[Evaluation of malnutrition, as a possible cause of persistence of goiter despite iodine supplementation]

Iodine deficiency is the most common cause of endemic goiter. Frequency of goiter has remained >5% despite iodide supplementation and sufficient iodide intake. Other causes have to be investigated. This study was conducted to assess influences of malnutrition on persistence of goiter frequency while iodine intake is sufficient. 1504 school age children [8-10 year] were selected randomly and examined in south of Iran - Firoozabad. 102 cases with goiter grade 2 and 3 were found. 100 completely normal children regarding thyroid examination were also selected randomly as control. Growth parameters [Weight for age, Height for age and Body Mass Index] and urinary iodine as an indicator of iodine intake were assessed in both groups. Median of urinary iodine was 21 micro g/dL in patients. [>10 micro g/dL indicates sufficiency of iodine intake.] Regarding growth indicators there was not statistically significant difference between the two groups, which rules out malnutrition as a cause of persistence of goiter. On the other hand our study may show that malnutrition [several nutritional deficiencies] could be as a cause of goiter just in the presence of iodine deficiency. Larger studies in iodine sufficient but with more severe malnutrition or comparison of frequency of goiter before and after nutritional improvement in a population with malnutrition and iodine sufficiency may be more helpful. Malnutrition per se could not be considered as a cause of goiter when iodine intake is sufficient