Treatment of Hypothyroidism by Age and Sex in the United States: A NHANES and Optum Claims Data Analysis

IF 3.7 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice Pub Date : 2025-03-01 DOI:10.1016/j.eprac.2024.12.004

Alexander H. Tessnow MD , Benjamin J. Gigliotti MD , Jennifer M. Perkins MD , Chris P. Schneiderman MPh , Brett Pinsky PhD , Dianlin Guo MD, PhD , Bruce Barger DO , Varinder Singh PhD , Oscar Antunez Flores MD , Kathleen L. Wyne MD

{"title":"Treatment of Hypothyroidism by Age and Sex in the United States: A NHANES and Optum Claims Data Analysis","authors":"Alexander H. Tessnow MD , Benjamin J. Gigliotti MD , Jennifer M. Perkins MD , Chris P. Schneiderman MPh , Brett Pinsky PhD , Dianlin Guo MD, PhD , Bruce Barger DO , Varinder Singh PhD , Oscar Antunez Flores MD , Kathleen L. Wyne MD","doi":"10.1016/j.eprac.2024.12.004","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>Recent data using NHANES and Optum Claims data (OCD) showed an increase in primary hypothyroidism (HT) prevalence in the United States following the 2002 NHANES III report. Using these data, we characterized treatment patterns of overt HT (OHT) in the United States.</div></div><div><h3>Methods</h3><div>Data on adults with OHT were collected from NHANES (2009-2012) and OCD (2012-2019). Disease status was determined from laboratory results or evidence of HT treatment (levothyroxine or liothyronine). OHT was defined as thyroid-stimulating hormone > 4.0 mIU/L and free thyroxine < 0.8 ng/dL or evidence of OHT treatment. Results were stratified by age group and sex. NHANES data were further stratified by insurance status (private/Medicare vs neither).</div></div><div><h3>Results</h3><div>Overall, > 72% received treatment, with > 80% of the OCD cohorts receiving treatment. Among the NHANES cohort, treatment rates increased with advancing age and were consistently higher in females than in males (age 18–44: 47.3% vs 39.9%; 45–59: 76.8% vs 51.1%; ≥ 60: 91.9% vs 65.6%, respectively). Among the OCD cohorts, treatment patterns were similar across age group and sex (> 78% treated). Among the NHANES cohort that were not privately/Medicare insured, overall treatment rates were 50%, with those ≥ 60 having highest treatment rates (> 75%). Moreover, < 50% of reproductive-aged women in the NHANES dataset received treatment, which was reduced to 22% among uninsured patients.</div></div><div><h3>Conclusions</h3><div>This study provides important updates regarding treatment of OHT and highlights treatment disparities, especially among men and women of reproductive age, using both total and insured population estimates.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 3","pages":"Pages 359-365"},"PeriodicalIF":3.7000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Endocrine Practice","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1530891X24008607","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

Recent data using NHANES and Optum Claims data (OCD) showed an increase in primary hypothyroidism (HT) prevalence in the United States following the 2002 NHANES III report. Using these data, we characterized treatment patterns of overt HT (OHT) in the United States.

Methods

Data on adults with OHT were collected from NHANES (2009-2012) and OCD (2012-2019). Disease status was determined from laboratory results or evidence of HT treatment (levothyroxine or liothyronine). OHT was defined as thyroid-stimulating hormone > 4.0 mIU/L and free thyroxine < 0.8 ng/dL or evidence of OHT treatment. Results were stratified by age group and sex. NHANES data were further stratified by insurance status (private/Medicare vs neither).

Results

Overall, > 72% received treatment, with > 80% of the OCD cohorts receiving treatment. Among the NHANES cohort, treatment rates increased with advancing age and were consistently higher in females than in males (age 18–44: 47.3% vs 39.9%; 45–59: 76.8% vs 51.1%; ≥ 60: 91.9% vs 65.6%, respectively). Among the OCD cohorts, treatment patterns were similar across age group and sex (> 78% treated). Among the NHANES cohort that were not privately/Medicare insured, overall treatment rates were 50%, with those ≥ 60 having highest treatment rates (> 75%). Moreover, < 50% of reproductive-aged women in the NHANES dataset received treatment, which was reduced to 22% among uninsured patients.

Conclusions

This study provides important updates regarding treatment of OHT and highlights treatment disparities, especially among men and women of reproductive age, using both total and insured population estimates.

查看原文本刊更多论文

在美国按年龄和性别治疗甲状腺功能减退：nhanes和optum索赔数据分析。

目的：最近使用NHANES和Optum Claims数据（OCD）的数据显示，2002年NHANES III报告发布后，美国原发性甲状腺功能减退症（HT）患病率有所增加。利用这些数据，我们描述了美国显性HT （OHT）的治疗模式。方法：收集NHANES（2009-2012）和OCD（2012-2019）的成人OHT数据。疾病状态由实验室结果或HT治疗证据（左甲状腺素或碘甲状腺原氨酸）确定。OHT定义为促甲状腺激素>4.0 mIU/L和游离甲状腺素。结果：总体而言，>组72%接受治疗，>组80%接受治疗。在NHANES队列中，治疗率随着年龄的增长而增加，并且女性的治疗率始终高于男性(18-44岁：47.3% vs 39.9%；45-59: 76.8% vs 51.1%；≥60:91.9% vs 65.6%)。在强迫症队列中，治疗模式在不同年龄组和性别之间是相似的（bb0.78%接受了治疗）。在未参加私人/医疗保险的NHANES队列中，总体治疗率为50%，≥60岁的患者治疗率最高（bb0为75%）。此外，结论：本研究提供了关于OHT治疗的重要更新，并强调了治疗差异，特别是在育龄男性和女性之间，使用了总体和参保人口估计。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Endocrine Practice ENDOCRINOLOGY & METABOLISM-

CiteScore

7.60

自引率

2.40%

发文量

546

审稿时长

41 days

期刊介绍： Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.