Screening for thyroid dysfunction in a community population of diabetic patients

In a general practice population of 11 300 patients, 223 were known to have diabetes mellitus. Thirteen diabetic patients (5.8 %) had a previous diagnosis of thyroid disease. The study excluded 17 patients who received sole diabetes care at a secondary referral centre (of whom 5 had a previous diagnosis of thyroid disease), 8 with a previous diagnosis of thyroid disease receiving community care, and 1 patient who declined screening. New thyroid disease was diagnosed in 11 patients (8 female, 3 male): 5 with primary hypothyroidism, 4 with subclinical hypothyroidism, 1 with hyperthyroidism and 1 with subclinical hyperthyroidism. Thus the prevalence of undiagnosed thyroid disease in diabetic patients receiving community diabetes care was 5.5 % (9.5 % of female patients), and the prevalence of thyroid disease (previusly known and diagnosed as a result of screening) in the entire population of diabetic patients registered in the general practice was 10.8 %. These findings suggest that screening for thyroid disease should be considered in patients receiving diabetes care in the community. © 1998 John Wiley & Sons, Ltd.     

糖尿病住院患者434例甲状腺疾病患病率分析

目的 探讨江苏地区糖尿病患者中甲状腺疾病的现患情况.方法 横向断面调查2006年10月至2007年6月于南京医科大学第一附属医院就诊的长期居住于江苏地区的434例糖尿病患者的甲状腺功能,其中109例患者作了甲状腺超声检查.结果 (1)糖尿病患者合并甲状腺疾病的患病率为23.27%,女性多见(P＜0.05),其中甲状腺功能减退者占16.36%(临床甲减4.15%,亚临床甲减12.21%),明显高于甲状腺功能亢进者6.91%(临床甲亢4.61%,亚临床甲亢2.30%),两者差异有统计学意义.(2)糖尿病患者中,甲状腺功能减退的患病率随患者年龄和糖尿病病程的增加而增加(P＜0.01);甲状腺功能亢进的患病率随糖尿病痛程的增加而降低(P＜0.05),随年龄的增加患病率改变无统计学意义.(3)糖尿病患者中甲状腺结节患病率为40.37%,性别差异无统计学意义,患病率随年龄的增加而增加(P＜0.05),不随糖尿病痛程的增加而增加.结论 糖尿病患者合并甲状腺疾病较常见,可能影响糖尿病患者的病情和预后,筛查和随访糖尿病患者的甲状腺功能及形态学状态具有重要的临床意义.     

妊娠中晚期孕妇甲状腺功能异常和自身抗体筛查的研究

目的 研究妊娠中晚期孕妇甲状腺功能异常及自身抗体阳性的患病率,探讨在孕妇群体中进行甲状腺筛查的必要性.方法 研究对象为2006年6月至2008年2月期间在上海交通大学附属第一人民医院就诊的妊娠中晚期孕妇,以问卷调查方式采集病史资料,根据孕妇是否有甲状腺疾病既往史、家族史或其他相关疾病既往史,分为高甲状腺疾病风险组(高风险组)和低甲状腺疾病风险组(低风险组).对所有孕妇检测血清FT3、FT4、TSH、甲状腺过氧化物酶抗体(TPOAb)和促甲状腺激素受体抗体水平.结果 共筛查孕妇2 101名,发现有各种甲状腺功能异常或甲状腺抗体阳性712例(33.89％).高风险组孕妇中有较高比例的甲状腺功能异常,而低风险组1 983名孕妇中亦有2.27％(45例)诊断为甲状腺功能减退,11.60％(230例)为亚临床甲状腺功能减退,0.20％(4例)为甲状腺功能亢进,1.06％(21例)为亚临床甲状腺功能亢进,6.45％(128例)为低甲状腺素血症,10.74％(213例)甲状腺功能正常但TPOAb阳性.在TPOAb阳性孕妇中,甲状腺功能异常者更多见.其中79.74％甲状腺功能异常或TPOAb阳性孕妇经本次筛查发现.结论 妊娠中晚期孕妇中进行甲状腺筛查可发现33.89％孕妇存在甲状腺功能异常或TPOAb阳性,TPOAb阳性孕妇出现甲状腺功能异常的患病率增加.如果仅对高风险孕妇进行甲状腺筛查,则可能导致高达79.74％患者漏诊.     

2型糖尿病合并甲状腺功能异常的临床分析

目的 探讨T2DM合并甲状腺疾病的患病情况及临床特点. 方法 回顾性分析420例住院T2DM患者甲状腺功能相关指标及临床资料. 结果 （1）T2DM患者甲状腺疾病患病率16.67％;甲状腺功能异常患病率15.71％.甲状腺功能异常患病率甲亢组3.57％,甲减组8.10％,低T3综合征组4.05％.甲减组中,亚临床甲减甲状腺功能异常患病率（4.52％）最高,女性甲状腺疾病及甲状腺功能异常的患病率均高于男性（P＜0.05）.（2）与T2DM组相比,T2DM合并甲状腺疾病组病程及胰岛素泵治疗时间增加,C-P120min水平降低;两组UAlb 30～299 mg/24 h差异有统计学意义（P＜0.01）.（3）甲亢组DPN患病率最高,低T3组年龄最大,且合并冠心病史发生率最高（P＜0.05）. 结论 T2DM合并甲状腺疾病患病率较高,甲状腺功能异常表现形式多样,对T2DM患者进行早期甲状腺功能的筛查具有临床意义.     

Socio demographic wise risk assessment of thyroid function abnormalities in far western region of Nepal: A hospital based descriptive study

Objective

To know the status of thyroid disorder in population of far western region of Nepal.

Methods

A total of 808 cases (133 men and 675 non pregnant women) were included and study was carried out using data retrieved from the register maintained in the Department of Biochemistry of the Nepalgunj Teaching Hospital between 1st January, 2011 and 28th February, 2012. The variables collected were age, sex, and thyroid function profile including free T3, free T4 and TSH.

Results

The percentage of thyroid disorders was 33.66% in far western region of Nepal. The people were highly affected by overt hyperthyroidism (14.9%) followed by subclinical hyperthyroidism (9.9%). The subclinical hypothyroidism was 7.9% while 1% overt hypothyroidism only in a far western region of Nepal. Females were highly affected by overt hyperthyroidism (17.8%), followed by subclinical hyperthyroidism (11.9%). A total of 5.9% females were affected by subclinical hypothyroidism while only 1.2% by overt hypothyroidism. Males were affected only by subclinical hypothyroidism (18.0%) in this present study. High number of total thyroid dysfunction was observed in 21 to 40 years of age groups, followed by 41 to 60 years of age groups. Less than 40 years people were having 1.03, 0.99, 2.51 and 1.15 times risk of developing overt hyperthyroidism, subclinical hyperthyroidism, overt hypothyroidism and subclinical hyperthyroidism respectively compared to greater than 40. Female were having 0.29 times risk of developing subclinical hyperthyroidism compared to male. But overt hyperthyroidism, subclinical hyperthyroidism and overt hypothyroidism female were having more risk of developing compared to male.

Conclusions

The thyroid disorder, especially overt hyperthyroidism (14.9%) and subclinical hyperthyroidism (9.9%) was high. Further studies are required to characterize the reasons for this high prevalence.     

Achalasia and thyroid disease

AIM： To investigate some possible etiologies of achalasia by screening patients with achalasia for some autoimmune diseases such as thyroid disease.
METHODS： We examined 30 known cases of achalasia （20 females, 10 males）. Their age ranged 15-70 years. All of them were referred to our institute for treatment. Their sera were evaluated to detect some possible associations with rheumatoid disease, thyroid disease, inflammatory process, anemia, etc.
RESULTS： Seven out of 30 patients （23%） had thyroid disease including four patients with hypothyroidism （13.3%）, two patients with hyperthyroidism （6.6%）, and one had only thyroid nodule but was in euthyroid state （3.3%）. Two of these hypothyroid patients had no related clinical symptoms （subclinical） and two had clinical manifestations of hypothyroidism. There were no correlations between the intensity of thyroid diseases and the severity of achalasia symptoms.
CONCLUSION： The etiology of achalasia is unknown although autoimmunity has been implicated and is supported by several studies. Thyroid disease presents concomitantly with achalasia in about one fourth of our patients who may have a common etiology.     

河北某水源性高碘地区成人甲状腺疾病的流行病学调查

目的：调查水源性高碘地区－河北省黄骅市歧口村、高头村≥14岁人群甲状腺疾病的流行状况,方法：入户问卷调查4230人的基础上,采样调查1074人,所有采样调查对象均详细填与甲状腺疾病调查表,接受体检查和B超检查,测定血清促甲状腺激素（TSH）、甲状腺自身抗体（TAA）和甲状腺球蛋白（TG）,留取空腹尿样测量尿碘、TSH异常者测定甲状腺激素和TSH受体抗体（TRAb）。结果：采样人群的尿碘中位数为614．61μg/L。临床甲状腺功能亢进症（甲亢）和亚临床甲亢的患病率分别为1．21％和1．12％;临床甲亢中92．3％为Graves病所致,亚临床甲亢中75％TRAb阳性;回顾性分析普遍食盐碘化前后临床甲亢平均年发病率差异无显著性,临床甲状腺功能减低症（甲减）和亚临床甲减的患病率分别为1．96％和6．05％,患者TAA阳性率分别为85．71％和29．23％。采样人群甲状腺过氧化物酶抗体（TPOAb）和甲状腺球蛋白抗体（TGAb）阳性率分别为11．6％和9．3％。弥漫性甲状腺肿,结节性甲状腺肿、单发结节和多发结节的患病率分别为3．26％、2．61％、1．77％和6．4％。甲状腺癌病率为91．58／10万,结论：在尿磺中位数为614．61μg/L的碘营养状态下,甲状腺功能减退症和甲状腺癌患病率显著增高,提示这一碘摄入量并不安全。     

Subclinical hyperthyroidism in patients with type 2 diabetes

Both subclinical hyperthyroidism and type 2 diabetes (T2D) have been associated with an increase in cardiovascular disease risk and mortality. We aimed to assess the prevalence of newly diagnosed subclinical hyperthyroidism in a cohort of patients with T2D, and also to analyse the relationships between diabetes-related characteristics and the presence of subclinical hyperthyroidism. 933 diabetic patients without previous history of thyroid disease (45.4% females, mean age 66.3 years, median duration of diabetes 10 years) were evaluated. A sample of 911 non-diabetic subjects without known thyroid dysfunction was studied as control group. Serum concentrations of thyrotropin were measured in all subjects. Subclinical hyperthyroidism was present in 4.3% of female and 3.5% of male diabetic patients. Relative risk was significant only for the female gender (OR 3.69, 95% CI 1.56-8.71). In comparison with diabetic patients without thyroid hyperfunction, patients with subclinical hyperthyroidism were older, had longer duration of diabetes, showed lower fasting glucose levels, had greater proportion of goitre and diet therapy, and had lower proportion of treatment with oral agents. Logistic regression analysis showed that age and the presence of goitre were significantly related to subclinical hyperthyroidism in patients with T2D. The risk for subclinical hyperthyroidism is increased in women with T2D. Advanced age and the presence of goitre are significantly and independently related with the presence of subclinical hyperthyroidism in diabetic population.     

No association between HIV disease and its treatment and thyroid function

OBJECTIVES: The aims of the study were (i) to investigate the prevalence of overt and subclinical thyroid disease in HIV-positive patients in a London teaching hospital; (ii) to determine risk factors associated with the development of thyroid dysfunction, including highly active antiretroviral therapy (HAART) and individual antivirals, and (iii) to determine the occurrence of thyroid dysfunction longitudinally over 3 years. METHODS: The study consisted of retrospective analyses of thyroid function tests (TFT) in HIV-positive patients. The period prevalence of and factors associated with clinical and subclinical thyroid dysfunction were investigated. Patients with normal TFT but previous thyroid disease were identified from pharmacy records and included in the overt category. RESULTS: A total of 1565 patients (73% of the clinic population) had at least one TFT taken since 2001. Overall, 3584 samples were analysed. Of the patients included in the study, 1233 (79%) were male, 1043 (66%) were white and 365 (23%) were black African, and in 969 (62%) the main risk for HIV was homosexual sex. Median age at baseline was 37 years. Nine hundred patients (58%) were on HAART at the start of the study. Thirty-nine (2.5%) were found to have overt hypothyroidism, and eight (<1%) had overt hyperthyroidism. Sixty-one (4%) had subclinical hypothyroidism, five (<1%) had subclinical hyperthyroidism and 263 (17%) had a nonthyroidal illness. A normal TFT was obtained for 1118 patients (75.5%). Multivariate analysis suggested that no independent variables were significantly associated with overt hypothyroidism, including HAART and stavudine use specifically. Repeated measurements over 3 years were available for 825 patients and only eight new cases (1%) of overt thyroid disease occurred. CONCLUSIONS: The prevalence of overt thyroid disease was low in this cohort, suggesting that screening is not warranted.     

Subclinical hypothyroidism is a risk factor for nephropathy and cardiovascular diseases in Type 2 diabetic patients.

AIMS: The purpose of this study was to determine the relationship between subclinical hypothyroidism and prevalence of retinopathy and nephropathy, incident cardiovascular disease, and mortality in Type 2 diabetic patients without taking thyroid medication. METHODS: Serum thyrotropin and free thyroxine concentrations were measured in 588 Type 2 diabetic subjects in Taipei Veterans General Hospital, Taiwan. In a cross-sectional study, we examined the prevalence of retinopathy and nephropathy. In a longitudinal study, we examined the risk of cardiovascular disease events, cardiovascular mortality and total mortality in the 4-year follow-up. RESULTS: In the cross-sectional analysis, subclinical hypothyroidism was associated with a greater prevalence of diabetic nephropathy (odds ratio, 3.15 [95% CI, 1.48-6.69]) and did not show a high prevalence of diabetic retinopathy (odds ratio, 1.15 [95% CI, 0.59-2.26]) compare to euthyroid diabetics. During the 44.0 +/- 7.4 months of follow-up, 51 participants had cardiovascular events. The risk of cardiovascular events was significantly increased in Type 2 diabetics with subclinical hypothyroidism after adjustment for age, sex, A1C, other standard cardiovascular risk factors and medication (hazard ratio, 2.93; 95% CI, 1.15-7.48; P = 0.024), but it became nonsignificant after additional adjustment for urinary albumin-to-creatinine ratio (hazard ratio, 2.06; 95% CI, 0.67-6.36; P = 0.211). The rates of cardiovascular-related and total mortality did not significantly differ by thyroid status. CONCLUSIONS: Type 2 diabetic patients with subclinical hypothyroidism are associated with an increased risk of nephropathy and cardiovascular events, but not with retinopathy. Our data suggest that the higher cardiovascular events in subclinical hypothyroidism with Type 2 diabetes may be mediated with nephropathy.     

Prevalence of thyroid disorders among patients with diabetes in rural South India

Background & aimsDiabetes mellitus (DM) and thyroid disorders are the most common endocrine disorders in clinical practice. Unrecognized thyroid disorders have an adverse effect on metabolic functions. The aim of the study is to demonstrate the prevalence of thyroid disorders in individuals with diabetes mellitus.MethodsA prospective observational study, conducted at Sree Sidhi Vinayaka Diabetic Center, between September 2013 to December 2019. A total of 5037 patients attended the outpatient clinic, among which 2470 met the inclusion criteria. All patients underwent a clinical and laboratory evaluation.ResultsA total of 2321 individuals with diabetes had consented to be the part of the study, 102 had Type 1 diabetes mellitus (T1DM) and 2219 Type 2 diabetes mellitus (T2DM). The mean age was 48.4 ± 10.7, among which 1128 females and 1193 are males. 79.9% (1853) individuals with diabetes were euthyroid; 13.8% (321) subclinical hypothyroidism; 3.4% (79) clinical hypothyroidism, and 2.9% (68) were having hyperthyroidism. 14.1% of T2DM had subclinical hypothyroidism, in contrast, clinical hypothyroidism was common in T1DM (6.9%).ConclusionA high index of suspicion for thyroid dysfunction in diabetics should be considered to screen for thyroid function in them for early detection and effective management of both the conditions.     

干扰素治疗慢性丙型肝炎发生甲状腺功能异常的分析

目的：探讨干扰素治疗慢性丙型肝炎患者后发生甲状腺功能异常的情况及相关因素的分析。方法回顾性分析206例慢性丙型肝炎患者,观察89例干扰素治疗前和117例治疗后甲状腺功能的异常情况及其影响因素,Logistic分析发生甲状腺功能异常的危险因素。结果干扰素治疗前的89例患者中,有23例合并甲状腺功能异常,其中甲状腺功能减退症7例,甲状腺功能亢进症2例,亚临床甲状腺功能减退症14例;干扰素治疗后的117例患者中,有17例发生甲状腺功能异常,其中甲状腺功能减退4例,为桥本甲状腺炎2例和非自身免疫性甲状腺功能减退2例;甲状腺功能亢进1例;亚临床甲状腺功能减退症12例。多元Logistic回归分析显示,女性（OR＝5．828）、体内预存抗甲状腺自身抗体（OR＝35．393）是慢性丙型肝炎患者使用干扰素治疗后诱发甲状腺疾病的独立危险因素。结论干扰素治疗慢性丙型肝炎可导致甲状腺功能异常的发生;对体内预存大量抗甲状腺过氧化物酶抗体的女性,要监测甲状腺功能,定期复查。     

High prevalence of thyroid autoimmunity and hypothyroidism in patients with psoriatic arthritis

OBJECTIVE:To evaluate the prevalence of thyroid disorders in a group of patients with psoriatic arthritis (PsA). METHODS: A complete thyroid investigation was carried out in 80 patients with PsA, in gender- and age-matched subjects (1:5) drawn from the general population (controls), and in 112 patients with rheumatoid arthrtitis (RA) with similar iodine intake. RESULTS: Anti-thyroid peroxidase antibodies (AbTPO), a hypoechoic thyroid, and subclinical hypothyroidism were significantly more frequent in women with PsA than in control women, and their frequency was similar to that in patients with RA (positive AbTPO titer 28%, 12%, and 31%; hypoechoic thyroid 31%, 16%, and 36%; subclinical hypothyroidism 25%, 8%, and 12%, respectively). Among men, positive AbTPO titers and a hypoechoic thyroid were found more frequently in the patients with PsA and RA than in controls (positive AbTPO titer 14%, 5%, and 2%; hypoechoic thyroid 16%, 10%, and 3%, respectively). All patients with PsA with subclinical hypothyroidism had polyarticular involvement (p 相似文献   

亚临床甲状腺疾病与缺血性卒中的风险和转归

亚临床甲状腺疾病包括亚临床甲状腺功能减退和亚临床甲状腺功能亢进,以后者更常见。亚临床甲状腺疾病可能导致高血压、糖尿病、血脂异常、动脉粥样硬化、心房颤动、高同型半胱氨酸血症等血管危险因素的发生率显著增高,同时与急性缺血性卒中的转归可能有关。     

The spectrum of thyroid disorders in systemic lupus erythematosus

To study the spectrum of thyroid disorders in systemic lupus erythematosus (SLE). Hundred SLE patients as per American Rheumatology Association(ARA) classification criteria underwent clinical examination, including assessment of disease activity (SLEDAI) and laboratory evaluation for serum triiodothyronine (T3),free thyroxine (FT4), thyroid stimulating hormone (TSH), antithyroperoxidase (TPO) antibody and antithyroglobulin (TG) antibody. Hundred age- and sex-matched apparently healthy individuals served as control. Thirty-six (36%) lupus patients had thyroid dysfunction when compared to 8 (8%) of controls and all of them were women. Primary hypothyroidism was the commonest dysfunction in 14 (14%), while subclinical hypothyroidism and subclinical hyperthyroidism was seen in 12 (12%) and 2 (2%), respectively. Eight (8%) had isolated low T3 consistent with sick euthyroid syndrome. Eighteen (50%) of thyroid dysfunction were autoimmune in nature (autoantibody positive) and rest 18 (50%) were non-autoimmune. Euthyroid state with the elevation of antibodies alone was seen in 12 (12%) of the lupus patients. In contrast, only 5 (5%) of controls had primary hypothyroidism and 3 (3%) had subclinical hypothyroidism, while none had hyperthyroidism. SLEDAI score and disease duration were compared between lupus patients with thyroid dysfunction to those with normal thyroid function. A statistically significant association was found between SLEDAI and thyroid dysfunction of sick euthyroid type.SLE disease duration had no statistically significant association with thyroid dysfunction. Prevalence of thyroid autoantibodies in lupus patients was 30% when compared to 10% of controls. Ninety-six (96%) of the SLE patients were ANA positive, while 4 (4%) of them were ANA negative but were anti-Sm antibody positive. There were no suggestions of any other autoimmune endocrine diseases like diabetes or Addison’s disease (clinically and on baseline investigations) in our lupus cohort and hence no further work up was done for these diseases. Thyroid disorders are frequent in SLE and are multifactorial with a definite higher prevalence of hypothyroidism as well as thyroid autoantibodies.     

Subclinical thyroid dysfunction and cardiac function amongst minority ethnic groups in the UK: A cross sectional study

Background

Subclinical thyroid disease is associated with abnormal cardiovascular haemodynamics and increased risk of heart failure. The burden of raised/low thyroid stimulating hormone (TSH) levels amongst South Asian (SA) and African–Caribbean (AC) minority groups in the UK is not well defined. Given that these groups are particularly susceptible to CVD, we hypothesised that STD would reflect abnormal cardiac function and heightened cardiovascular risk in these ethnic groups.

Methods

We examined SA (n = 1111, 56% male, mean age 57.6 yrs) and AC (n = 763, 44% male, mean age 59.2 yrs) participants from a large heart failure screening study. Euthyroidism is defined as TSH (0.4 – 4.9 mlU/l), subclinical hypothyroidism is defined as a raised TSH with normal serum free thyroxine (FT4) concentrations (9–19 pmol/l). Subclinical hyperthyroidism is defined as a low TSH with both FT4 and free triiodothyronine (FT3) concentrations within range (2.6–5.7 pmol/l).

Results

Across ethnic groups, prevalence of subclinical hypothyroidism was 2.9% (95% CI 2.1–3.7), and of hyperthyroidism was 2.0% (1.4–2.7). Hyperthyroidism was more common amongst SA compared to AC (2.8% vs. 0.9%, P = 0.017), while rates of subclinical hypothyroidism were similar. On multivariate analysis of variations in subclinical thyroid function, ethnicity was not independently significant.

Conclusion

The prevalence of subclinical thyroid disorders amongst SA and AC minority groups in Britain reflects levels reported in other populations. The clinical cardiovascular significance of subclinical thyroid disease is unclear, and it does not appear to be ethnically specific.     

Long term thyroid function after subtotal thyroidectomy for Graves' disease

Between 1973 and 1980, 93 patients with Graves' disease underwent subtotal thyroidectomy by the same surgeon (the size of thyroid remnant was 4 g per side). No case of operative mortality, no case of thyroid storm nor of surgical complications occurred. Three months after surgery 40% of patients were euthyroid, 25% had overt hypothyroidism, 35% had subclinical hypothyroidism. In the following yr important variations of thyroid function were observed. The number of patients with subclinical hypothyroidism decreased slowly (22% and 9% at 3 and 6 yr, respectively), and some became euthyroid, some hypothyroid, others relapsed. Seven patients had recurrent hyperthyroidism. In particular at 3 yr 45% of patients were euthyroid, 28% had overt hypothyroidism, 22% had subclinical hypothyroidism, 4% had recurrence; at 6 yr 56% were euthyroid, 32% had overt hypothyroidism, 9% had subclinical hypothyroidism, 3% had recurrence. Four out of the 8 patients operated under 20-yr-old became hypothyroid in comparison with only 2 out of the 15 patients over 50-yr-old. Relapses were present only in patients operated at less than 40-yr and only in females. No correlation was found between thyroid lymphocytic infiltration and thyroid function after surgery, nor between the presence of antithyroid antibodies and hypothyroidism. All cases who relapsed had high TMA titers both before and after operation. This study confirms the need for accurate follow-up after subtotal thyroidectomy for Graves' disease.     

轻度碘缺乏城市食盐加碘后甲状腺疾病流行病学调查研究

 目的 评价轻度碘缺乏城市贵阳食盐加碘25年后的碘营养状态及各种甲状腺疾病的患病情况。
方法 采用分层整群抽样方法,抽取贵阳市云岩区宅吉社区20岁及以上居民1509人,测定其血清促甲状腺素（TSH）、游离T₃、游离T₄、甲状腺过氧化物酶抗体（TPOAb）、甲状腺球蛋白抗体（TgAb）水平、尿碘水平及甲状腺B超检查;同时抽取8~10岁学龄儿童80名,测定其尿碘水平。
结果 8~10岁儿童尿碘中位数为228.7 μg/L。成人临床甲状腺功能减退症（甲减）、亚临床甲减、临床甲状腺功能亢进症（甲亢）及亚临床甲亢的患病率分别为1.79%、14.12%、1.52%及1.06%,亚临床甲减的患病率显著高于临床甲减（P < 0.05）;TPOAb及TgAb的阳性率分别为14.38%及 13.59%,自身免疫性甲状腺炎的患病率为4.44%。甲状腺肿大患病率为1.06%,其中,弥漫性甲状腺肿（0.86%）较结节性甲状腺肿（0.20%）多见（P < 0.05）。
结论 食盐加碘25年后,贵阳市处于碘超足量状态,成人临床甲减、亚临床甲减、甲状腺自身抗体阳性及自身免疫性甲状腺炎的患病率均较高。     

Study on the screening of thyroidal dysfunction in adult

For the purpose of screening of thyroidal dysfunction in adult, we have collected blood of 15,905 (male 11,559, female 4,346) adult normal workers and school students on filter papers at the time of the annual health examination. Both TSH and total T4 were measured by radioimmunoassay. Either TSH or total T4 or both showed abnormal values in 148 cases. For these subjects, serum TSH, total T4 and T3, free T4, TBG, antimicrosomal and antithyroglobulin antibody were estimated. From these results, diagnosis was made as follows: 6 hyperthyroidism, 12 primary hypothyroidism (including 3 subclinical hypothyroidism who showed elevated TSH and normal free T4 values) and 29 TBG abnormality (increase: 8, decrease or deficiency: 21). The incidence by this study was: hyperthyroidism 0.038% (1/2650), primary hypothyroidism 0.075% (1/1330), TBG increase or deficiency 0.132% (1/760). Sex ratio of thyroidal dysfunction were higher in female than male. In hyperthyroidism, ratio of male to female was 1:2.66, and in hypothyroidism, it was 1:133. Most of these patients were not diagnosed before this screening. The fact that the incidence of hypothyroidism was higher than hyperthyroidism in this population was apparent in this study. TBG abnormality was noted more in male than female. This report is important to show the incidence of thyroidal abnormalities and the necessity of the screening test of thyroid in adult.     

Screening of an Elderly Female Population for Hypo- and Hyperthyroidism by Use of a Thyroid Hormone Panel

ABSTRACT. The elderly female population living in a rural primary health care district in the south of Sweden was screened for hypo- and hyperthyroidism. A total of 1 442 (97.3 %) of the 1 482 women 60 years of age or older attended the study. By use of a computer-evaluated thyroid hormone panel, 178 women (12.3%) were identified as probably abnormal. Among them, 8 women (0.55% of total) with previously unknown thyroid disease were detected as overtly hypothyroid. If also 13 women with spontaneous subclinical hypothyroidism were included, the prevalence of earlier unknown hypothyroidism was 21/1 442 (1.5%). The number of subjects with hyperthyroidism discovered by screening was 28/1 442 (1.9%). Although much remains to be elucidated regarding medical, social and economic factors, the high figures obtained for newly discovered abnormal thyroid function suggest that screening for hyper- and hypothyroidism may be worthwhile in such an elderly female population.