成人の甲状腺機能異常症のスクリーニングに関する研究

抄録

For the purpose of screening of thyroidal dysfunction in adult, we have collected blood of 15,905 (male 11,559, female 4,346) adult normal workers and school students on filter papers at the time of the annual health examination. Both TSH and total T₄ were measured by radioimmunoassay. Either TSH or total T₄ or both showed abnormal values in 148 cases. For these subjects, serum TSH, total T₄ and T₃, free T₄, TBG, antimicrosomal and antithyroglobulin antibody were estimated. From these results, diagnosis was made as follows : 6 hyperthyroidism, 12 primary hypothyroidism (including 3 subclinical hypothyroidism who showed elevated TSH and normal free T₄ values) and 29 TBG abnormality (increase : 8, decrease or deficiently : 21). The incidence by this study was : hyperthyroidism 0.038% (1/2650), primary hypothyroidism 0.075% (1/1330), TBG increase or deficiency 0.132% (1/760). Sex ratio of thyroidal dysfunction were higher in female than male. In hyperthyroidism, ratio of male to female was 1 : 2.66, and in hypothyroidism, it was 1 : 133. Most of these patients were not diagnosed before this screening. The fact that the incidence of hypothyroidism was higher than hyperthyroidism in this population was apparent in this study. TBG abnormality was noted more in male than female. This report is important to show the incidence of thyroidal abnormalities and the necessity of the screening test of thyroid in adult.