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Prevalence of subclinical thyroid dysfunction and its relation to socioeconomic deprivation in the elderly: a community-based cross-sectional survey.
J Clin Endocrinol Metab. 2006 Dec; 91(12):4809-16.JC

Abstract

CONTEXT

Population-based screening has been advocated for subclinical thyroid dysfunction in the elderly because the disorder is perceived to be common, and health benefits may be accrued by detection and treatment.

OBJECTIVE

The objective of the study was to determine the prevalence of subclinical thyroid dysfunction and unidentified overt thyroid dysfunction in an elderly population.

DESIGN, SETTING, AND PARTICIPANTS

A cross-sectional survey of a community sample of participants aged 65 yr and older registered with 20 family practices in the United Kingdom.

EXCLUSIONS

Exclusions included current therapy for thyroid disease, thyroid surgery, or treatment within 12 months.

OUTCOME MEASURE

Tests of thyroid function (TSH concentration and free T4 concentration in all, with measurement of free T3 in those with low TSH) were conducted. EXPLANATORY VARIABLES: These included all current medical diagnoses and drug therapies, age, gender, and socioeconomic deprivation (Index of Multiple Deprivation, 2004).

ANALYSIS

Standardized prevalence rates were analyzed. Logistic regression modeling was used to determine factors associated with the presence of subclinical thyroid dysfunction.

RESULTS

A total of 5960 attended for screening. Using biochemical definitions, 94.2% [95% confidence interval (CI) 93.8-94.6%] were euthyroid. Unidentified overt hyper- and hypothyroidism were uncommon (0.3, 0.4%, respectively). Subclinical hyperthyroidism and hypothyroidism were identified with similar frequency (2.1%, 95% CI 1.8-2.3%; 2.9%, 95% CI 2.6-3.1%, respectively). Subclinical thyroid dysfunction was more common in females (P < 0.001) and with increasing age (P < 0.001). After allowing for comorbidities, concurrent drug therapies, age, and gender, an association between subclinical hyperthyroidism and a composite measure of socioeconomic deprivation remained.

CONCLUSIONS

Undiagnosed overt thyroid dysfunction is uncommon. The prevalence of subclinical thyroid dysfunction is 5%. We have, for the first time, identified an independent association between the prevalence of subclinical thyroid dysfunction and deprivation that cannot be explained solely by the greater burden of chronic disease and/or consequent drug therapies in the deprived population.

Authors+Show Affiliations

Department of Primary Care and General Practice, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom. s.wilson@bham.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17003083

Citation

Wilson, Sue, et al. "Prevalence of Subclinical Thyroid Dysfunction and Its Relation to Socioeconomic Deprivation in the Elderly: a Community-based Cross-sectional Survey." The Journal of Clinical Endocrinology and Metabolism, vol. 91, no. 12, 2006, pp. 4809-16.
Wilson S, Parle JV, Roberts LM, et al. Prevalence of subclinical thyroid dysfunction and its relation to socioeconomic deprivation in the elderly: a community-based cross-sectional survey. J Clin Endocrinol Metab. 2006;91(12):4809-16.
Wilson, S., Parle, J. V., Roberts, L. M., Roalfe, A. K., Hobbs, F. D., Clark, P., Sheppard, M. C., Gammage, M. D., Pattison, H. M., & Franklyn, J. A. (2006). Prevalence of subclinical thyroid dysfunction and its relation to socioeconomic deprivation in the elderly: a community-based cross-sectional survey. The Journal of Clinical Endocrinology and Metabolism, 91(12), 4809-16.
Wilson S, et al. Prevalence of Subclinical Thyroid Dysfunction and Its Relation to Socioeconomic Deprivation in the Elderly: a Community-based Cross-sectional Survey. J Clin Endocrinol Metab. 2006;91(12):4809-16. PubMed PMID: 17003083.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of subclinical thyroid dysfunction and its relation to socioeconomic deprivation in the elderly: a community-based cross-sectional survey. AU - Wilson,Sue, AU - Parle,James V, AU - Roberts,Lesley M, AU - Roalfe,Andrea K, AU - Hobbs,F D Richard, AU - Clark,Penny, AU - Sheppard,Michael C, AU - Gammage,Michael D, AU - Pattison,Helen M, AU - Franklyn,Jayne A, AU - ,, Y1 - 2006/09/26/ PY - 2006/9/28/pubmed PY - 2007/1/26/medline PY - 2006/9/28/entrez SP - 4809 EP - 16 JF - The Journal of clinical endocrinology and metabolism JO - J Clin Endocrinol Metab VL - 91 IS - 12 N2 - CONTEXT: Population-based screening has been advocated for subclinical thyroid dysfunction in the elderly because the disorder is perceived to be common, and health benefits may be accrued by detection and treatment. OBJECTIVE: The objective of the study was to determine the prevalence of subclinical thyroid dysfunction and unidentified overt thyroid dysfunction in an elderly population. DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional survey of a community sample of participants aged 65 yr and older registered with 20 family practices in the United Kingdom. EXCLUSIONS: Exclusions included current therapy for thyroid disease, thyroid surgery, or treatment within 12 months. OUTCOME MEASURE: Tests of thyroid function (TSH concentration and free T4 concentration in all, with measurement of free T3 in those with low TSH) were conducted. EXPLANATORY VARIABLES: These included all current medical diagnoses and drug therapies, age, gender, and socioeconomic deprivation (Index of Multiple Deprivation, 2004). ANALYSIS: Standardized prevalence rates were analyzed. Logistic regression modeling was used to determine factors associated with the presence of subclinical thyroid dysfunction. RESULTS: A total of 5960 attended for screening. Using biochemical definitions, 94.2% [95% confidence interval (CI) 93.8-94.6%] were euthyroid. Unidentified overt hyper- and hypothyroidism were uncommon (0.3, 0.4%, respectively). Subclinical hyperthyroidism and hypothyroidism were identified with similar frequency (2.1%, 95% CI 1.8-2.3%; 2.9%, 95% CI 2.6-3.1%, respectively). Subclinical thyroid dysfunction was more common in females (P < 0.001) and with increasing age (P < 0.001). After allowing for comorbidities, concurrent drug therapies, age, and gender, an association between subclinical hyperthyroidism and a composite measure of socioeconomic deprivation remained. CONCLUSIONS: Undiagnosed overt thyroid dysfunction is uncommon. The prevalence of subclinical thyroid dysfunction is 5%. We have, for the first time, identified an independent association between the prevalence of subclinical thyroid dysfunction and deprivation that cannot be explained solely by the greater burden of chronic disease and/or consequent drug therapies in the deprived population. SN - 0021-972X UR - https://www.unboundmedicine.com/medline/citation/17003083/Prevalence_of_subclinical_thyroid_dysfunction_and_its_relation_to_socioeconomic_deprivation_in_the_elderly:_a_community_based_cross_sectional_survey_ L2 - https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2006-1557 DB - PRIME DP - Unbound Medicine ER -