{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T23:01:56Z","timestamp":1782860516656,"version":"3.54.5"},"reference-count":38,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Horm Metab Res"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Inadequate control of thyroid dysfunction is common and has deleterious health\n                    consequences. Our objective was to determine the prevalence of TSH values\n                    outside the reference range, as an indicator of inadequate control of\n                    hypothyroidism and hyperthyroidism in patients undergoing treatment for thyroid\n                    dysfunction in Spain. An observational, retrospective, non-interventional study\n                    was conducted using the Primary Care Clinical Database (BDCAP). Patients treated\n                    with thyroid hormone for hypothyroidism and with antithyroid drugs for\n                    hyperthyroidism were identified. We assessed serum TSH concentration,\n                    considering values from 0.4 to 4.0 mU\/l as the reference interval. We\n                    found 360 313 people with hypothyroidism on thyroid hormone replacement and 9239\n                    with hyperthyroidism on antithyroid drugs therapy. TSH values outside the\n                    reference range in hypothyroid subject were detected in 126 866 (35.20%)\n                    people, of whom 107 205 (29.75%) had TSH&gt;4.0 mU\/l,\n                    suggesting inappropriately low doses of levothyroxine, and 19 661\n                    (5.46%) had TSH&lt;0.4 mU\/l, suggesting inappropriate over\n                    replacement. In the hyperthyroid group, TSH values outside the reference range\n                    were observed in 4252 (46.02%) patients. There were 2833\n                    (30.66%) patients with TSH&lt;0.4 mU\/l, suggesting\n                    undertreatment, and 1419 (15.36%) with TSH&gt;4.0 mU\/l,\n                    suggesting overtreatment with antithyroid medication. People over 65 years of\n                    age had a lower frequency of undertreatment of hypothyroidism and a lower\n                    frequency of overtreatment and undertreatment of hyperthyroidism. In conclusion,\n                    our results suggest that inadequate control of thyroid dysfunction, due to its\n                    high frequency and its consequences for health, is a public health problem that\n                    should be addressed by clinicians and health authorities.<\/jats:p>","DOI":"10.1055\/a-2014-4589","type":"journal-article","created":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T23:49:56Z","timestamp":1675986596000},"page":"184-190","source":"Crossref","is-referenced-by-count":9,"title":["Control of Thyroid Dysfunction in Spanish Population Registered in\n                    the Primary Care Clinical Database: An Analysis of the Proportion of Patients\n                    with Thyrotropin Values Outside the Reference Range"],"prefix":"10.1055","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2017-0694","authenticated-orcid":false,"given":"Juan J.","family":"D\u00edez","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Hospital Universitario Puerta de Hierro\n                    Majadahonda, Instituto de Investigaci\u00f3n Sanitaria Puerta de Hierro\n                    Segovia de Arana Majadahonda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Iglesias","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Hospital Universitario Puerta de Hierro\n                    Majadahonda, Instituto de Investigaci\u00f3n Sanitaria Puerta de Hierro\n                    Segovia de Arana Majadahonda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,2,9]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1210\/jcem.87.2.8182","article-title":"Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to\n                    1994): National Health and Nutrition Examination Survey (NHANES III)","volume":"87","author":"J G Hollowell","year":"2002","journal-title":"J Clin Endocrinol Metab"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1001\/archinte.160.4.526","article-title":"The Colorado thyroid disease prevalence study","volume":"160","author":"G J Canaris","year":"2000","journal-title":"Arch Intern Med"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1210\/jc.2013-2409","article-title":"The incidence and prevalence of thyroid dysfunction in Europe: a\n                    meta-analysis","volume":"99","author":"A Garmendia Madariaga","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1111\/cen.13764","article-title":"Prevalence of thyroid dysfunction in a large southern European population.\n                    Analysis of modulatory factors. 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D\u00edez","year":"2012","journal-title":"Diabet Med"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1210\/jc.2011-2532","article-title":"Update in lipid alterations in subclinical hypothyroidism","volume":"97","author":"E N Pearce","year":"2012","journal-title":"J Clin Endocrinol Metab"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1097\/HJH.0000000000002655","article-title":"Blood pressure characteristics of subclinical hypothyroidism: an observation\n                    study combined with office blood pressure and 24-h ambulatory blood\n                    pressure","volume":"39","author":"P Cai","year":"2021","journal-title":"J Hypertens"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1055\/a-1018-9564","article-title":"Endothelial function in patients with subclinical hypothyroidism: a\n                    meta-analysis","volume":"51","author":"N Gong","year":"2019","journal-title":"Horm Metab 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(Oxf)"},{"key":"ref39","doi-asserted-by":"crossref","first-page":"1765","DOI":"10.1089\/thy.2013.0661","article-title":"Factors contributing to high levothyroxine doses in primary hypothyroidism: an\n                    interventional audit of a large community database","volume":"24","author":"H M Robertson","year":"2014","journal-title":"Thyroid"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"828","DOI":"10.1016\/j.endinu.2021.10.014","article-title":"Educational and research needs in hypothyroidism of primary care physicians in\n                    the Community of Madrid","volume":"69","author":"J J D\u00edez","year":"2022","journal-title":"Endocrinol Diabetes Nutr"}],"container-title":["Hormone and Metabolic Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2014-4589.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T10:56:58Z","timestamp":1683284218000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2014-4589"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,9]]},"references-count":38,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2023,2,27]]},"published-print":{"date-parts":[[2023,3]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2014-4589","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0018-5043","1439-4286"],"issn-type":[{"value":"0018-5043","type":"print"},{"value":"1439-4286","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,9]]}}}