Work

TR03 Multi-diagnostic thyroid burden, selected comorbidities and six-fold geographic variation in a nationwide eHealth registry analysis from North Macedonia

Year: 2026

Type: conference-abstract

Abstract: Background/Introduction Patient-level data on diagnostic complexity, comorbidity burden, and geographic variation in thyroid disorders remain limited, particularly in underrepresented national registry settings. Purpose To quantify multi-diagnostic thyroid burden, selected non-thyroid comorbidities, and geographic variation among patients with thyroid disorders in North Macedonia. Methods This nationwide cross-sectional study analysed anonymized patient-level data from the National eHealth System. Living individuals with ICD-10 E00–E07 thyroid disorders recorded by 31 October 2024 were included. Duplicate records were consolidated at the patient level. Multi-diagnostic thyroid burden was defined as the presence of more than one recorded thyroid diagnosis. Selected non-thyroid comorbidities were identified using predefined ICD-10 groups. Results The final cohort comprised 269,688 individuals. Multi-diagnostic thyroid burden was identified in 199,383 patients (73.9%). Selected non-thyroid comorbidities included mental and behavioural disorders (29.8%), anaemia (17.8%), cardiomyopathy or heart failure (10.2%), and ischaemic heart disease (9.8%). Peripheral vascular disease and reproductive or infertility-related diagnoses each affected 3.2% of patients, followed by hypotension (2.4%), cerebrovascular disease (1.7%), obesity (1.3%), gonadal dysfunction (0.9%), and psoriasis (0.7%). Less frequent diagnoses (<0.5%) included inflammatory bowel disease, other or postprocedural endocrine-metabolic disorders, rheumatic autoimmune disease, sleep apnoea, sarcoidosis, and cystic fibrosis. The prevalence of diagnosed thyroid disorders varied 6.3-fold across municipalities, ranging from 4.17% to 26.21%, with a higher median prevalence in urban than rural municipalities (13.96% vs. 10.55%). Conclusion Thyroid disorders were characterized by a high burden of multiple thyroid diagnoses, frequent systemic comorbidities, and marked geographic variation. These findings support a more comprehensive clinical approach, incorporating broader comorbidity assessment and integrated endocrine care.

Source: European Journal of Endocrinology

DOI: 10.1093/ejendo/lvag128.083