{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:36:43Z","timestamp":1791218203475,"version":"4.1.0"},"reference-count":38,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2017,2,1]],"date-time":"2017-02-01T00:00:00Z","timestamp":1485907200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The aim of this study was to investigate the national prevalence of thyroid dysfunction in Spain and its association with various clinical, environmental, and demographic variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The study included 4554 subjects (42.4% men) with a mean age of 50 years (range 18\u201393 years), who were participants in a national, cross-sectional, population-based survey conducted in 2009\u20132010. Data gathered included clinical and demographic characteristics, physical examination, and blood sampling. Thyrotropin, free thyroxine, free triiodothyronine, and thyroid peroxidase antibody (TPOAb) concentrations were analyzed by electrochemiluminescence. Urinary iodine (UI) levels were measured in an isolated urine sample.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The prevalence of treated hypothyroidism, untreated subclinical hypothyroidism, and untreated clinical hypothyroidism was 4.2% [confidence interval (CI) 3.6\u20134.9%], 4.6% [CI 4.0\u20135.2%], and 0.3% [CI 0.1\u20130.5%], respectively. The prevalence of total hypothyroidism (including all fractions) was 9.1% [CI 8.2\u201310.0%]. The prevalence of total hyperthyroidism was 0.8% [CI 0.6\u20131.1]. A total of 7.5% [CI 6.7\u20138.3%] of the population tested positive for TPOAbs (\u226550 IU\/mL). In multivariate logistic regression models, TPOAbs were strongly associated with both hypothyroidism (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and hyperthyroidism (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.005), whereas high UI levels (&gt;200\u2009\u03bcg\/g creatinine) were associated with hypothyroidism (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The positive association between UI and hypothyroidism remained for both treated (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and untreated (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.05) hypothyroidism, whereas it was especially significant for non-autoimmune (TPOAbs negative) forms (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). At UI levels \u2265200\u2009\u03bcg\/g, there was a positive correlation between UI and thyrotropin levels (\u03b2\u2009=\u20090.152,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and a negative correlation between UI and free triiodothyronine levels (\u03b2\u2009=\u2009\u22120.134,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>According to the data, a large proportion (10%) of the Spanish population has some evidence of thyroid dysfunction. High TPOAb concentrations were associated with both hypo- and hyperthyroidism, whereas high UI concentrations were associated with hypothyroidism.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/thy.2016.0353","type":"journal-article","created":{"date-parts":[[2016,11,12]],"date-time":"2016-11-12T00:19:08Z","timestamp":1478909948000},"page":"156-166","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":64,"title":["Population-Based National Prevalence of Thyroid Dysfunction in Spain and Associated Factors: Di@bet.es Study"],"prefix":"10.1177","volume":"27","author":[{"given":"Sergio","family":"Vald\u00e9s","sequence":"first","affiliation":[{"name":"Instituto de Salud Carlos III","place":["Spain"]},{"name":"Hospital Regional Universitario de M\u00e1laga","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Maldonado-Araque","sequence":"additional","affiliation":[{"name":"Instituto de Salud Carlos III","place":["Spain"]},{"name":"Hospital Regional Universitario de M\u00e1laga","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Lago-Sampedro","sequence":"additional","affiliation":[{"name":"Instituto de Salud Carlos III","place":["Spain"]},{"name":"Hospital Regional Universitario de M\u00e1laga","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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