Clin Epidemiol. 2018 Jul 02;10:763-770. doi: 10.2147/CLEP.S164824. eCollection 2018.
Trends in treatments of thyroid disease following iodine fortification in Denmark: a nationwide register-based study.
Clinical epidemiology
Line Tang Møllehave, Allan Linneberg, Tea Skaaby, Nils Knudsen, Torben Jørgensen, Betina Heinsbæk Thuesen
Affiliations
Affiliations
- Center for Clinical Research and Disease Prevention, Bispebjerg and Frederiksberg Hospital, Capital Region, Copenhagen, Denmark, [email protected].
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
- Juliane Marie Centre, Rigshospitalet, Copenhagen, Denmark.
- Department of Endocrinology, Bispebjerg University Hospital, University of Copenhagen, Copenhagen, Denmark.
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
- Faculty of Medicine, Aalborg University, Aalborg, Denmark.
PMID: 29997442
PMCID: PMC6033086 DOI: 10.2147/CLEP.S164824
Abstract
BACKGROUND: Long-term iodine exposure may influence the frequency of thyroid disease treatments through fluctuations in thyroid diseases. Yet, the long-term fluctuations in thyroid disease treatments upon iodine fortification (IF) are not fully known. We aimed to examine the development in thyroid disease treatments in Denmark before and following the implementation of IF in 2000.
METHODS: Nationwide data on antithyroid medication, thyroid hormone therapy, thyroid surgery, and radioiodine treatment were obtained from Danish registries. Negative binominal regression was applied to analyze annual changes in treatment rates adjusted for region of residence, sex, and age.
RESULTS: Incidence of antithyroid medication transiently increased but fell and reached steady state from 2010 at an incidence rate ratio (RR) of 0.72 (95% confidence interval [CI] 0.67-0.77) compared to year 2000. Thyroid hormone therapy increased and reached steady state in 2010 at an incidence RR of 1.75 (95% CI 1.62-1.89) compared to year 2000. Thyroid surgery was constant except for higher rates in 2014-2015, and radioiodine treatment fluctuated with no apparent pattern.
CONCLUSION: Ten years after IF, a steady state was observed for incident antithyroid medication below the level at IF, and thyroid hormone therapy above the level at IF. Only small changes were observed in thyroid surgery and radioiodine treatment. In the same period, changes in diagnostic and treatment practices and lifestyle factors are likely to have occurred and should be considered when evaluating the effects of IF on treatment of thyroid diseases.
Keywords: iodine; pharmacoepidemiology; thyroid diseases
Conflict of interest statement
Disclosure The authors report no conflicts of interest in this work.
References
- Clin Endocrinol (Oxf). 2016 Jan;84(1):115-20 - PubMed
- Curr Opin Endocrinol Diabetes Obes. 2015 Oct;22(5):392-401 - PubMed
- Clin Epidemiol. 2015 Nov 17;7:449-90 - PubMed
- Endocrinol Metab Clin North Am. 1987 Jun;16(2):327-42 - PubMed
- Eur J Intern Med. 2015 Oct;26(8):563-71 - PubMed
- Br J Nutr. 2008 Jul;100(1):166-73 - PubMed
- Lancet Diabetes Endocrinol. 2015 Apr;3(4):286-95 - PubMed
- Scand J Public Health. 2011 Jul;39(7 Suppl):34-7 - PubMed
- Eur J Endocrinol. 2010 Apr;162(4):755-62 - PubMed
- J Clin Endocrinol Metab. 2013 Mar;98(3):1031-9 - PubMed
- Lancet. 1998 Sep 26;352(9133):1034 - PubMed
- J Clin Endocrinol Metab. 2006 Oct;91(10):3830-4 - PubMed
- J Endocr Soc. 2017 Nov 29;2(1):63-76 - PubMed
- J Clin Endocrinol Metab. 2016 Jul;101(7):2853-62 - PubMed
- Clin Endocrinol (Oxf). 2000 Jul;53(1):5-12 - PubMed
- Thyroid. 2002 Oct;12(10):867-78 - PubMed
- Eur J Endocrinol. 2006 Jan;154(1):21-8 - PubMed
- Eur J Epidemiol. 2011 Aug;26(8):629-35 - PubMed
- Clin Endocrinol (Oxf). 2011 Jul;75(1):120-6 - PubMed
- Best Pract Res Clin Endocrinol Metab. 2010 Feb;24(1):13-27 - PubMed
- Eur Thyroid J. 2018 Mar;7(2):75-83 - PubMed
- J Clin Endocrinol Metab. 2014 Dec;99(12):4749-57 - PubMed
- Clin Endocrinol (Oxf). 2009 Sep;71(3):440-5 - PubMed
- Eur J Endocrinol. 2006 Aug;155(2):219-28 - PubMed
- J Clin Endocrinol Metab. 2007 Apr;92(4):1397-401 - PubMed
- Scand J Public Health. 2015 Jun;43(4):333-9 - PubMed
- J Clin Endocrinol Metab. 2007 Aug;92(8):3122-7 - PubMed
- Med Clin North Am. 2012 Mar;96(2):283-95 - PubMed
- Clin Nutr. 2014 Dec;33(6):1033-40 - PubMed
- J Clin Endocrinol Metab. 2009 Jul;94(7):2400-5 - PubMed
- Br J Nutr. 2014 Dec 28;112(12):1993-2001 - PubMed
- Thyroid. 2001 May;11(5):501-10 - PubMed
Publication Types