J Korean Acad Fam Med.  2001 Sep;22(9):1363-1374.

Prevalence of thyroid diseases among adult for health check-up in a Youngdong area of Kwangwon province

Affiliations
  • 1Department of Family Medicine, Ulsan University, Asan Kangnung Hospital.
  • 2Department of Radiology, Ulsan University, Asan Kangnung Hospital.
  • 3Department of Internal Medicine, Ulsan University, Asan Kangnung Hospital.
  • 4Department of Family Medicine, Chungnam National University Hospital.

Abstract

BACKGROUND: Thyroid diseases is common in adult and frequently has significant clinical consequences. But, Prevalence have not been accurately estimated before performance of sensitive TSH and high resolution ultrasound devices on thyroid gland in practice. The objective of the study was to obstain prevalance rate of thyroid dysfunction and structural abnormality by sensitive TSH, Free T4 and high resolution ultrasound.
METHODS
The subjects were 10,543(5,638 male and 4,815 female) individuals who visited a health care center of a general hospital in Kangnung city during the period of Jan. 1st, 1997 through May 31st, 2000. For thyroid dysfunction, serum TSH(Thyroid Stimulation Hormone) and Free T4 concentration of those were measured by RIA or IRMA. During the period of Dec. 1st, 1997 through May 25th, 1998, 1,316 individuals were examined by radiology specialists using high resolution ultrasonography with 7.5 MHz linear array. Consequently 21 patients who showed thyroid nodule were performed ultrasound-guided fine needle aspiration. Accordingly medical records containing results of physical examination made by 3 specialists in family medicine before thyroid ultrasonography were investigated in association with other diagnostic modalities.
RESULTS
The measurements of thyroid function revealed that 10,090(96.5%) were normal, 240(2.3%) low(below 0.39 mU/L) and 123(1.2%) high(above 5.1 mU/L) in TSH. In terms of prevalence rate per 1,000 population, 15.2 cases were with subclinical hyperthyroidism, and 9.0 cases with subclinical hypothyroidism, 7.7 cases with hyperthyroidism and 3.3 cases with hypothyroidism. Among 94 individuals(7.1%) with structural abnormality on thyroid gland by ultrasonography, 60(4.6%) showed solitary solid nodule, 12(0.9%) multiple solid nodules, 18(1.4%) cystic nodules and 3(0.3%) diffuse parenchymal lesions. Physical examination found only 13.3% of 91 nodules found by high-resolution ultrasonography, and nodules as large as above 1.0 cm in size were palpable only in 22.2%. 21 Of 91 thyroid nodules was received ultrasound-guided FNA and 4(19%) were found to have malignant nodules.
CONCLUSION
The study results showed the relatively high rate of thyroid diseases among general population, with the prevalence rate of thyroid dysfunction 3.6%, thyroid nodule 6.9%, malignant incidentaloma among thyroid nodules 4.4%. Physical examination was relative ineffective in detection for thyroid nodules in routine health examinations.

Keyword

thyroid disease; prevalence; hyperthyroidism; hypothyroidism; subclinical hyperthyroidsm; subclinical hypothyoidism; thyroid nodule

MeSH Terms

Adult*
Biopsy, Fine-Needle
Delivery of Health Care
Gangwon-do*
Hospitals, General
Humans
Hyperthyroidism
Hypothyroidism
Male
Medical Records
Physical Examination
Prevalence*
Specialization
Thyroid Diseases*
Thyroid Gland*
Thyroid Nodule
Ultrasonography
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