Prevalence of Thyroid Disorders in Family Practice
Ergebnisse der SESAM-4german translation / full article
Results of SESAM-4
Introduction: The prevalence of thyroid disorders varies worldwide depending on natural regional iodine supply. Because of an improved nutritional situation, Germany is turning into a country with sufficient iodine supply. The existing prevalence data on thyroid disorders for the adult German population and for patients in primary care is heterogeneous. This paper aims to analyse actual prevalence data (2008/2009) on thyroid disorders in the primary care setting in the state of Saxony, Germany.
Methods: The 4th Epidemiologic Study of the Saxon Association of Primary Care (SESAM-4) was a cross sectional study aiming to collect representative data to describe the consultation in family practitioners‘ (FPs‘) practices in Saxony. 28.9 % of the 253 invited FPs, organized in the Saxon Association for Family Medicine (SGAM), participated in the study. 2.529 FP-patient-contacts from a one-year period (1.4.2008 – 31.3.2009) were documented by FPs and included in the analysis.
Results: 10.5 % of all included patients had a thyroid disorder (coded in ICD-10) as a permanent diagnosis: female patients showed a prevalence that was almost three times (14.7 %) as high as males (5.5 %). The most common prevalences after differentiation by ICD-10-codes were iodine deficiency based or other non-toxic goitre (6.1 %), hyperthyreosis/thyreotoxicosis (2.1 %) and hypothyreosis (2.0 %). The most common co-morbidities in patients with thyroid disorder – similar to those not suffering from a thyroid disorder – were cardiovascular diseases (I10) and/or metabolic disorders (E11, E78).
Conclusions: The prevalences of thyroid disorders in SESAM-4 are clearly lower than the prevalence values presented in German population-based studies. On the one hand, this is based on different populations and methods of the studies. On the other hand, presumably not all persons with thyroid disorders use primary health care services. The increase of prevalence of thyroid disorders in the SESAM-4 compared to SESAM-2 (conducted ten years ago) might be based on the improvement of diagnostic methods and the growing number of elderly in the population. This study confirmed the stronger occurrence of thyroid disorders in women and in older age groups ( 75). Nearly all patients with thyroid disorders (95 %) had an additional diagnosis or co-morbidity not significantly different than those of the patients without thyroid disorders. Age-associated co-morbidities, such as circulatory diseases or metabolic disorders, played a special role. The effects or adverse effects of drug therapy (medical interactions) should consequently be observed in patients with (but also without) a thyroid disorder.