Gender,race and socioeconomic influence on diagnosis and treatment of
thyroid disorders in the Brazilian Longitudinal Study of Adult Health
(ELSA-Brasil) |
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Authors: | RD Olmos RC de Figueiredo EM Aquino PA Lotufo IM Bensenor |
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Institution: | 1.Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil;2.Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil;3.Universidade Federal de São João Del-Rei,, São João Del-Rei, MG, Brasil;4.Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BA, Brasil |
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Abstract: | Thyroid diseases are common, and use of levothyroxine is increasing worldwide. We
investigated the influence of gender, race and socioeconomic status on the diagnosis
and treatment of thyroid disorders using data from the Brazilian Longitudinal Study
of Adult Health (ELSA-Brasil), a multicenter cohort study of civil servants (35-74
years of age) from six Brazilian cities. Diagnosis of thyroid dysfunction was by
thyrotropin (TSH), and free thyroxine (FT4) if TSH was altered, and the use of
specific medications. Multivariate logistic regression models were constructed using
overt hyperthyroidism/hypothyroidism and levothyroxine use as dependent variables and
sociodemographic characteristics as independent variables. The frequencies of overt
hyper- and hypothyroidism were 0.7 and 7.4%, respectively. Using whites as the
reference ethnicity, brown, and black race were protective for overt hypothyroidism
(OR=0.76, 95%CI=0.64-0.89, and OR=0.53, 95%CI=0.43-0.67, respectively, and black race
was associated with overt hyperthyroidism (OR=1.82, 95%CI=1.06-3.11). Frequency of
hypothyroidism treatment was higher in women, browns, highly educated participants
and those with high net family incomes. After multivariate adjustment, levothyroxine
use was associated with female gender (OR=6.06, 95%CI=3.19-11.49) and high net family
income (OR=3.23, 95%CI=1.02-10.23). Frequency of hyperthyroidism treatment was higher
in older than in younger individuals. Sociodemographic factors strongly influenced
the diagnosis and treatment of thyroid disorders, including the use of
levothyroxine. |
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Keywords: | Thyroid dysfunction Treatment of thyroid disorders Levothyroxine Gender Socioeconomic status Race |
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