Prevalence of thyroid autoimmunity and by age, sex, geographic region, and socioeconomic status among 1.7 million chinese adults

Dan Shen; Sailimai Man; Xiaochen Yang; Canqing Yu; ming Li; Bo Wang; Jun Lv

doi:10.1530/endoabs.110.EP1487

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Endocrine Abstracts (2025) 110 EP1487 | DOI: 10.1530/endoabs.110.EP1487

ECEESPE2025 ePoster Presentations Thyroid (198 abstracts)

Prevalence of thyroid autoimmunity and by age, sex, geographic region, and socioeconomic status among 1.7 million chinese adults

Dan Shen ¹ , Sailimai Man ^{1 2 3} , Xiaochen Yang ^{2 4} , Canqing Yu ^{1 3 5} , Liming Li ^{1 3 5} , Bo Wang ^{2 3 6} & Jun Lv ^{1 3 5}

Author affiliations

¹School of Public Health, Peking University, Department of Epidemiology and Biostatistics, Beijing, China; ²Meinian Institute of Health, Beijing, China; ³Peking University Health Science Center Meinian Public Health Institute, Beijing, China; ⁴School of Public Health, Peking University, Department of Social Medicine and Health Education, Beijing, China; ⁵Key Laboratory of Epidemiology of Major Diseases (Peking University), Beijing, China; ⁶Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China.

JOINT331

Background: Thyroid autoimmunity (TAI) is among the most common autoimmune disorders, and it has been linked to an elevated risk of numerous autoimmune and non-autoimmune diseases. However, current estimates of TAI prevalence are limited due to small sample size or single jurisdiction data. This study aimed to investigate the prevalence of TAI in Chinese population and how it varies by age, sex, geographic region, and socioeconomic status.

Methods: The Meinian Health Check-up database was used in this nationwide, large-scale, cross-sectional study. The study included 1,758,425 individuals aged ≥18 years who had health check-ups between 2017 and 2023 and collected blood samples for thyroid function and thyroid antibody tests. TAI was defined as positivity for thyroid peroxidase antibody (TPOAb) and/or thyroglobulin antibody (TgAb). Sample weights based on the 2020 Chinese census were assigned to account for the unequal sample distributions across provinces and to adjust for age and sex proportions. Weighted prevalence with a 95% confidence interval (CI) was computed using the Taylor Series Linearization method.

Results: Among the overall study population (mean age 44.7±12.8 years; 60.0% female), the weighted prevalence of TAI was 23.5% (95% CI 21.7%-25.3%). Near half (46.3%) of those with TAI had positive results for both TPOAb and TgAb, 30.6% were TPOAb+ only, and 23.1% were TgAb+ only. Most of TAI (70.8%) had normal thyroid function, while 22.0% had hypothyroidism. The prevalence of TAI increased with age, peaked at the age of 50 to 59 years, and declined thereafter. Overall, females had more than double the prevalence compared to males (33.6% [32.3%-35.0%] vs. 14.1% [12.8%-15.3%]), with a similar pattern across each age group. Geographically, TAI was most prevalent in the northern (26.5% [24.3%-28.6%]) and central (26.7% [24.1%-29.2%]) regions of China, followed by the eastern region (25.7% [22.6%-28.8%). No significant difference was observed for the prevalence of TAI between coastal and non-coastal region. A socioeconomic gradient was also identified, with individuals resided in higher gross domestic product level cities having a lower prevalence of TAI.

Conclusions: TAI was common in the Chinese population and varied by age, sex, geographic region, and socioeconomic status. A notable proportion of individuals with TAI had normal thyroid function, suggesting that many cases may go undetected without routine assessment. These findings highlight early detection may be useful in preventing the progression to overt thyroid dysfunction and reducing the broader burden of autoimmune disorders.