Coste Joël, Mandereau-Bruno Laurence, Bertagna Xavier, Wémeau Jean-Louis
Eur Thyroid J. 2025 Jun 20;14(3). doi: 10.1530/ETJ-25-0041. Print 2025 Jun 1.
Healthcare claims data are increasingly used to investigate the epidemiology of benign thyroid diseases. Here, we estimate the prevalence of treated hyper- and hypo-thyroidism and assess the potential sociodemographic and geographic disparities in France in 2020, given the country's poor epidemiological knowledge of these conditions.
We used the French national healthcare data system, which covers nearly the entire population residing in France (over 67 million inhabitants in metropolitan and overseas departments). Prevalent cases were identified based on patients' long-term disease status, hospitalisation for hyper- and hypo-thyroidism and reimbursements for thyroid hormones, antithyroid drugs, iodine-131 and thyroid surgery. Thyroid-stimulating hormone, antithyroid antibodies and previous therapy for thyroid cancer and hyperthyroidism were considered to characterise the origin and surveillance of hypothyroidism.
In 2020, we identified 112,992 and 2,986,333 cases of treated hyper- and hypo-thyroidism, respectively, with an overall prevalence of 0.17 and 4.45 per 100 inhabitants. Marked differences were observed in terms of sex, age group and geographic area (department) for both conditions and deprivation level of the place of residence for hyperthyroidism only. The proportion of hypothyroidism following previous therapy for thyroid cancer or hyperthyroidism was less than 10%. Adequate monitoring (thyroid-stimulating hormone checked in the past year) occurred in 73.7% of hypothyroid subjects, with large variations across departments.
This study provides prevalence estimates of treated hyper- and hypo-thyroidism at the national and departmental levels in France and improves epidemiological knowledge of both conditions. It also supports using healthcare claims data for their epidemiological surveillance.
医疗保健索赔数据越来越多地用于调查良性甲状腺疾病的流行病学。鉴于法国对这些疾病的流行病学了解不足,我们在此估计2020年法国接受治疗的甲状腺功能亢进症和甲状腺功能减退症的患病率,并评估潜在的社会人口统计学和地理差异。
我们使用了法国国家医疗保健数据系统,该系统覆盖了居住在法国的几乎全部人口(法国本土和海外省超过6700万居民)。根据患者的长期疾病状况、甲状腺功能亢进症和甲状腺功能减退症的住院情况以及甲状腺激素、抗甲状腺药物、碘-131和甲状腺手术的报销情况来确定现患病例。甲状腺刺激激素、抗甲状腺抗体以及既往甲状腺癌和甲状腺功能亢进症的治疗情况被视为甲状腺功能减退症的病因和监测特征。
2020年,我们分别确定了112992例和2986333例接受治疗的甲状腺功能亢进症和甲状腺功能减退症病例,总体患病率分别为每100名居民0.17例和4.45例。在性别、年龄组和地理区域(部门)方面,这两种疾病均存在显著差异,仅甲状腺功能亢进症在居住地贫困水平方面存在差异。既往接受甲状腺癌或甲状腺功能亢进症治疗后发生甲状腺功能减退症的比例不到10%。73.7%的甲状腺功能减退症患者进行了充分监测(过去一年检查了甲状腺刺激激素),各部门之间存在很大差异。
本研究提供了法国国家和部门层面接受治疗的甲状腺功能亢进症和甲状腺功能减退症的患病率估计,并提高了对这两种疾病的流行病学认识。它还支持将医疗保健索赔数据用于其流行病学监测。