Division of Endocrinology, Department of Medicine, University of Florida, Gainesville, Florida.
Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine.
Curr Opin Endocrinol Diabetes Obes. 2024 Oct 1;31(5):184-190. doi: 10.1097/MED.0000000000000877. Epub 2024 Aug 1.
To analyze the evolving epidemiologic trends in thyroid disease, focusing on risk factors, underlying drivers of these changes, and their implications on clinical practice and research priorities.
Thyroid disease remains one of the most prevalent groups of disorders globally, and the shift in its frequency and distribution is multifactorial. The prevalence of hypothyroidism increases with age, although normal thyrotropin ranges appear to be age-dependent, raising concern for potentially inappropriate levothyroxine use. Hyperthyroidism and Graves' disease continue to be predominant in reproductive-age women but exhibit a milder phenotype at diagnosis. Thyroid nodules are increasingly found in asymptomatic patients, likely from more widespread use of neck and chest imaging. Thyroid cancer incidence has risen exponentially over the years, mostly driven by overdiagnosis of low-risk tumors; however, a small rise in incidence of higher risk tumors has been noted. Obesity appears to be a risk factor for thyroid cancer occurrence and more aggressive forms of the disease.
Understanding epidemiologic trends in thyroid disease is crucial for guiding clinical practice and research efforts, aiming to optimize patient outcomes while preventing unnecessary and potentially harmful interventions.
分析甲状腺疾病不断变化的流行病学趋势，重点关注危险因素、这些变化的潜在驱动因素，以及它们对临床实践和研究重点的影响。
甲状腺疾病仍然是全球最常见的疾病之一，其发病率和分布的变化是多因素的。甲状腺功能减退症的患病率随年龄增长而增加，尽管正常促甲状腺激素范围似乎与年龄有关，这引起了人们对潜在不适当使用左甲状腺素的担忧。甲状腺功能亢进症和 Graves 病在育龄妇女中仍然占主导地位，但在诊断时表现出较轻的表型。甲状腺结节在无症状患者中越来越常见，可能是由于颈部和胸部成像的广泛应用。多年来，甲状腺癌的发病率呈指数级增长，主要是由于低风险肿瘤的过度诊断所致；然而，已经注意到高风险肿瘤的发病率略有上升。肥胖似乎是甲状腺癌发生和更具侵袭性形式的疾病的危险因素。
了解甲状腺疾病的流行病学趋势对于指导临床实践和研究工作至关重要，旨在优化患者的治疗效果，同时预防不必要和潜在有害的干预措施。
