺功能信息且无报告使用可能干扰甲状腺功能的药物的参与者。甲状腺功能通过 TSH/FT4 水平或常规使用甲状腺激素/抗甲状腺药物来定义。年和累积（4 年）发病率以百分比（95%置信区间）表示。
所有显性和亚临床甲状腺疾病的发病率为 6.7%（1.73%/年）：显性甲状腺功能亢进症为 0.19%（0.048%/年），亚临床甲状腺功能亢进症为 0.54%（1.4%/年），显性甲状腺功能减退症为 1.98%（0.51%/年），亚临床甲状腺功能减退症为 3.99%（1.03%/年）。与男性相比，女性所有甲状腺疾病的发病率更高，女性与男性的比例较低（1.36）。对于黑人，显性甲状腺功能亢进症的发病率最高，而对于白人，显性甲状腺功能减退症的发病率最高。然而，显性甲状腺功能亢进症的发病率最高的是亚裔。基线时存在抗甲状腺过氧化物酶抗体与显性甲状腺疾病的发病率较高有关。
这些结果显示出高发病率的甲状腺功能减退症，这与碘摄入充足的国家相吻合。甲状腺功能障碍发生率的低女性与男性比例突出了在巴西诊断男性甲状腺疾病的重要性。
