Frontiers in Endocrinology (May 2021)
Hyperthyroidism Prevalence in China After Universal Salt Iodization
- Chuyuan Wang,
- Yongze Li,
- Di Teng,
- Xiaoguang Shi,
- Jianming Ba,
- Bing Chen,
- Jianling Du,
- Lanjie He,
- Xiaoyang Lai,
- Yanbo Li,
- Haiyi Chi,
- Eryuan Liao,
- Chao Liu,
- Libin Liu,
- Guijun Qin,
- Yingfen Qin,
- Huibiao Quan,
- Bingyin Shi,
- Hui Sun,
- Xulei Tang,
- Nanwei Tong,
- Guixia Wang,
- Jin-an Zhang,
- Youmin Wang,
- Yuanming Xue,
- Li Yan,
- Jing Yang,
- Lihui Yang,
- Yongli Yao,
- Zhen Ye,
- Qiao Zhang,
- Lihui Zhang,
- Jun Zhu,
- Mei Zhu,
- Zhongyan Shan,
- Weiping Teng
Affiliations
- Chuyuan Wang
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of China Medical University, Shenyang, China
- Yongze Li
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of China Medical University, Shenyang, China
- Di Teng
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of China Medical University, Shenyang, China
- Xiaoguang Shi
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of China Medical University, Shenyang, China
- Jianming Ba
- Department of Endocrinology, Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
- Bing Chen
- Department of Endocrinology, Southwest Hospital, Third Military Medical University, Chongqing, China
- Jianling Du
- Department of Endocrinology, First Affiliated Hospital, Dalian Medical University, Dalian, China
- Lanjie He
- Department of Endocrinology, Cardiovascular and Cerebrovascular Disease Hospital, General Hospital of Ningxia Medical University, Jinfeng, China
- Xiaoyang Lai
- Department of Endocrinology and Metabolism, Second Affiliated Hospital of Nanchang University, Nanchang, China
- Yanbo Li
- Department of Endocrinology, First Affiliated Hospital of Harbin Medical University, Harbin, China
- Haiyi Chi
- Department of Endocrinology, Hohhot First Hospital, Hohhot, China
- Eryuan Liao
- Department of Endocrinology and Metabolism, Second Xiangya Hospital, Central South University, Changsha, China
- Chao Liu
- 0Research Center of Endocrine and Metabolic Diseases, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Libin Liu
- 1Fujian Institute of Hematology, Union Hospital, Fujian Medical University, Fuzhou, China
- Guijun Qin
- 2International Medical Center, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
- Yingfen Qin
- 3Department of Endocrinology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Huibiao Quan
- 4Department of Endocrinology, Hainan General Hospital, Haikou, China
- Bingyin Shi
- 5Department of Endocrinology, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Hui Sun
- 6Department of Endocrinology, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Xulei Tang
- 7Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou, China
- Nanwei Tong
- 8State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
- Guixia Wang
- 9Department of Endocrinology and Metabolism, First Affiliated Hospital of Jilin University, Changchun, China
- Jin-an Zhang
- 0Department of Endocrinology, Zhoupu Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, China
- Youmin Wang
- 1Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, Hefei, China
- Yuanming Xue
- 2Department of Endocrinology, The First People’s Hospital of Yunnan Province, Kunming, China
- Li Yan
- 3Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Jing Yang
- 4Department of Endocrinology, First Hospital of Shanxi Medical University, Taiyuan, China
- Lihui Yang
- 5Department of Endocrinology and Metabolism, People’s Hospital of Tibet Autonomous Region, Lhasa, China
- Yongli Yao
- 6Department of Endocrinology, Qinghai Provincial People’s Hospital, Xining, China
- Zhen Ye
- 7Zhejiang Center for Disease Control and Prevention (Zhejiang CDC), Hangzhou, China
- Qiao Zhang
- 8Department of Endocrinology and Metabolism, Affiliated Hospital of Guiyang Medical University, Guiyang, China
- Lihui Zhang
- 9Department of Endocrinology, Second Hospital of Hebei Medical University, Shijiazhuang, China
- Jun Zhu
- 0Department of Endocrinology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- Mei Zhu
- 1Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
- Zhongyan Shan
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of China Medical University, Shenyang, China
- Weiping Teng
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of China Medical University, Shenyang, China
- DOI
- https://doi.org/10.3389/fendo.2021.651534
- Journal volume & issue
-
Vol. 12
Abstract
BackgroundUniversal salt iodization (USI) was implemented in mainland China in 1996. The prevalence of hyperthyroidism and its risk factors now require examination.MethodsData were acquired from a nationwide Thyroid, Iodine, and Diabetes Epidemiological survey (TIDE 2015–2017) of 78,470 subjects from 31 provinces. Iodine status, and thyroid hormones and antibodies were measured. ResultsAfter two decades of USI, the prevalence of overt hyperthyroidism (OH), Graves’ disease (GD), severe subclinical hyperthyroidism (severe SCH), and mild subclinical hyperthyroidism (mild SCH) in mainland China was 0.78%, 0.53%, 0.22%, and 0.22%, respectively. OH and GD prevalence were higher in women than in men (OH: 1.16% vs. 0.64%, P<0.001; GD: 0.65% vs. 0.37%, P<0.001).Prevalence was significantly decreased after 60 years-of-age compared with 30–39 years-of-age (OH:0.61% vs. 0.81%, P<0.001; GD: 0.38% vs. 0.57%, P<0.001).Excessive iodine(EI) and deficient iodine(DI) were both related to increased prevalence of OH (odds ratio [OR] 2.09, 95% confidence interval [CI] 1.68–2.59; OR1.35, 95%CI 1.07–1.72, respectively); however, only deficient iodine was associated with increased prevalence of GD (OR1.67, 95%CI 1.30–2.15). Increased thyroid peroxidase antibody and thyroglobulin antibody levels were significantly associated with prevalence of OH and GD, but not severe SCH and mild SCH. Although hyperthyroidism was more prevalent in women, the association disappeared after adjusting for other factors such as antibody levels.ConclusionOH and GD prevalences in mainland China are stable after two decades of USI. Iodine deficiency, elevated thyroid antibody levels, and middle age are the main risk factors for OH and GD. The severe SCH population, rather than the mild SCH population, shows similar characteristics to the OH population.
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