Thyroid dysfunction in Greece: Results from the national health examination survey EMENO

Paraskevi V Voulgari; Aliki I Venetsanopoulou; Natasa Kalpourtzi; Magda Gavana; Apostolos Vantarakis; Christos Hadjichristodoulou; Grigoris Chlouverakis; Grigoris Trypsianis; Yannis Alamanos; Giota Touloumi; EMENO study group

doi:10.1371/journal.pone.0264388

Thyroid dysfunction in Greece: Results from the national health examination survey EMENO

PLoS One. 2022 Mar 4;17(3):e0264388. doi: 10.1371/journal.pone.0264388. eCollection 2022.

Affiliations

¹ Department of Internal Medicine, Rheumatology Clinic, Medical School, University of Ioannina, Ioannina, Greece.
² Dept of Hygiene, Epidemiology, & Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
³ Dept of Primary Health Care, General Practice and Health Services Research, Medical School of Aristotle University, Thessaloniki, Greece.
⁴ Public Health, Medical School, University of Patras, Patra, Greece.
⁵ Dept of Hygiene and Epidemiology, Medical Faculty, University of Thessaly, Larisa, Greece.
⁶ Laboratory of Biostatistics, School of Medicine, University of Crete, Crete, Greece.
⁷ Laboratory of Medical Statistics, Medical School, Democritus University of Thrace, Thrace, Greece.
⁸ Institute of Epidemiology, Preventive Medicine and Public Health, Corfu, Greece.

Abstract

Background: Nationwide data on thyroid disease prevalence in Greece is lacking. Using the national health examination survey EMENO data resources, we aimed to estimate the prevalence of hypothyroidism and hyperthyroidism and associated risk factors in adults living in Greece.

Methods: A random sample of the adults (≥18 years) living in Greece was drawn by multi-stage stratified random sampling based on the 2011 census. During home visits, trained interviewers administered a standardized questionnaire to study participants. All participants answered questions concerning demographic parameters (e.g., age, sex, degree of urbanization, income) and questions concerning smoking habits, alcohol, dietary habits and psychological parameters such as anxiety and thyroid disease. Weighted logistic regression models were fitted to assess factors associated with thyroid disease.

Results: In total, 6006 individuals were recruited in the Greek Health Examination Survey EMENO (response rate 72%) of whom 5981 were eligible for this study. The prevalence of thyroid disease was 9%, where 0.4% was related to hyperthyroidism and 8.6% to hypothyroidism. The prevalence of thyroid disease was higher in women (14.9%) than men (2.7%) (p<0.001). The highest rates of thyroid disease were observed in former iodine-deficient areas. A decrease in the prevalence of thyroidopathies with increasing alcohol consumption was found. Thyroid disease was associated with anxiety in men. Multivariable regression analysis showed that age, geographic area, and smoking were related to thyroid disease.

Conclusion: The prevalence of thyroid disease in Greece is higher in women. Age, habits, and characteristics of geographic areas determine the distribution of thyroidopathies in Greece.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Cross-Sectional Studies
Female
Greece / epidemiology
Humans
Hyperthyroidism* / epidemiology
Hypothyroidism* / epidemiology
Male
Prevalence
Thyroid Diseases* / epidemiology

Grants and funding

we declare that the EMENO survey was implemented under the Operational Program “Education and Lifelong Learning” and was co-funded by the European Union (European Social Fund) and national resources [grant number: MIS 376659]. Additional funding was obtained from the Hellenic Diabetes Association to measure glycated hemoglobin [grant number: Κ.Ε. 12008]The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.