Characteristics and Dynamics of Thyroid Dysfunction in the Bulgarian Population - Screening 2024
Year: 2025
Type: article
Study design: Observational Study
Abstract: In 1994 universal iodization of salt was introduced on the whole Bulgarian territory. In 2005, аn international expert group gave the country credit for solving the problem of iodine deficiency. The last screening of pregnant Bulgarian women in 2019 confirmed the presence of iodine sufficiency among the population. The current study aimed at updating the data on the prevalence of thyroid dysfunction (hypothyroidism and hyperthyroidism) in the country under conditions of iodine sufficiency in the Bulgarian population. The last population screening was conducted 12 years ago, allowing us to make a comparison with the current one in 2024, as both screenings were carried out under the conditions of systematic and continuous universal iodization of salt across the entire territory of Bulgaria. Material and Methods: 936 subjects were distributed into three age groups: 20-44 years - 342 (36.5%), 45-59 years - 301 (32.2%) and 60-79 years - 293 (31.3%). TSH (ECLIA-sandwich method), FT4 (competitive ECLIA method), TPOAb (ECLIA-method of the Cobas e601 analyzer) were examined. Thyroid dysfunction, which includes subclinical and clinical forms, was analysed regarding the frequency of each type and form in the studied population, as well as its distribution according to gender and among the three age groups. The data gathered in 2012 and 2024 were compared. Results: Hypothyroidism is the dominant disorder - 14.4% (135/936), while hyperthyroidism is 1.81% (17/936), p < 0.05. The highest number of patients have subclinical hypothyroidism - 13.67% (128/936). The prevalence of increased TPO antibodies is 14.4% (133/936) and as expected, it is more common in women - 71.4% (95/133) compared to men - 28.6% (38/133), p < 0.001. The current thyroid dysfunction in our country has significantly increased - from 6.91% (166/2402) in 2012 to 16.23% (152/936) in 2024, p < 0.01. The relative share of known diagnosed cases during this 12-year period shows a marked rise - from 44.51% (73/164) to 63.16% (96/152) - p < 0.02 > 0.01, while the relative share of newly diagnosed cases during screening has a significant drop - from 55.49% (91/164) to 36.84% (56/152) - p < 0.02. Conclusion: These favorable trends in the reduction of undiagnosed cases of thyroid dysfunction are the result of increased diagnosis of thyroid pathology, ongoing regular screening campaigns, and raised awareness among the population, which is proof of the medical community beneficial work in the country.
Source: Clinical Medicine Research
Institution: Sofia University "St. Kliment Ohridski"
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4411840657