Studies have shown the thyroid peroxidase antibody (TPOAb)-positive human population with normal thyroid function has a two-fold higher risk of progression to hyperthyroidism within 6 years than the TPOAb-negative human population (9). The distribution of iodine, the most important element in thyroid hormone synthesis, is uneven throughout the world, with some regions adequately supplied with iodine supplemented and additional regions iodine deficient (10). 30C39 years-of-age (OH:0.61% vs. 0.81%, P<0.001; GD: 0.38% vs. 0.57%, P<0.001).Excessive iodine(EI) and deficient iodine(DI) were both related to increased prevalence of OH (odds ratio [OR] 2.09, 95% confidence interval [CI] 1.68C2.59; OR1.35, 95%CI 1.07C1.72, Goserelin respectively); however, only deficient iodine was associated with improved prevalence of GD (OR1.67, 95%CI 1.30C2.15). Improved thyroid peroxidase antibody and thyroglobulin antibody levels were significantly associated with prevalence of OH and GD, but not severe SCH Goserelin and slight SCH. Although hyperthyroidism was more prevalent in ladies, the association disappeared after modifying for other factors such as antibody levels. Summary OH and GD prevalences in mainland China are stable after two decades of USI. Iodine deficiency, elevated thyroid antibody levels, and middle age are the main risk factors for OH and GD. The severe SCH human population, rather than the slight SCH human population, shows similar characteristics to the OH human population. Keywords: thyroid autoimmune antibodies, cross-sectional study, Graves disease, iodine intake, hyperthyroidism Intro Hyperthyroidism signifies a group of medical syndromes characterized by hypermetabolism and improved activation in the nervous, circulatory, and digestive systems Goserelin caused by excessive thyroid hormone synthesis and secretion. The most common causes include Graves disease (GD), harmful multinodular goiter (TMNG), and harmful adenoma (TA) (1).Hyperthyroidism is divided into overt (overt hyperthyroidism [OH]) or subclinical (subclinical hyperthyroidism [SCH]). Goserelin OH is definitely characterized by a decrease in serum thyroid-stimulating hormone (TSH) and an increase in serum thyroxine (T4) and/or triiodothyronine (T3) levels. In SCH, serum TSH level is definitely decreased, but serum T4 and T3 levels are in the normal range (2). According to the degree of inhibition of TSH, SCH can be further divided into severe SCH (TSH<0.1mIU/L) and slight SCH (TSH between 0.1mIU/L and lower limit of research range) (3). As major regulators of cell proliferation and energy rate of metabolism, thyroid hormones impact almost all cells in the body (4). Studies have shown that OH increases the risk of fracture, stroke, atrial fibrillation, and cardiovascular events (5, 6). Although SCH has milder clinical symptoms than OH, the long-term effects on health and its potential for progression toward OH Goserelin should not be underestimated (7).Hyperthyroidism prevalence is mainly influenced by thyroid autoimmunity levels and iodine status. It also varies with age, gender, and race (8). Studies have shown that this thyroid peroxidase antibody (TPOAb)-positive populace with normal thyroid function has a two-fold higher risk of progression to hyperthyroidism within 6 years than the TPOAb-negative populace (9). The distribution of iodine, the most important element in thyroid hormone synthesis, is usually uneven throughout the world, with some regions adequately supplied with iodine supplemented and other regions iodine deficient (10). China was once an iodine-deficient country, with the prevalence of thyroid goiter as high as 20.4% (11). Because of this, China implemented a national universal salt iodization (USI) program in 1996. Since USI started, the national iodine status has changed along with prevalence of hyperthyroidism, which has decreased since the early years of the USI program from 1.68% to 0.89%, after gradual adaptation and several adjustments (12, 13). To clarify the status of thyroid-associated disease nationally after two decades of USI, we had implemented Thyroid, Iodine, Diabetes Epidemiology SHH study (TIDE study) to investigate iodine and thyroid status in urban and rural areas in 31 provinces of mainland China from 2015 to 2017. The data in this study were obtained from the TIDE project, to analyze the prevalences of OH, GD, severe.
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