Monitoring the Prevalence of Thyroid Disorders in the Adult Population of Northeast Germany

Overview

Journal Popul Health Metr

Publisher Biomed Central

Specialty Public Health

Date 2016 Nov 12

PMID 27833458

Citations 29

Authors

Rehman Mehmood Khattak

Till Ittermann

Matthias Nauck

Harald Below

Henry Volzke

Affiliations

Soon will be listed here.

Abstract

Background: Only a few studies like ours have investigated the effect of long-term stable iodine supply on thyroid disorders in a historically iodine-deficient population, but not with a long follow-up time of 10 years.

Methods: Data were derived from two independent population-based cohorts of the Study of Health in Pomerania (SHIP-0 [1997-2001] and SHIP-TREND [2008-2012]) comprising 4308 and 4420 subjects, respectively. Diagnosed thyroid disorders were assessed. Thyroid gland dimensions were examined by ultrasound. Levels of serum thyrotropin (TSH) and autoantibodies to thyroperoxidase (anti-TPO Abs) were measured from blood samples.

Results: Median urinary iodine excretion levels decreased from 123.0 μg/l to 112.0 μg/l ( = <0.001) between 2000 and 2010. The prevalence of known thyroid disorders increased from 7.6 % [CI 6.9-8.5] to 18.9 % [CI 17.6-20.1] and of thyroid medication use from 6.2 to 11.1 %. The prevalence of goiter decreased from 35.1 to 29.4 % ( = <0.001), while the prevalence of positive anti-TPO Abs decreased from 3.9 to 2.9 % ( = 0.022). Median serum TSH levels increased from 0.69 mIU/L to 1.19 mIU/L ( = <0.001). Consequently, prevalence of high TSH (mIU/L) increased from 2.6 to 2.9 % ( = 0.452), and low TSH (mIU/L) decreased from 6.6 to 6.4 % ( = 0.737).

Conclusion: The decreased prevalence of iodine-deficient disorders and a stable prevalence of markers of autoimmune thyroid disorders argue for an improved iodine supply of the adult population in Northeast Germany. In contrast, the prevalence of diagnosed thyroid disorders and the intake of thyroid medication increased, although this might be related to inappropriate therapeutic decisions.

Citing Articles

Autoimmune Thyroid Disease and Pregnancy: The Interaction Between Genetics, Epigenetics and Environmental Factors.

Bogovic Crncic T, Curko-Cofek B, Baticic L, Girotto N, Tomas M, Krsek A J Clin Med. 2025; 14(1.

PMID: 39797274 PMC: 11721206. DOI: 10.3390/jcm14010190.

Thyroid Autoimmunity During Universal Salt Iodisation-Possible Short-Term Modulation with Longer-Term Stability.

Atapattu N, Jayatissa R, de Silva H, Adlan M, Obuobie E, Premawardhana L Nutrients. 2025; 16(24.

PMID: 39770919 PMC: 11677496. DOI: 10.3390/nu16244299.

Trends of Pathological Findings in Patients with Thyroid Diseases: A Single-center, Retrospective Study.

Naseem M, Ali S, Qadir S, Riaz A, Monawwer A, Tahir B Clin Med Insights Endocrinol Diabetes. 2024; 17:11795514241299709.

PMID: 39525566 PMC: 11550499. DOI: 10.1177/11795514241299709.

Iodine Nutritional Status and Thyroid Autoimmunity in Chinese Children and Adolescents Aged 6-17 Years.

Li X, Zhang J, Ding H, Tu P, Wu L, Xing M Nutrients. 2024; 16(21).

PMID: 39519552 PMC: 11547706. DOI: 10.3390/nu16213720.

The Relationships among the Urinary Iodine Concentration, Selenium Intake, and Thyroid Antibodies in Adults, Including the Interaction between Iodine and Selenium: National Health and Nutrition Examination Survey 2007-2012.

Zhang C, Wang H, Teng W, Shan Z Nutrients. 2024; 16(20).

PMID: 39458439 PMC: 11509967. DOI: 10.3390/nu16203443.

References

Volzke H, Robinson D, Schminke U, Ludemann J, Rettig R, Felix S . Thyroid function and carotid wall thickness. J Clin Endocrinol Metab. 2004; 89(5):2145-9. DOI: 10.1210/jc.2003-031028. View

Volzke H, Ludemann J, Robinson D, Spieker K, Schwahn C, Kramer A . The prevalence of undiagnosed thyroid disorders in a previously iodine-deficient area. Thyroid. 2003; 13(8):803-10. DOI: 10.1089/105072503768499680. View

Volzke H, Werner A, Wallaschofski H, Friedrich N, Robinson D, Kindler S . Occupational exposure to ionizing radiation is associated with autoimmune thyroid disease. J Clin Endocrinol Metab. 2005; 90(8):4587-92. DOI: 10.1210/jc.2005-0286. View

Volzke H, Ittermann T, Albers M, Friedrich N, Nauck M, Below H . Five-year change in morphological and functional alterations of the thyroid gland: the Study of Health in Pomerania. Thyroid. 2012; 22(7):737-46. DOI: 10.1089/thy.2011.0525. View

Meisinger C, Ittermann T, Wallaschofski H, Heier M, Below H, Kramer A . Geographic variations in the frequency of thyroid disorders and thyroid peroxidase antibodies in persons without former thyroid disease within Germany. Eur J Endocrinol. 2012; 167(3):363-71. DOI: 10.1530/EJE-12-0111. View

Soldin O . Controversies in urinary iodine determinations. Clin Biochem. 2002; 35(8):575-9. PMC: 3637997. DOI: 10.1016/s0009-9120(02)00406-x. View

Knudsen N, Jorgensen T, Rasmussen S, Christiansen E, Perrild H . The prevalence of thyroid dysfunction in a population with borderline iodine deficiency. Clin Endocrinol (Oxf). 1999; 51(3):361-7. DOI: 10.1046/j.1365-2265.1999.00816.x. View

Surks M, Boucai L . Age- and race-based serum thyrotropin reference limits. J Clin Endocrinol Metab. 2009; 95(2):496-502. DOI: 10.1210/jc.2009-1845. View

Laurberg P, Bulow Pedersen I, Knudsen N, Ovesen L, Andersen S . Environmental iodine intake affects the type of nonmalignant thyroid disease. Thyroid. 2001; 11(5):457-69. DOI: 10.1089/105072501300176417. View

10.

Siesser W, Zhao J, MILLER L, Cheng S, McDonald M . Transgenic mice expressing a human mutant beta1 thyroid receptor are hyperactive, impulsive, and inattentive. Genes Brain Behav. 2006; 5(3):282-97. DOI: 10.1111/j.1601-183X.2005.00161.x. View

11.

Zimmermann M, Andersson M . Update on iodine status worldwide. Curr Opin Endocrinol Diabetes Obes. 2012; 19(5):382-7. DOI: 10.1097/MED.0b013e328357271a. View

12.

Kahaly G, Dienes H, Beyer J, Hommel G . Iodide induces thyroid autoimmunity in patients with endemic goitre: a randomised, double-blind, placebo-controlled trial. Eur J Endocrinol. 1998; 139(3):290-7. DOI: 10.1530/eje.0.1390290. View

13.

Laurberg P, Pedersen K, Hreidarsson A, Sigfusson N, Iversen E, Knudsen P . Iodine intake and the pattern of thyroid disorders: a comparative epidemiological study of thyroid abnormalities in the elderly in Iceland and in Jutland, Denmark. J Clin Endocrinol Metab. 1998; 83(3):765-9. DOI: 10.1210/jcem.83.3.4624. View

14.

John U, Greiner B, Hensel E, Ludemann J, Piek M, Sauer S . Study of Health In Pomerania (SHIP): a health examination survey in an east German region: objectives and design. Soz Praventivmed. 2001; 46(3):186-94. DOI: 10.1007/BF01324255. View

15.

Sawin C, Geller A, Hershman J, Castelli W, Bacharach P . The aging thyroid. The use of thyroid hormone in older persons. JAMA. 1989; 261(18):2653-5. DOI: 10.1001/jama.261.18.2653. View

16.

Bulow Pedersen I, Laurberg P, Arnfred T, Knudsen N, Jorgensen T, Perrild H . Surveyance of disease frequency in a population by linkage to diagnostic laboratory databases. A system for monitoring the incidences of hyper- and hypothyroidism as part of the Danish iodine supplementation program. Comput Methods Programs Biomed. 2002; 67(3):209-16. DOI: 10.1016/s0169-2607(01)00125-0. View

17.

Li C, Guan H, Teng X, Lai Y, Chen Y, Yu J . An epidemiological study of the serum thyrotropin reference range and factors that influence serum thyrotropin levels in iodine sufficient areas of China. Endocr J. 2011; 58(11):995-1002. DOI: 10.1507/endocrj.k11e-101. View

18.

Ittermann T, Khattak R, Nauck M, Cordova C, Volzke H . Shift of the TSH reference range with improved iodine supply in Northeast Germany. Eur J Endocrinol. 2014; 172(3):261-7. DOI: 10.1530/EJE-14-0898. View

19.

Knudsen N, Laurberg P, Rasmussen L, Bulow I, Perrild H, Ovesen L . Small differences in thyroid function may be important for body mass index and the occurrence of obesity in the population. J Clin Endocrinol Metab. 2005; 90(7):4019-24. DOI: 10.1210/jc.2004-2225. View

20.

Liesenkotter K, Kiebler A, Stach B, Willgerodt H, Gruters A . Small thyroid volumes and normal iodine excretion in Berlin schoolchildren indicate full normalization of iodine supply. Exp Clin Endocrinol Diabetes. 1997; 105 Suppl 4:46-50. DOI: 10.1055/s-0029-1211932. View