[The prevalence of antithyroid antibodies in Lleida]. / Prevalencia de anticuerpos antitiroideos en Lleida.

OBJECTIVE: To evaluate the prevalence of autoimmune thyroid antibody, goiter and levels of ioduria in the region of Lleida. METHODS: Cross-sectional study on a randomized sample of 601 individuals above 6 years old. Examination and palpation of thyroid gland, TSH, T4, FT4, T3, peroxidase antibodies, thyroglobulin antibodies, and ioduria. RESULTS: The prevalence of positive peroxidase antibodies was 3.4% (IC 95%: 0.9-5.9), and that of positive thyroglobulin antibodies 9.7% (IC 95%: 6.5-12.9). Palpable goiter was found in 18.3% of individuals, and visible goiter in 13.3%. The mean ioduria was 120.2 +/- 68 mg/l. The mean TSH value was higher in the individuals with thyroid autoimmunity (3.4 +/- 2.4 mU/l) than in the rest (1.6 +/- 1.2 mU/l) the difference was significant. CONCLUSIONS: Although cases of hypothyroidism are common in populations with iodine deficiency, in regions with adequate iodine intake justifies monitoring for hypothyroidism in these populations as well.

[How many patients need treatment for hypercholesterolemia?]. / Cuántos pacientes precisan tratamiento para la hipercolesteremia?

OBJECTIVE: To find out the percentage of individuals from a population who need pharmacologic treatment for their hypercholesterolemia according to different guidelines. DESIGN: Descriptive transversal study. SETTING: Population from 6 areas of Lleida (province) including the city of Lleida. METHOD: The study has been done on a randomized sample of 401 individuals. First the cardiovascular risk from the equation in the Framingham study was calculated, then the percentage of individuals who should be treated with lipid-lowering medication according to the US National Cholesterol Education Program, The European Society of Atherosclerosis and The Spanish Society of Atherosclerosis. RESULTS: The prevalence of individuals with cholesterolemia > 250 mg/dl has been 16.3% among men and 22.4% in women. According to NCEP, 20.5% of men and 17.6% of women from 383 individuals older then 6 years old need pharmacologic treatment for hypercholesterolemia. The Framingham equation was applied to 281 individuals (over 30 and under 75 years old) estimating a risk higher than 20% in 10 years for 13.7% of the population under study (23.9% in men and 3.5% in women). CONCLUSIONS: The percentage of patients who need pharmacologic treatment for hypercholesterolemia varies according to the different guidelines employed. We consider necessary the calculation of the cardiovascular risk with the Framingham equation to use lipid-lowering medication in order to achieve a better protection of the population at higher risk of developing a cardiovascular disease.

[Current situation of goiter endemic and iodine intake in the population of the Pyrenees and the Segrià region of Lleida]. / Situación actual de la endemia de bocio y del consumo de yodo en la población del Pirineo y de la comarca del Segrià de Lleida.

OBJECTIVE: To assess the prevalence of goiter in five areas of the Pyrineans and in the region of Segrià in Lleida. DESIGN: Transversal descriptive study. SETTING: Five Pyrinean's regions and Segrià. PATIENTS: Randomised selection of a sample of 601 subjects from the population over 6 years old. MEASUREMENTS: The field work, which was preceded by an informative campaign in the media, was carried out from October of 1994 through February of 1995. Survey with a personal interview, blood pressure, weight, height, goiter palpation, blood analysis with thyroidal hormones and urine analysis with the iodine/creatine ratio determination. RESULTS: The prevalence of goiter was 18.3% which was higher among women, the ratio being 3.7/1 (women/men). No significant differences were found in regard to geographic distribution. Mean iodinuria was 120 micrograms/l, though it was below 50 in 11.1% subjects. The prevalence of goiter has been founded to be related to age, increasing from the age of 45 onwards. Higher percentage of goiter was found among individuals with a family history of the disease and women who have had children. The prevalence of hypothyroidism was 3.4%. CONCLUSIONS: We have found a medium degree of goiter's endemia in the study area, the mean iodinuria in the population is in normal range. The women with children have a higher prevalence of goiter probably due to a lack of sufficient iodine intake being a subgroup at risk.

[Prevalence of tobacco dependence in 6 counties of Lleida]. / Prevalencia de tabaquismo en 6 comarcas de Lleida.

OBJECTIVE: To find the prevalence of tobacco dependency in the population of six counties in Lleida and in patients with chronic diseases or vascular risk factors. DESIGN: Cross-sectional study. A descriptive analysis of the data. SETTING: Six counties in Lleida: 5 Pyrenean counties with a rural population and the Segrià county with an urban population. PARTICIPANTS: A personal questionnaire covering 900 people over 15 (95% CI, 4% accuracy), chosen by randomised sampling, stratified for urban or rural, from the Municipal Rolls. MEASUREMENTS AND MAIN RESULTS: 543 individuals took part. Prevalence of tobacco dependency was 19.7%, higher in men (27.7%) than in women (12%) (p < 0.05). However, among the young there were no difference between the sexes. CONCLUSIONS: We found a low, in comparison with other studies, percentage of smokers in our sample, with a high prevalence of ex-smokers among patients with ictus or Coronary Disease. However, the high prevalence of smokers among the individuals with some cardiovascular risk factor points to the need to redouble efforts in health education on tobacco.

[The prevalence of thyroid functional disorders in the province of Lleida]. / Prevalencia de trastorno de la función tiroidea en la provincia de Lleida.

OBJECTIVE: To assess the prevalence of thyroidal disorders in our area using a representative sample of the population in terms of age and distribution by sex. DESIGN: Descriptive observational transversal study. SETTING: Six areas from the province of Lleida including its capital. PARTICIPANTS: All the inhabitants older than 6 and living in the region during the time of the study. MEASUREMENTS AND MAIN RESULTS: The study was carried out using a representative sample of the population. Several demographic and clinical parameters that are considered to be related to thyroidal disorders were gathered. A blood sample was performed to measure thyrotropin and thyroidal hormones (total T3, free T3 and free T4) and antithyroidal antibodies. 4 diagnostic categories were defined: overt hypothyroidism, subclinical hypothyroidism, overt hyperthyroidism and subclinical hyperthyroidism. Blood samples from 401 individuals were analyzed. The prevalence of hyperthyroidism has been 5.6% +/- 2.3% of which 4.6% +/- 2.1% corresponds to subclinical hyperthyroidism. The prevalence of hypothyroidism has been 3.48% +/- 1.7% with 1.24% of overt condition and 2.23% of subclinical. We have not found statistical significance by sex in hyperthyroidism while the prevalence of hypothyroidism is significantly higher among women. 42.8% of hypothyroidism showed positive values for antithyroidal antibodies. CONCLUSIONS: The prevalence of thyroidal disorders in the studied area is similar to those other regions with an adequate iodine intake. Hypothyroidism has diminished in the last years. Hyperthyroidism has not changed. Data about prevalence of thyroidal disorders will have increased value in the future if strategies such as screening and treatment of subclinical disorders prove to be beneficial.

¿Cuántos pacientes precisan tratamiento para la hipercolesteremia? / How many patients need treatment for hypercholesterolemia?

Objetivo. Calcular el porcentaje de individuos de una población que precisa tratamiento farmacológico según las diferentes guías para el tratamiento de la hipercolesteremia. Diseño. Estudio descriptivo transversal. Emplazamiento. Población de 6 comarcas de Lleida: cinco pirenaicas y una en el llano, donde se emplaza la capital de la provincia. Método. En 401 individuos procedentes de una muestra aleatoria de 6 comarcas de Lleida se calculó el riesgo cardiovascular según la tabla de cálculo del estudio de Framingham y el porcentaje de individuos que precisan fármacos hipolipemiantes según el US National Cholesterol Education Program, la Sociedad Europea de Aterosclerosis y la Sociedad Española de Aterosclerosis. Resultados. La prevalencia de individuos con colesterol total > 250 mg/dl fue del 16,2 por ciento en los varones y del 22,4 por ciento en las mujeres. Precisaban tratamiento farmacológico para la hipercolesteremia un 20,5 por ciento de los varones y un 17,6 por ciento de las mujeres de los 383 individuos mayores de 6 años de la población, según el NCEP. La ecuación de Framingham se aplicó a 281 individuos (mayores de 30 y menores de 75 años); estima un riesgo superior al 20 por ciento en 10 años en un 13,7 por ciento de la población, siendo de un 23,9 por ciento en los varones y un 3,5 por ciento en las mujeres. Conclusiones. El porcentaje de pacientes que precisa tratamiento farmacológico para la hipercolesteremia varía según las diferentes guías utilizadas. Consideramos necesario el cálculo del riesgo cardiovascular según la ecuación de Framingham en el uso de fármacos para que éste se ajuste a la población con mayor riesgo, dado el origen multifactorial de la enfermedad cardiovascular (AU)

Prevalencia de anticuerpos antitiroideos en Lleida / Prevalence of autoimmune thyroid antibody in Lleida

Objetivo: Investigar la prevalencia de anticuerpos antitiroideos, bocio y nivel de yoduria en la población de Lleida. Métodos: Estudio epidemiológico descriptivo transversal, muestra aleatoria de 601 individuos mayores de 6 años. Exploración tiroidea, TSH, T4, T4L, T3, anticuerpos antiperoxidasa tiroidea, anticuerpos antitiroglobulina y yoduria. Resultados: La prevalencia de Ac antiperoxidasa tiroidea fue de 3,4 porciento (IC 95 porciento: 0,9-5,9 ) y de Ac antitiroglobulina de 9,7 porciento ( IC 95 porciento: 6,5-12,9). La prevalencia de bocio palpable fue del 18,3 porciento y visible de 13,3 porciento. La yoduria media fue de 120,2 ñ 68 mg/l. El valor medio de TSH fue superior en los individuos con autoinmunidad tiroidea (3,5 ñ 2,4 mU/l) que en el resto (1,6 ñ 1,2 mU/l) (p<0,05). Conclusiones: Aunque son frecuentes los casos de hipotiroidismo en poblaciones con déficit de yodo, la búsqueda del hipotiroidismo en zonas con aporte adecuado de yodo se justifica por la alta prevalencia de enfermedad autoinmune tiroidea (AU)