Classical Thyroid Epidemiology - Trends, Reference Values and Predictive Models

点击翻译按钮获取中文摘要

For the past 15 years, iodine deficiency in Germany has been effectively treated by the iodine fortification programme. We can expect that the improved iodine supply of the German population lead to a decreased prevalence of iodine deficiency-related thyroid disorders. It is very likely that particularly young individuals without any pre-existent thyroid disorder will benefit from this situation. Some risks, however, can also be postulated currently. These risks include an increased incidence of hyperthyroidism in elder people with previous nodular goitre as well as an increased incidence of autoimmune thyroid disorders and hypothyroidism in the whole population. Finally, complacency may lead to an uncontrolled, unstable iodine supply in the absence of monitoring programmes. Therefore, there is a strong need for studies observing the trend of iodine supply and thyroid disorders in the general population.The first funding period of the present project supported the data collection for a thyroid module, which was implemented in a ten-year population-based trend study (SHIP-Trend) in Northeast Germany. The second funding period is now aimed at using these data to answer the primary scientific questions regarding the prevalence trend of hyperthyroidism, autoimmune thyroid disorders, hypothyroidism and iodine supply. In addition, available data will be used to answer secondary questions on reference values of thyroid function tests, the safe TSH range, socioeconomic determinants of thyroid disorders and the exploration of new, yet unknown predictors of thyroid diseases. On the one hand, the scientific results of this project are of potential interest for epidemiologists as well as clinical endocrinologists, general practitioners and internists. On the other hand, this study provides important data on the iodine monitoring, which are of high relevance to asses and adjust the effectiveness of the German iodine fortification programme.