Trends in Prevalence of Thyroid Dysfunction and its Associations With Mortality Among US Participants, 1988-2012
Authors' conclusion
The prevalence of subclinical thyroid dysfunction remained relatively unchanged, whereas that of overt thyroid dysfunction decreased. Subclinical hypothyroidism was associated with a higher mortality among individuals aged 65 years or older.
Study context
- Population
- US participants aged 12 years or older in NHANES III (1988–1994), 1999–2002 and 2007–2012; weighted mean age 41.6 years, 48.3% men
- Participants
- 33,117 participants
- Outcome
- Prevalence of thyroid dysfunction and its temporal trends; association of thyroid dysfunction with mortality
Methodological detailsnationally representative survey (NHANES III 1988-1994, 1999-2002, 2007-2012), mortality follow-up
- Nationally representative survey (NHANES III 1988-1994, 1999-2002, 2007-2012)
- Mortality follow-up
Main finding
As reported in the abstract
Prevalence of thyroid dysfunction · 2007-2012
- Subclinical hypothyroidism prevalence
- 4.3%
- Overt hypothyroidism prevalence
- 0.33%
- Subclinical hyperthyroidism prevalence
- 3.2%
- Overt hyperthyroidism prevalence
- 0.2%
- Thyroid dysfunction previously undiagnosed
- 80%
Observational data: associations, not effects.
Further findings
Trends in prevalence, 2007-2012 vs 1988-1994
- Overt hypothyroidism, 1988-1994 vs 2007-2012 (less prevalent in 2007-2012)
- 0.54% (95% CI 0.35-0.8) vs 0.33% (95% CI 0.23-0.48)
- Overt hyperthyroidism, 1988-1994 vs 2007-2012 (less prevalent in 2007-2012)
- 0.8% (95% CI 0.58-1.1) vs 0.2% (95% CI 0.12-0.33)
- Subclinical hypothyroidism and hyperthyroidism prevalence stable
Risk factors
- Hypothyroidism: older age, White Americans, obesity, TPOAb and thyroglobulin antibody positivity
- Hyperthyroidism: older age, women, Black Americans
Total and CV mortality · median follow-up 17.2 years
- No significant association between any type of thyroid dysfunction and total or CV mortality
Mortality with SCH, age ≥65 years · median follow-up 17.2 years
- Total mortality, HR
- 1.17 (95% CI 1.00-1.37; P = .05)
- CV mortality, HR
- 1.29 (95% CI 1.04-1.62; P = .02)
Original publication
Trends in Prevalence of Thyroid Dysfunction and its Associations With Mortality Among US Participants, 1988-2012. J Clin Endocrinol Metab. Published 20 September 2023. doi:10.
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