Papini Enrico, Attanasio Roberto, Žarković Miloš, Nagy Endre Vezekenyi, Negro Roberto, Perros Petros, Galofré Juan Carlos, Cohen Chagit Adler, Akarsu Ersin, Alevizaki Maria, Ayvaz Göksun, Bednarczuk Tomasz, Beleslin Biljana Nedeljković, Berta Eszter, Bodor Miklos, Borissova Anna Maria, Boyanov Mihail, Buffet Camille, Burlacu Maria-Cristina, Ćirić Jasmina, Díez Juan J, Dobnig Harald, Fadeyev Valentin, Field Benjamin C T, Führer-Sakel Dagmar, Hakala Tommi, Jiskra Jan, Kopp Peter Andreas, Krebs Michael, Kršek Michal, Lantz Mikael, Lazúrová Ivica, Leenhardt Laurence, Luchytskiy Vitaliy, Puga Francisca Marques, McGowan Anne, Melo Miguel, Metso Saara, Moran Carla, Morgunova Tatyana, Niculescu Dan Alexandru, Perić Božidar, Planck Tereza, Robenshtok Eyal, Rosselet Patrick Olivier, Ruchala Marek, Riis Kamilla Ryom, Shepelkevich Alla, Tronko Mykola, Unuane David, Vardarli Irfan, Visser W Edward, Vryonidou Andromachi, Younes Younes Ramazan, Hegedüs Laszlo
Department of Endocrinology and Metabolism, Regina Apostolorum Hospital, Albano Laziale, Rome, Italy.
Scientific Committee Associazione Medici Endocrinologi, Milan, Italy.
Endocrine. 2025 Jan;87(1):262-272. doi: 10.1007/s12020-024-04002-z. Epub 2024 Aug 31.
Treatment of simple goiter (SG) growing over time with thyroid hormone (TH) therapy is discouraged by international guidelines.
To ascertain views of European thyroid specialists about TH treatment for euthyroid patients with growing SG and explore associations with management choice.
Online survey on the use of TH for growing SG among thyroid experts from 28 European countries.
The response rate was 31.5% (5430/17,247). Most respondents were endocrinologists. Twenty-eight percent asserted that TH therapy may be indicated in euthyroid patients with a growing SG. National and regional differences were noted, from 7% of positive responses in The Netherlands to 78% in Czech Republic (p < 0.0001). TH was more frequently prescribed by respondents over 40 years old (OR 1.77, 2.13, 2.41 if 41-50, 51-60, >60, respectively), and working in areas of former iodine insufficiency (OR 1.24, 95% CI 1.03-1.50). TH was less frequently prescribed by endocrinologists (OR 0.77, 95% CI 0.62-0.94) and respondents working in Southern Europe (OR 0.40, 95% CI 0.33-0.48), Northern Europe (OR 0.28, 95% CI 0.22-0.36) and Western Asia (OR 0.16, 95% CI 0.11-0.24) compared to Western Europe. Associations with respondents' sex, country, availability of national thyroid guidelines, and gross national income per capita were absent or weak.
Almost a third of European thyroid specialists support treating SG with TH, contrary to current guidelines and recommendations. This calls for urgent attention.
国际指南不鼓励使用甲状腺激素（TH）疗法治疗随时间增长的单纯性甲状腺肿（SG）。
确定欧洲甲状腺专家对于甲状腺功能正常但甲状腺肿不断增大的患者使用TH治疗的看法，并探讨其与治疗选择的关联。
对来自28个欧洲国家的甲状腺专家进行关于使用TH治疗不断增大的SG的在线调查。
回复率为31.5%（5430/17247）。大多数受访者为内分泌科医生。28%的受访者断言，甲状腺功能正常但甲状腺肿不断增大的患者可能需要使用TH治疗。存在国家和地区差异，从荷兰的7%的肯定答复到捷克共和国的78%（p < 0.0001）。40岁以上的受访者更频繁地开具TH处方（41 - 50岁、51 - 60岁、60岁以上的比值比分别为1.77、2.13、2.41），且在既往碘缺乏地区工作的受访者更频繁开具（比值比1.24，95%置信区间1.03 - 1.50）。与西欧相比，内分泌科医生（比值比0.77，95%置信区间0.62 - 0.94）以及在南欧（比值比0.40，95%置信区间0.33 - 0.48）、北欧（比值比0.28，95%置信区间0.22 - 0.36）和西亚（比值比0.16，95%置信区间0.11 - 0.24）工作的受访者开具TH的频率较低。与受访者的性别、国家、国家甲状腺指南的可用性以及人均国民总收入之间不存在关联或关联较弱。
近三分之一的欧洲甲状腺专家支持使用TH治疗SG，这与当前的指南和建议相悖。这需要引起紧急关注。
