J Korean Thyroid Assoc.  2013 May;6(1):56-63. 10.11106/jkta.2013.6.1.56.

Incidence & Prevalence of Hyperthyroidism and Preference for Therapeutic Modalities in Korea

• Seo GH
• Kim SW
• Chung JH

• KMID: 1428454
• DOI: http://doi.org/10.11106/jkta.2013.6.1.56

Abstract

BACKGROUND AND OBJECTIVES
The incidence and prevalence of hyperthyroidism has been reported to be 0.2-0.9/1000 population/year and 5-10/1000 population in foreign countries, respectively. However, there has been no nationwide survey to evaluate them in Korea. Therefore, this study was conducted to investigate the incidence and prevalence of hyperthyroidism in Korea using medicare claims data provided by the Health Insurance Review and Assessment Service. Preference for its therapeutic modalities and its change were also analyzed.
MATERIALS AND METHODS
This study was performed in 308,584 (men 86,460, women 222,124) Korean patients with hyperthyroidism treated from January 2006 to June 2012. Patients with past history of hyperthyroidism were not included.
RESULTS
The incidence of hyperthyroidism was 0.72/1000 population/year (men 0.40, women 1.03), and its prevalence was 3.40/1000 population (men 2.09, women 4.70) in Korea. Its peak prevalence was detected between 45 and 49 years of age. Among 177,487 patients with hyperthyroidism treated from 2007 to 2011, anti-thyroid drugs were prescribed in 97.9%, and radioiodine therapy and surgery were finally performed in 8.2% and 0.9%, respectively. The prescription of propylthiouracil (PTU) has been reduced from 63.3% in 2007 to 42.9% in 2011, but the use of methimazole (MMI) increased from 33.9% in 2007 to 54.8% in 2011. Primary physicians preferred PTU to MMI, but physicians in general hospitals preferred MMI to PTU.
CONCLUSION
This is the first nationwide report to investigate the incidence and prevalence of hyperthyroidism in Korea.

Keyword

Hyperthyroidism; Incidence; Prevalence; Propylthiouracil; Methimazole

MeSH Terms

Female
Hospitals, General
Humans
Hyperthyroidism
Incidence
Insurance, Health
Korea
Medicare
Methimazole
Prescriptions
Prevalence
Propylthiouracil
Methimazole
Propylthiouracil

Figure

• 

  Fig. 1. Annual change of prescription rate of anti-thyroid drugs from 2007 to 2011. The prescription of propylthiouracil (PTU) has been reduced from 63% in 2007 to 43% in 2011, but the use of methimazole (MMI) increased from 34% in 2007 to 55% in 2011. CAMZ: carbimazole, MMI: methimazole, PTU: propylthiouracil.

Reference

References

1. Tunbridge WM, Evered DC, Hall R, Appleton D, Brewis M, Clark F, et al. The spectrum of thyroid disease in a community: the Whickham survey. Clin Endocrinol (Oxf). 1977; 7(6):481–93.

2. Vanderpump MP, Tunbridge WM, French JM, Appleton D, Bates D, Clark F, et al. The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham Survey. Clin Endocrinol (Oxf). 1995; 43(1):55–68.

3. dos Remedios LV, Weber PM, Feldman R, Schurr DA, Tsoi TG. Detecting unsuspected thyroid dysfunction by the free thyroxine index. Arch Intern Med. 1980; 140(8):1045–9.

4. Mogensen EF, Green A. The epidemiology of thyrotoxicosis in Denmark. Incidence and geographical variation in the Funen region 1972-1974. Acta Med Scand. 1980; 208(3):183–6.

5. Barker DJ, Phillips DI. Current incidence of thyrotoxicosis and past prevalence of goitre in 12 British towns. Lancet. 1984; 2(8402):567–70.

6. Haraldsson A, Gudmundsson ST, Larusson G, Sigurdsson G. Thyrotoxicosis in Iceland 1980-1982. An epidemiological survey. Acta Med Scand. 1985; 217(3):253–8.

7. Berglund J, Christensen SB, Hallengren B. Total and age-specific incidence of Graves’ thyrotoxicosis, toxic nodular goitre and solitary toxic adenoma in Malmo 1970-74. J Intern Med. 1990; 227(2):137–41.

8. Berglund J, Ericsson UB, Hallengren B. Increased incidence of thyrotoxicosis in Malmo during the years 1988-1990 as compared to the years 1970-1974. J Intern Med. 1996; 239(1):57–62.

9. Galofre JC, Garcia-Mayor RV, Fluiters E, Fernandez-Calvet L, Rego A, Paramo C, et al. Incidence of different forms of thyroid dysfunction and its degrees in an iodine sufficient area. Thyroidology. 1994; 6(2):49–54.

10. Bulow Pedersen I, Knudsen N, Jorgensen T, Perrild H, Ovesen L, Laurberg P. Large differences in incidences of overt hyper- and hypothyroidism associated with a small difference in iodine intake: a prospective comparative register-based population survey. J Clin Endocrinol Metab. 2002; 87(10):4462–9.

11. Flynn RW, MacDonald TM, Morris AD, Jung RT, Leese GP. The thyroid epidemiology, audit, and research study: thyroid dysfunction in the general population. J Clin Endocrinol Metab. 2004; 89(8):3879–84.

12. Holm IA, Manson JE, Michels KB, Alexander EK, Willett WC, Utiger RD. Smoking and other lifestyle factors and the risk of Graves’ hyperthyroidism. Arch Intern Med. 2005; 165(14):1606–11.

13. Chung JH, Kim BJ, Choi YH, Shin MH, Kim SH, Min YK, et al. Prevalence of thyrotoxicosis and hypothyroidism in the subjects for health check-up. J Korean Soc Endocrinol. 1999; 14(2):301–13.

14. Oh MK, Cheon KS, Jung SM, Ryu DS, Park MS, Cheong SS, et al. Prevalence of thyroid diseases among adult for health check-up in a Youngdong area of Kwangwon province. J Korean Acad Fam Med. 2001; 22(9):1363–74.

15. Park JE, Cho HC. Clinical review of thyroid dysfunction in the subjects for health check-up. J Korean Thyroid Assoc. 2012; 5(1):52–9.

16. 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. 2002; 87(2):489–99.

17. Golden SH, Robinson KA, Saldanha I, Anton B, Ladenson PW. Clinical review: Prevalence and incidence of endocrine and metabolic disorders in the United States: a comprehensive review. J Clin Endocrinol Metab. 2009; 94(6):1853–78.

18. Vanderpump MP. The epidemiology of thyroid disease. Br Med Bull. 2011; 99:39–51.

19. Aghini-Lombardi F, Antonangeli L, Martino E, Vitti P, Maccherini D, Leoli F, et al. The spectrum of thyroid disorders in an iodine-deficient community: the Pescopagano survey. J Clin Endocrinol Metab. 1999; 84(2):561–6.

20. Knudsen N, Jorgensen T, Rasmussen S, Christiansen E, Perrild H. The prevalence of thyroid dysfunction in a population with borderline iodine deficiency. Clin Endocrinol (Oxf). 1999; 51(3):361–7.

21. Cho BY, Koh CS. Current trends in the diagnosis and treatment of Graves’ disease in Korea. J Korean Soc Endocrinol. 1992; 7(3):216–27.

22. Rivkees SA, Mattison DR. Ending propylthiouracil-induced liver failure in children. N Engl J Med. 2009; 360(15):1574–5.

23. Bahn RS, Burch HS, Cooper DS, Garber JR, Greenlee CM, Klein IL, et al. The Role of Propylthiouracil in the Management of Graves’ Disease in Adults: report of a meeting jointly sponsored by the American Thyroid Association and the Food and Drug Administration. Thyroid. 2009; 19(7):673–4.

24. Bahn Chair RS, Burch HB, Cooper DS, Garber JR, Greenlee MC, Klein I, et al. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Thyroid. 2011; 21(6):593–646.