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Serum TSH and total T4 in the United States population and their association with participant characteristics: National Health and Nutrition Examination Survey (NHANES 1999-2002).
Thyroid 2007; 17(12):1211-23T

Abstract

OBJECTIVE

Describe thyrotropin (TSH) and thyroxine (T4) levels in the U.S. population and their association with selected participant characteristics.

DESIGN

Secondary analysis of data from the National Health and Nutrition Examination Survey (NHANES) collected from 4392 participants, reflecting 222 million individuals, during 1999-2002.

RESULTS

Hypothyroidism prevalence (TSH > 4.5 mIU/L) in the general population was 3.7%, and hyperthyroidism prevalence (TSH < 0.1 mIU/L) was 0.5%. Among women of reproductive age (12-49 years), hypothyroidism prevalence was 3.1%. Individuals aged 80 years and older had five times greater odds for hypothyroidism compared to 12- to 49-year-olds (adjusted odds ratio [OR] = 5.0, p = 0.0002). ORs were adjusted for sex, race, annual income, pregnancy status, and usage of thyroid-related medications (levothyroxine/thyroid, estrogen, androgen, lithium, and amiodarone). Compared to non-Hispanic whites, non-Hispanic blacks had a lower risk for hypothyroidism (OR = 0.46, p = 0.04) and a higher risk for hyperthyroidism (OR = 3.18, p = 0.0005), while Mexican Americans had the same risk as non-Hispanic whites for hypothyroidism, but a higher risk for hyperthyroidism (OR = 1.98, p = 0.04). Among those taking levothyroxine or desiccated thyroid, the adjusted risk for either hypothyroidism (OR = 4.0, p = 0.0001) or hyperthyroidism (OR = 11.4, p = 4 x 10(-9)) was elevated.

CONCLUSIONS

Associations with known factors such as age, race, and sex were confirmed using this data set. Understanding the prevalence of abnormal thyroid tests among reproductive-aged women informs decisions about screening in this population. The finding that individuals on thyroid hormone replacement medication often remain hypothyroid or become hyperthyroid underscores the importance of monitoring.

Authors+Show Affiliations

Association of Schools of Public Health, Washington, DC, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18177256

Citation

Aoki, Yutaka, et al. "Serum TSH and Total T4 in the United States Population and Their Association With Participant Characteristics: National Health and Nutrition Examination Survey (NHANES 1999-2002)." Thyroid : Official Journal of the American Thyroid Association, vol. 17, no. 12, 2007, pp. 1211-23.
Aoki Y, Belin RM, Clickner R, et al. Serum TSH and total T4 in the United States population and their association with participant characteristics: National Health and Nutrition Examination Survey (NHANES 1999-2002). Thyroid. 2007;17(12):1211-23.
Aoki, Y., Belin, R. M., Clickner, R., Jeffries, R., Phillips, L., & Mahaffey, K. R. (2007). Serum TSH and total T4 in the United States population and their association with participant characteristics: National Health and Nutrition Examination Survey (NHANES 1999-2002). Thyroid : Official Journal of the American Thyroid Association, 17(12), pp. 1211-23. doi:10.1089/thy.2006.0235.
Aoki Y, et al. Serum TSH and Total T4 in the United States Population and Their Association With Participant Characteristics: National Health and Nutrition Examination Survey (NHANES 1999-2002). Thyroid. 2007;17(12):1211-23. PubMed PMID: 18177256.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum TSH and total T4 in the United States population and their association with participant characteristics: National Health and Nutrition Examination Survey (NHANES 1999-2002). AU - Aoki,Yutaka, AU - Belin,Ruth M, AU - Clickner,Robert, AU - Jeffries,Rebecca, AU - Phillips,Linda, AU - Mahaffey,Kathryn R, PY - 2008/1/8/pubmed PY - 2008/2/29/medline PY - 2008/1/8/entrez SP - 1211 EP - 23 JF - Thyroid : official journal of the American Thyroid Association JO - Thyroid VL - 17 IS - 12 N2 - OBJECTIVE: Describe thyrotropin (TSH) and thyroxine (T4) levels in the U.S. population and their association with selected participant characteristics. DESIGN: Secondary analysis of data from the National Health and Nutrition Examination Survey (NHANES) collected from 4392 participants, reflecting 222 million individuals, during 1999-2002. RESULTS: Hypothyroidism prevalence (TSH > 4.5 mIU/L) in the general population was 3.7%, and hyperthyroidism prevalence (TSH < 0.1 mIU/L) was 0.5%. Among women of reproductive age (12-49 years), hypothyroidism prevalence was 3.1%. Individuals aged 80 years and older had five times greater odds for hypothyroidism compared to 12- to 49-year-olds (adjusted odds ratio [OR] = 5.0, p = 0.0002). ORs were adjusted for sex, race, annual income, pregnancy status, and usage of thyroid-related medications (levothyroxine/thyroid, estrogen, androgen, lithium, and amiodarone). Compared to non-Hispanic whites, non-Hispanic blacks had a lower risk for hypothyroidism (OR = 0.46, p = 0.04) and a higher risk for hyperthyroidism (OR = 3.18, p = 0.0005), while Mexican Americans had the same risk as non-Hispanic whites for hypothyroidism, but a higher risk for hyperthyroidism (OR = 1.98, p = 0.04). Among those taking levothyroxine or desiccated thyroid, the adjusted risk for either hypothyroidism (OR = 4.0, p = 0.0001) or hyperthyroidism (OR = 11.4, p = 4 x 10(-9)) was elevated. CONCLUSIONS: Associations with known factors such as age, race, and sex were confirmed using this data set. Understanding the prevalence of abnormal thyroid tests among reproductive-aged women informs decisions about screening in this population. The finding that individuals on thyroid hormone replacement medication often remain hypothyroid or become hyperthyroid underscores the importance of monitoring. SN - 1050-7256 UR - https://www.unboundmedicine.com/medline/citation/18177256/Serum_TSH_and_total_T4_in_the_United_States_population_and_their_association_with_participant_characteristics:_National_Health_and_Nutrition_Examination_Survey__NHANES_1999_2002__ L2 - https://www.liebertpub.com/doi/full/10.1089/thy.2006.0235?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -