Data_Sheet_1_Overall, sex-and race/ethnicity-specific prevalence of thyroid dysfunction in US adolescents aged 12–18 years.DOCX

BackgroundThyroid dysfunction significantly affects the health and development of adolescents. However, comprehensive studies on its prevalence and characteristics in US adolescents are lacking.
MethodsWe investigated the prevalence of thyroid dysfunction in US adolescents aged 12–18 years using data from the National Health and Nutrition Examination Survey (NHANES) 2001–2002 and 2007–2012 cycles. Thyroid dysfunction was assessed using serum thyroid-stimulating hormone (TSH) and free thyroxine (fT4) measurements. We analyzed the prevalence across demographic subgroups and identified associated risk factors.
ResultsThe study included 2,182 participants, representing an estimated 12.97 million adolescents. The group had a weighted mean age of 15.1 ± 0.06 years, with males constituting 51.4%. Subclinical hyperthyroidism emerged as the most prevalent thyroid dysfunction, affecting 4.4% of the population. From 2001–2002 to 2011–2012, subclinical hyperthyroidism remained consistent at 4.99% vs. 5.13% in the overall cohort. Subclinical and overt hypothyroidism was found in 0.41 and 1.03% of adolescents respectively, and overt hyperthyroidism was rare (0.04%). The prevalence of thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) positivity in the overall population were 5.8 and 9.8%, respectively. Positivity for TgAb was risk factors for hypothyroidism, while older age, female and Black Americans were risk factors for hyperthyroidism. Female adolescents and adolescents with an older age were more likely to be positive for TPOAb and TgAb, while Black and Mexican Americans had a lower risk of TPOAb and TgAb positivity.
ConclusionSubclinical hyperthyroidism was the most common form of thyroid dysfunction, and its prevalence remained stable from 2001–2002 to 2011–2012. Notable disparities in the prevalence of hyperthyroidism and antibody positivity were observed among different age, sex and racial/ethnic groups.

背景：甲状腺功能异常会显著影响青少年的健康与发育，但目前针对美国青少年甲状腺功能异常的患病率及特征的全面研究仍较为匮乏。
方法：本研究借助2001-2002年及2007-2012年周期的美国国家健康与营养调查（National Health and Nutrition Examination Survey, NHANES）数据，对12-18岁美国青少年的甲状腺功能异常患病率展开调研。研究通过检测血清促甲状腺激素（thyroid-stimulating hormone, TSH）与游离甲状腺素（free thyroxine, fT4）水平评估甲状腺功能异常情况，分析不同人口学亚组的患病率并识别相关危险因素。
结果：本研究共纳入2182名参与者，对应估算的青少年人群规模为1297万。该队列的加权平均年龄为15.1±0.06岁，男性占比51.4%。亚临床甲状腺功能亢进是最为常见的甲状腺功能异常类型，受累人群占比达4.4%。在2001-2002至2011-2012年间，亚临床甲状腺功能亢进的患病率保持稳定，整体队列中分别为4.99%与5.13%。亚临床甲状腺功能减退与显性甲状腺功能减退的患病率分别为0.41%与1.03%，而显性甲状腺功能亢进较为罕见（占比0.04%）。总体人群中甲状腺过氧化物酶抗体（thyroid peroxidase antibody, TPOAb）与甲状腺球蛋白抗体（thyroglobulin antibody, TgAb）阳性率分别为5.8%与9.8%。TgAb阳性是甲状腺功能减退的危险因素，而年龄较大、女性以及非裔美国人是甲状腺功能亢进的危险因素。女性青少年与年龄较大的青少年更易出现TPOAb与TgAb阳性，而非裔美国人和墨西哥裔美国人的TPOAb及TgAb阳性风险则更低。
结论：亚临床甲状腺功能亢进是最为常见的甲状腺功能异常类型，其患病率在2001-2002至2011-2012年间保持稳定。不同年龄、性别以及种族/族裔群体间，甲状腺功能亢进的患病率及抗体阳性率存在显著差异。