Epidemiological analysis of thyroid disorders in Brazil: an ecological study
DOI:
https://doi.org/10.37951/2358-9868.2022v10i1.p38-47Keywords:
Epidemiology, Endocrinology, Thyroid DiseasesAbstract
Objective: The thyroid is responsible for the production of the hormones thyroxine (T4) and triiodothyronine (T3), which regulates metabolism. Changes in any physiological level of these substances can trigger diseases. Therefore, this project aims to investigate the epidemiology of hospitalizations and deaths caused by thyroid disorders in Brazil between 2012 and 2021. Method: A cross-sectional ecological study of thyroid disorders related to iodine deficiency and thyrotoxicosis, based on secondary data from the TABNET-DATASUS platform, by analyzing the number of hospitalizations and deaths, year of care, sex, age group and color. Results: In the analyzed period, the female sex was the most affected, mainly the white and brown ones. In addition, thyrotoxicosis had a higher rate of mortality and occurrence than disorders linked to iodine deficiency, and the prevalence of hospitalizations for hyperthyroidism was almost double the value achieved for hypothyroidism. Conclusion: A greater number of hospitalizations for thyrotoxicosis were recorded in women with lighter skin tones. It is hoped that the study can provide interventions in the care network for people with thyroid disorders, aiming to reduce cases of exacerbation that result in hospitalizations and death.
References
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23- Greene, R. J.; Harris, N. D. Patologia e terapêuticas para farmacêuticos - Bases para a prática da farmácia clínica. Artmed, 3. ed (2012).
24- Silva AS, Maciel LMZ, Mello LM, Magalhães PKR, Nunes AA. Principais distúrbios tireoidianos e suas abordagens na atenção primária à saúde. Revista da Amrigs, 55, 380-388, (2011).
25- Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, Spencer CA et al. Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J. Clin. Endocrinol. Metab. 87, 489–499 (2002).
26- Aoki Y, Belin RM, Clickner R, Jeffries R, Phillips L, Mahaffey KR. 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 17, 1211–1223 (2007).
27- Maciel, L. M. Z.; Magalhães, P. K. Thyroid and pregnancy. Arquivos Brasileiros de Endocrinologia & Metabologia, São Paulo, 52, 1084–1095 (2008).
28- Vanderpump MPJ. The epidemiology of thyroid diseases. In: Braverman LE, Utiger RD (eds). Werner and Ingbar’s The Thyroid: A Fundamental and Clinical Text, 9th edn. JB Lippincott-Raven: Philadelphia, 2005,398–496.
29- Tunbridge WMG, Evered DC, Hall R et al. The spectrum of thyroid disease in the community: the Whickham survey. Clin Endocrinol (Oxf ) 1977;7:481–93.
30- Zimmerman MB. Iodine deficiency. Endocr Rev 2009;30:376–408.
2- Guyton, C. A., Hall, J. E. Endocrinologia e reprodução. In: GUYTON, C. A.; HALL, J. E. Tratado de fisiologia médica. 12. ed. rev. [S. l.]: Elselvier, 2011. cap. Hormônios Metabólicos da Tireóide, p. 955-964. ISBN 9788535237351.
3- Lima-Costa, M. F., Barreto, S. M. Tipos de estudos epidemiológicos: conceitos básicos e aplicações na área do envelhecimento. Epidemiologia e Serviços de Saúde. Brasília: 2003, 12 (4). DOI: 10.5123/S1679-49742003000400003.
4- Banco de dados do Sistema Único de Saúde: DATASUS - TABNET. Ministério da Saúde do Brasil [Internet]. Brasília: MS. [acesso 2022 Fev 22]. Disponível em https://datasus.saude.gov.br/informacoes-de-saude-tabnet.
5- Taylor PN, Albrecht D, Scholz A, Gutierrez-Buey G, Lazarus JH, Dayan CM, et al. Global epidemiology of hyperthyroidism and hypothyroidism. Nat Rev Endocrinol [Internet]. [acesso 2022 Mar 20]. Disponível em: http://www.nature.com/articles/nrendo.2018.18
6- Medici M, Porcu E, Pistis G, Teumer A, Brown SJ, Jensen RA et al. Identification of novel genetic Loci associated with thyroid peroxidase antibodies and clinical thyroid disease. PLoS Genet. 2014 Feb 27;10(2):e1004123. doi: 10.1371/journal.pgen.1004123. PMID: 24586183; PMCID: PMC3937134.
7- Sichieri R, Baima J, Marante T, de Vasconcellos MT, Moura AS, Vaisman M. Low prevalence of hypothyroidism among black and Mulatto people in a population based study of Brazilian women. Clin. Endocrinol. 66, 803–807 (2007)
8- De Groot L, Abalovich M, Alexander EK, Amino N, Barbour L, Cobin RH et al. Management of thyroid dysfunction during pregnancy and postpartum: an endocrine society clinical practice guideline. J. Clin. Endocrinol. Metab. 97, 2543–2565 (2012).
9- Wiersinga, W. M. Smoking and thyroid. Clin. Endocrinol. 79, 145–151 (2013).
10- Wiersinga, W. M. Clinical relevance of environmental factors in the pathogenesis of autoimmune thyroid disease. Endocrinol. Metab. 31, 213–222 (2016).
11- Boelaert K, Newby PR, Simmonds MJ, Holder RL, Carr-Smith JD, Heward JM, et al. Prevalence and relative risk of other autoimmune diseases in subjects with autoimmune thyroid disease. Am. J. Med. 123, 183.e1–183.e9 (2010).
12- Pierce, M. J., LaFranchi, S. H. & Pinter, J. D. Characterization of thyroid abnormalities in a large cohort of children with Down syndrome. Hormone Res. Paediatr. 87, 170–178 (2017).
13- Bartalena L, Wiersinga WM, Tanda ML, Bogazzi F, Piantanida E, Lai A et al. Diagnosis and management of amiodarone-induced thyrotoxicosis in Europe: results of an international survey among members of the European Thyroid Association. Clin. Endocrinol. 61, 494–502 (2004).
14- Shine, B., McKnight, R. F., Leaver, L. & Geddes, J. R. Long-term effects of lithium on renal, thyroid, and parathyroid function: a retrospective analysis of laboratory data. Lancet 386, 461–468 (2015).
15- Sociedade Brasileira de Endocrinologia e Metabologia. Hipotireoidismo e Hipertireoidismo. Humaitá, 2014. [acesso 2022 Mar 18]. Disponível em: https://www.endocrino.org.br/hipertireoidismo-e-hipotireoidismo/.
16- Vanderpump, M. P. The epidemiology of thyroid disease. Br. Med. Bull. 99, 39–51 (2011).
17- De Leo, S., Lee, S. Y. & Braverman, L. E. Hyperthyroidism. Lancet 388, 906–918 (2016).
18- Vitti, P., Rago, T., Tonacchera, M. & Pinchera, A. Toxic multinodular goiter in the elderly. J. Endocrinol. Invest. 25, 16–18 (2002).
19- Laurberg, P., Pedersen, K. M., Vestergaard, H. & Sigurdsson, G. High incidence of multinodular toxic goitre in the elderly population in a low iodine intake area versus high incidence of Graves’ disease in the young in a high iodine intake area: comparative surveys of thyrotoxicosis epidemiology in East-Jutland Denmark and Iceland. J. Intern. Med. 229, 415–420 (1991).
20- Pearce, E. N., Farwell, A. P. & Braverman, L. E. Thyroiditis. N. Engl. J. Med. 348, 2646–2655 (2003).
21- Nikolai, T. F., Brosseau, J., Kettrick, M. A., Roberts, R. & Beltaos, E. Lymphocytic thyroiditis with spontaneously resolving hyperthyroidism (silent thyroiditis). Arch. Intern. Med. 140, 478–482 (1980).
22- Chaker, L., Bianco, A. C., Jonklaas, J. & Peeters, R. P. Hypothyroidism. Lancet 390, 1550–1562 (2017).
23- Greene, R. J.; Harris, N. D. Patologia e terapêuticas para farmacêuticos - Bases para a prática da farmácia clínica. Artmed, 3. ed (2012).
24- Silva AS, Maciel LMZ, Mello LM, Magalhães PKR, Nunes AA. Principais distúrbios tireoidianos e suas abordagens na atenção primária à saúde. Revista da Amrigs, 55, 380-388, (2011).
25- Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, Spencer CA et al. Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J. Clin. Endocrinol. Metab. 87, 489–499 (2002).
26- Aoki Y, Belin RM, Clickner R, Jeffries R, Phillips L, Mahaffey KR. 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 17, 1211–1223 (2007).
27- Maciel, L. M. Z.; Magalhães, P. K. Thyroid and pregnancy. Arquivos Brasileiros de Endocrinologia & Metabologia, São Paulo, 52, 1084–1095 (2008).
28- Vanderpump MPJ. The epidemiology of thyroid diseases. In: Braverman LE, Utiger RD (eds). Werner and Ingbar’s The Thyroid: A Fundamental and Clinical Text, 9th edn. JB Lippincott-Raven: Philadelphia, 2005,398–496.
29- Tunbridge WMG, Evered DC, Hall R et al. The spectrum of thyroid disease in the community: the Whickham survey. Clin Endocrinol (Oxf ) 1977;7:481–93.
30- Zimmerman MB. Iodine deficiency. Endocr Rev 2009;30:376–408.
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2022-07-04
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