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Temporal trends in thyroid-stimulating hormone (TSH) and thyroid peroxidase antibody (ATPO) testing across two phases of iodine fortification in Tasmania (1995-2013)

Hong, A, Stokes, B, Otahal, P ORCID: 0000-0003-4042-1769, Owens, D and Burgess, JR ORCID: 0000-0003-4748-9571 2017 , 'Temporal trends in thyroid-stimulating hormone (TSH) and thyroid peroxidase antibody (ATPO) testing across two phases of iodine fortification in Tasmania (1995-2013)' , Clinical endocrinology, vol. 87, no. 4 , pp. 386-393 , doi: 10.1111/cen.13371.

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Context: Tasmania is an island state of the Australian Commonwealth with a welldocumentedhistory of mild iodine deficiency. Between 2001 and 2009, Tasmaniaexperienced two incremental phases of iodine fortification.Objective: To examine trends in thyroid-stimulating hormone (TSH) and thyroid peroxidaseantibody (ATPO) testing and their relationship to different phases of iodinenutrition in the Tasmanian population between 1995 and 2013.Design: Retrospective longitudinal study.Setting and participants: The major primary care and largest public hospital pathologyproviders in Tasmania submitted data for all TSH and ATPO tests performed between1995 and 2013. Data linkage methodology was used to determine trends in TSH andATPO testing.Results: A total of 1.66 million TSH assessments, involving 389,910 individual patients,were performed in Tasmania between 1995 and 2013. There was approximatelya fourfold increase in the overall rate of TSH testing during this period with therate of incident TSH assessment remaining relatively stable over the study period. Theincidence of overt suppression and elevation of TSH (TSH≤0.1 mIU/L and ≥10 mIU/L)declined 62.3% and 59.7%, respectively, with a trend for increased incidence of borderlineTSH elevation ≥4.0 mIU/L. The incidence of thyroid autoimmunity as determinedby the proportion of abnormal ATPO results remained stable, with the absolutenumber of positive test results increasing during the study period.Conclusion: Iodine supplementation of this mildly iodine-deficient population was notassociated with an obvious increase in incidence of overt thyroid dysfunction or autoimmunity.Whilst the volume of TSH testing increased over the study period, the increasewas driven by patients undergoing follow-up TSH assessments.

Item Type: Article
Authors/Creators:Hong, A and Stokes, B and Otahal, P and Owens, D and Burgess, JR
Keywords: Thyroid, Tasmania, Data Linkage, Iodine
Journal or Publication Title: Clinical endocrinology
Publisher: Blackwell Publishing Ltd
ISSN: 0300-0664
DOI / ID Number: 10.1111/cen.13371
Copyright Information:

© 2017 John Wiley & Sons Ltd

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