Register-based information on thyroid diseases in Europe: lessons and results from the EUthyroid collaboration

Line Tang Møllehave; Marie Holm Eliasen; Ieva Strēle; Allan Linneberg; Rodrigo Moreno-Reyes; Ludmila B. Ivanova; Zvonko Kusić; Iris Erlund; Till Ittermann; Endre V. Nagy; Ingibjörg Gunnarsdóttir; Jonathan Eli Arbelle; Aaron Milton Troen; Valdis Pīrāgs; Lisbeth Dahl; Alicja Hubalewska-Dydejczyk; Malgorzata Trofimiuk-Müldner; João Jacome de Castro; Mafalda Marcelino; Simona Gaberšček; Katja Zaltel; Manuel Puig-Domingo; Lluis Vila; Sofia Manousou; Helena Filipsson Nyström; Michael Bruce Zimmermann; Karen R. Mullan; Jayne Valerie Woodside; Henry Völzke; Betina Heinsbæk Thuesen

doi:10.1530/EC-21-0525

Register-based information on thyroid diseases in Europe: lessons and results from the EUthyroid collaboration

Line Tang Møllehave^*, Marie Holm Eliasen, Ieva Strēle, Allan Linneberg, Rodrigo Moreno-Reyes, Ludmila B. Ivanova, Zvonko Kusić, Iris Erlund, Till Ittermann, Endre V. Nagy, Ingibjörg Gunnarsdóttir, Jonathan Eli Arbelle, Aaron Milton Troen, Valdis Pīrāgs, Lisbeth Dahl, Alicja Hubalewska-Dydejczyk, Malgorzata Trofimiuk-Müldner, João Jacome de Castro, Mafalda Marcelino, Simona GaberščekKatja Zaltel, Manuel Puig-Domingo, Lluis Vila, Sofia Manousou, Helena Filipsson Nyström, Michael Bruce Zimmermann, Karen R. Mullan, Jayne Valerie Woodside, Henry Völzke, Betina Heinsbæk Thuesen

^*Corresponding author for this work

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Abstract

Objective: Registers of diagnoses and treatments exist in different forms in the European countries and are potential sources to answer important research questions. Prevalence and incidence of thyroid diseases are highly dependent on iodine intake and, thus, iodine deficiency disease prevention programs. We aimed to collect European register data on thyroid outcomes to compare the rates between countries/regions with different iodine status and prevention programs. Design: Register-based cross-sectional study. Methods: National register data on thyroid diagnoses and treatments were requested from 23 European countries/regions. The provided data were critically assessed for suitability for comparison between countries/regions. Sex-and age-standardized rates were calculated. Results: Register data on ≥1 thyroid diagnoses or treatments were available from 22 countries/regions. After critical assessment, data on medication, surgery, and cancer were found suitable for comparison between 9, 10, and 13 countries/regions, respectively. Higher rates of antithyroid medication and thyroid surgery for benign disease and lower rates of thyroid hormone therapy were found for countries with iodine insufficiency before approx. 2001, and no relationship was observed with recent iodine intake or prevention programs. Conclusions: The collation of register data on thyroid outcomes from European countries is impeded by a high degree of heterogeneity in the availability and quality of data between countries. Nevertheless, a relationship between historic iodine intake and rates of treatments for hyper-and hypothyroid disorders is indicated. This study illustrates both the challenges and the potential for the application of register data of thyroid outcomes across Europe.

Original language	English
Article number	e210525
Journal	Endocrine Connections
Volume	11
Issue number	3
DOIs	https://doi.org/10.1530/EC-21-0525
Publication status	Published - 10 Mar 2022

Bibliographical note

Funding Information:
The EUthyroid project was an ambitious collaborative project with participation and representatives from most EU countries funded by the European Union’s Horizon 2020 research and innovation program under grant agreement no. 634453. The overall aim of the EUthyroid project was to ‘evaluate iodine deficiency prevention and monitoring programs in European countries, to initiate capacity building for harmonized European ID prevention and monitoring programs’.

Funding Information:
This work was supported by the European Union?s Horizon 2020 research and innovation program under grant agreement no. 634453. Data analyses were further supported by the project SUPERTHYREOSE, funded by the German G-BA (VSF2_2019-167). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Publisher Copyright:
© 2022 The authors Published by Bioscientifica Ltd.

Other keywords

Europe
iodine
registries
thyroid diseases

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10.1530/EC-21-0525

Register-based ...Final published version, 937 KBLicence: CC BY-NC

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Møllehave, L. T., Eliasen, M. H., Strēle, I., Linneberg, A., Moreno-Reyes, R., Ivanova, L. B., Kusić, Z., Erlund, I., Ittermann, T., Nagy, E. V., Gunnarsdóttir, I., Arbelle, J. E., Troen, A. M., Pīrāgs, V., Dahl, L., Hubalewska-Dydejczyk, A., Trofimiuk-Müldner, M., de Castro, J. J., Marcelino, M., ... Thuesen, B. H. (2022). Register-based information on thyroid diseases in Europe: lessons and results from the EUthyroid collaboration. Endocrine Connections, 11(3), Article e210525. https://doi.org/10.1530/EC-21-0525

@article{1d796bc5f70a4e4fa62a33da7b863daf,

title = "Register-based information on thyroid diseases in Europe: lessons and results from the EUthyroid collaboration",

abstract = "Objective: Registers of diagnoses and treatments exist in different forms in the European countries and are potential sources to answer important research questions. Prevalence and incidence of thyroid diseases are highly dependent on iodine intake and, thus, iodine deficiency disease prevention programs. We aimed to collect European register data on thyroid outcomes to compare the rates between countries/regions with different iodine status and prevention programs. Design: Register-based cross-sectional study. Methods: National register data on thyroid diagnoses and treatments were requested from 23 European countries/regions. The provided data were critically assessed for suitability for comparison between countries/regions. Sex-and age-standardized rates were calculated. Results: Register data on ≥1 thyroid diagnoses or treatments were available from 22 countries/regions. After critical assessment, data on medication, surgery, and cancer were found suitable for comparison between 9, 10, and 13 countries/regions, respectively. Higher rates of antithyroid medication and thyroid surgery for benign disease and lower rates of thyroid hormone therapy were found for countries with iodine insufficiency before approx. 2001, and no relationship was observed with recent iodine intake or prevention programs. Conclusions: The collation of register data on thyroid outcomes from European countries is impeded by a high degree of heterogeneity in the availability and quality of data between countries. Nevertheless, a relationship between historic iodine intake and rates of treatments for hyper-and hypothyroid disorders is indicated. This study illustrates both the challenges and the potential for the application of register data of thyroid outcomes across Europe.",

keywords = "Europe, iodine, registries, thyroid diseases",

author = "M{\o}llehave, {Line Tang} and Eliasen, {Marie Holm} and Ieva Strēle and Allan Linneberg and Rodrigo Moreno-Reyes and Ivanova, {Ludmila B.} and Zvonko Kusi{\'c} and Iris Erlund and Till Ittermann and Nagy, {Endre V.} and Ingibj{\"o}rg Gunnarsd{\'o}ttir and Arbelle, {Jonathan Eli} and Troen, {Aaron Milton} and Valdis Pīrāgs and Lisbeth Dahl and Alicja Hubalewska-Dydejczyk and Malgorzata Trofimiuk-M{\"u}ldner and {de Castro}, {Jo{\~a}o Jacome} and Mafalda Marcelino and Simona Gaber{\v s}{\v c}ek and Katja Zaltel and Manuel Puig-Domingo and Lluis Vila and Sofia Manousou and Nystr{\"o}m, {Helena Filipsson} and Zimmermann, {Michael Bruce} and Mullan, {Karen R.} and Woodside, {Jayne Valerie} and Henry V{\"o}lzke and Thuesen, {Betina Heinsb{\ae}k}",

note = "Funding Information: The EUthyroid project was an ambitious collaborative project with participation and representatives from most EU countries funded by the European Union{\textquoteright}s Horizon 2020 research and innovation program under grant agreement no. 634453. The overall aim of the EUthyroid project was to {\textquoteleft}evaluate iodine deficiency prevention and monitoring programs in European countries, to initiate capacity building for harmonized European ID prevention and monitoring programs{\textquoteright}. Funding Information: This work was supported by the European Union?s Horizon 2020 research and innovation program under grant agreement no. 634453. Data analyses were further supported by the project SUPERTHYREOSE, funded by the German G-BA (VSF2_2019-167). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: {\textcopyright} 2022 The authors Published by Bioscientifica Ltd.",

year = "2022",

month = mar,

day = "10",

doi = "10.1530/EC-21-0525",

language = "English",

volume = "11",

journal = "Endocrine Connections",

issn = "2049-3614",

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Møllehave, LT, Eliasen, MH, Strēle, I, Linneberg, A, Moreno-Reyes, R, Ivanova, LB, Kusić, Z, Erlund, I, Ittermann, T, Nagy, EV, Gunnarsdóttir, I, Arbelle, JE, Troen, AM, Pīrāgs, V, Dahl, L, Hubalewska-Dydejczyk, A, Trofimiuk-Müldner, M, de Castro, JJ, Marcelino, M, Gaberšček, S, Zaltel, K, Puig-Domingo, M, Vila, L, Manousou, S, Nyström, HF, Zimmermann, MB, Mullan, KR, Woodside, JV, Völzke, H & Thuesen, BH 2022, 'Register-based information on thyroid diseases in Europe: lessons and results from the EUthyroid collaboration', Endocrine Connections, vol. 11, no. 3, e210525. https://doi.org/10.1530/EC-21-0525

TY - JOUR

T1 - Register-based information on thyroid diseases in Europe

T2 - lessons and results from the EUthyroid collaboration

AU - Møllehave, Line Tang

AU - Eliasen, Marie Holm

AU - Strēle, Ieva

AU - Linneberg, Allan

AU - Moreno-Reyes, Rodrigo

AU - Ivanova, Ludmila B.

AU - Kusić, Zvonko

AU - Erlund, Iris

AU - Ittermann, Till

AU - Nagy, Endre V.

AU - Gunnarsdóttir, Ingibjörg

AU - Arbelle, Jonathan Eli

AU - Troen, Aaron Milton

AU - Pīrāgs, Valdis

AU - Dahl, Lisbeth

AU - Hubalewska-Dydejczyk, Alicja

AU - Trofimiuk-Müldner, Malgorzata

AU - de Castro, João Jacome

AU - Marcelino, Mafalda

AU - Gaberšček, Simona

AU - Zaltel, Katja

AU - Puig-Domingo, Manuel

AU - Vila, Lluis

AU - Manousou, Sofia

AU - Nyström, Helena Filipsson

AU - Zimmermann, Michael Bruce

AU - Mullan, Karen R.

AU - Woodside, Jayne Valerie

AU - Völzke, Henry

AU - Thuesen, Betina Heinsbæk

N1 - Funding Information: The EUthyroid project was an ambitious collaborative project with participation and representatives from most EU countries funded by the European Union’s Horizon 2020 research and innovation program under grant agreement no. 634453. The overall aim of the EUthyroid project was to ‘evaluate iodine deficiency prevention and monitoring programs in European countries, to initiate capacity building for harmonized European ID prevention and monitoring programs’. Funding Information: This work was supported by the European Union?s Horizon 2020 research and innovation program under grant agreement no. 634453. Data analyses were further supported by the project SUPERTHYREOSE, funded by the German G-BA (VSF2_2019-167). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: © 2022 The authors Published by Bioscientifica Ltd.

PY - 2022/3/10

Y1 - 2022/3/10

N2 - Objective: Registers of diagnoses and treatments exist in different forms in the European countries and are potential sources to answer important research questions. Prevalence and incidence of thyroid diseases are highly dependent on iodine intake and, thus, iodine deficiency disease prevention programs. We aimed to collect European register data on thyroid outcomes to compare the rates between countries/regions with different iodine status and prevention programs. Design: Register-based cross-sectional study. Methods: National register data on thyroid diagnoses and treatments were requested from 23 European countries/regions. The provided data were critically assessed for suitability for comparison between countries/regions. Sex-and age-standardized rates were calculated. Results: Register data on ≥1 thyroid diagnoses or treatments were available from 22 countries/regions. After critical assessment, data on medication, surgery, and cancer were found suitable for comparison between 9, 10, and 13 countries/regions, respectively. Higher rates of antithyroid medication and thyroid surgery for benign disease and lower rates of thyroid hormone therapy were found for countries with iodine insufficiency before approx. 2001, and no relationship was observed with recent iodine intake or prevention programs. Conclusions: The collation of register data on thyroid outcomes from European countries is impeded by a high degree of heterogeneity in the availability and quality of data between countries. Nevertheless, a relationship between historic iodine intake and rates of treatments for hyper-and hypothyroid disorders is indicated. This study illustrates both the challenges and the potential for the application of register data of thyroid outcomes across Europe.

AB - Objective: Registers of diagnoses and treatments exist in different forms in the European countries and are potential sources to answer important research questions. Prevalence and incidence of thyroid diseases are highly dependent on iodine intake and, thus, iodine deficiency disease prevention programs. We aimed to collect European register data on thyroid outcomes to compare the rates between countries/regions with different iodine status and prevention programs. Design: Register-based cross-sectional study. Methods: National register data on thyroid diagnoses and treatments were requested from 23 European countries/regions. The provided data were critically assessed for suitability for comparison between countries/regions. Sex-and age-standardized rates were calculated. Results: Register data on ≥1 thyroid diagnoses or treatments were available from 22 countries/regions. After critical assessment, data on medication, surgery, and cancer were found suitable for comparison between 9, 10, and 13 countries/regions, respectively. Higher rates of antithyroid medication and thyroid surgery for benign disease and lower rates of thyroid hormone therapy were found for countries with iodine insufficiency before approx. 2001, and no relationship was observed with recent iodine intake or prevention programs. Conclusions: The collation of register data on thyroid outcomes from European countries is impeded by a high degree of heterogeneity in the availability and quality of data between countries. Nevertheless, a relationship between historic iodine intake and rates of treatments for hyper-and hypothyroid disorders is indicated. This study illustrates both the challenges and the potential for the application of register data of thyroid outcomes across Europe.

KW - Europe

KW - iodine

KW - registries

KW - thyroid diseases

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U2 - 10.1530/EC-21-0525

DO - 10.1530/EC-21-0525

M3 - Article

C2 - 35044931

AN - SCOPUS:85127550080

SN - 2049-3614

VL - 11

JO - Endocrine Connections

JF - Endocrine Connections

IS - 3

M1 - e210525

ER -

Register-based information on thyroid diseases in Europe: lessons and results from the EUthyroid collaboration

Abstract

Bibliographical note

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