A case-control study on the association of mineral elements exposure and thyroid tumor and goiter.

Thyroid tumor and thyroid goiter are prevalent disease around the world. In this case-control study, we investigated the association between exposure to a total of twelve mineral elements and thyroid disease as well as thyroid functions. Participants with thyroid tumor or goiter (N = 197) were matched with a healthy population (N = 197) by age (± 2 years old) and same sex. Questionnaires were used to collect data about the demographic characteristics and information of subjects. Serum and urine samples were collected simultaneously for each of the subjects. Mineral elements, iodine level of urine and levels of the total seven thyroid function indexes in serum were detected respectively. Conditional logistic regression was applied to estimate the associations between mineral elements and the risk of thyroid tumor and goiter through single-element models and multiple-element models. Multiple linear regression was used to evaluate relationships between mineral elements and percentage changes of thyroid functions. Higher concentrations of mineral elements in the recruited population were found in this study than other comparable studies, and the levels of chromium (Cr), manganese (Mn), nickel (Ni), arsenic (As), cadmium (Cd), selenium (Se), antimony (Sb), thallium (Tl) and lead (Pb) in the case group were lower than the control group. According to the single-element models, Cr, Mn, Ni, Sb and Tl showed significant negative associations with the risk of thyroid tumor and goiter, and, Cd showed nonmonotonic dose response. Cd and mercury (Hg) showed a nonmonotonic percentage change with T4, while Tl was associated with the increased FT4 in the control group. Therefore, Cd, Hg and Tl may disturb the balance of thyroid function to some extent, and Cr, Mn, Ni, Cd, Sb, and Tl may become potential influencing factors for the risk of thyroid tumor and goiter.

Stopping the supply of iodized salt alone is not enough to make iodine nutrition suitable for children in higher water iodine areas: A cross-sectional study in northern China.

BACKGROUND: For the sake of children's health, iodized salt supply has been stopped in many areas with excessive iodine in the drinking water, but children's iodine nutrition status and thyroid function after terminating the iodized salt supply is unknown. Objective We assessed the iodine nutrition, thyroid function and influencing factors for thyroid abnormalities in children from areas with different concentrations of water iodine; the supply of iodized salt has been stopped in high water iodine areas. This study aimed to evaluate whether the strategy of stopping the supplies of iodized salt alone is enough to avoid thyroid dysfunction in all areas with excess water iodine while still meeting the iodine nutrition needs of children. METHODS: A cross-sectional study was conducted in children from four areas with different drinking water iodine concentrations in Tianjin, China. The drinking water samplings and spot urine samples were collected to estimate the external and internal iodine exposure levels. The thyroid volume was measured, and blood samples were collected to assess thyroid function. Logistic regression analysis was used to analyze risk factors for thyroid abnormalities. A dietary survey was conducted to determine the sources of iodine nutrition among the areas with different iodine concentrations in the drinking water. RESULTS: In the area with a drinking water iodine concentration ≥300 µg/L, the median urinary iodine concentration (UIC) in children was 476.30 (332.20-639.30) µg/L, which was higher than that in other groups (all P < 0.05), and the prevalence of thyroid nodules and the thyroid goiter rate were higher than those in the <100 µg/L, 100-150 µg/L and 150-300 µg/L areas (all P < 0.01). Binary logistic regression analysis indicated that the risk of thyroid abnormalities was significantly increased in the UIC 200-299 µg/L group (OR: 4.534; 95% CI: 1.565, 13.135; bootstrapped 95% CI: 1.689, 21.206, P = 0.004) and in the UIC ≥ 300 µg/L group (OR: 6.962; 95% CI: 2.490, 19.460; bootstrapped 95% CI: 2.838, 32.570, P = 0.001) compared to the 100-199 µg/L group. The iodine contribution rates from water in areas with water iodine concentrations ≥300 µg/L are up to 63.04%. CONCLUSIONS: After termination of the iodized salt supply, the level of iodine nutrition of children in the area with drinking water iodine concentrations ≥300 µg/L is still excessive. The water source needs to be replaced in this area. In the area with a water iodine concentration of 150-300 µg/L, it is proposed that stopping the supply of iodized salt is sufficient to achieve the proper iodine nutrition status in children.

Prevalence of goiter and its association with iodine status among the women of reproductive age group in coastal villages of Udupi Taluk, Karnataka, India.

BACKGROUND: Iodine deficiency is one of the most prevalent micronutrient deficiencies globally. Women in reproductive age group are vulnerable to develop iodine deficiency as there is an increase in demand for iodine, especially during pregnancy. OBJECTIVES: The objective is to assess the prevalence of goiter and its association with iodine status and salt usage practices among the women of reproductive age group. METHODS: A community-based cross-sectional study was conducted from August 2015 to July 2017 among 1500 women of reproductive age group in five villages of Udupi Taluk. Stratified sampling design and proportion to population size of the reproductive age women in the study area was used to select the study participants. A pretested semi-structured questionnaire was used for data collection. Goiter was assessed clinically and graded as per the recommended criteria of the WHO. Salt samples from every household were collected for iodine estimation. Blood and urine samples were collected from subsample to estimate thyroid-stimulating hormone levels and urinary iodine excretion levels, respectively. RESULTS: The overall prevalence of goiter was 13% with 11.5% being Grade 1 and 1.5% being Grade 2. No significant association of goiter with urinary iodine, salt iodine levels, and salt usage practices was found. CONCLUSIONS: Median urinary iodine among the women with goiter indicates iodine sufficiency and no significant difference observed in urinary iodine levels between women with and without goiter.

Urinary iodine concentration and thyroid volume of pregnant women attending antenatal care in two selected hospitals in Ashanti Region, Ghana: a comparative cross-sectional study.

BACKGROUND: Iodine deficiency is a major public health problem affecting people worldwide, particularly pregnant women. Iodine requirements increase substantially during pregnancy making pregnant women vulnerable to iodine deficiency and its disorders such as abortions, stillbirths and pregnancy goitre as well as congenital abnormalities, cretinism and mental retardation in their children. The primary aim of this study was to evaluate the prevalence of iodine deficiency and goitre among pregnant women attending antenatal sessions at two selected hospitals in Ashanti region, Ghana. METHODS: A cross-sectional study was carried out in 239 pregnant women who attended the antenatal clinic at Kwame Nkrumah University of Science and Technology (KNUST) Hospital or Ejura District Hospital, both in Ashanti Region, Ghana. Socio-demographic data and information related to iodine were captured using a questionnaire. Urinary iodine concentration (UIC) was determined on spot urine samples using the Sandell-Kolthoff reaction with ammonium persulfate as digesting agent. Each woman's thyroid volume was also measured by ultrasonography. RESULTS: The overall median UIC was 155.9 µg/L, indicating adequate iodine intake in the study population. However, goitre prevalence in the pregnant women was 11.3%, denoting mild iodine deficiency. The median UIC for pregnant women who attended KNUST Hospital was higher (163.8 µg/L) than that of Ejura District Hospital (149.0 µg/L). The proportion of women who did not consume iodised salt was significantly higher (p < 0.001) in Ejura District Hospital (71.2%) than KNUST Hospital (28.0%). In total, 47.3% of the pregnant women studied had a UIC < 150 µg/L. Only 16.3% knew about the increase in iodine requirement during pregnancy and 21.3% of them had knowledge of the effects of iodine deficiency during pregnancy with most (81.8%) knowing of pregnancy goitre. CONCLUSION: There is generally adequate iodine intake among the pregnant women, however, iodine deficiency and goitre still exist among some pregnant women. Thus, assessment and continuous monitoring of iodine nutritional status in pregnant women in the country are warranted. Also, intensification of effective public health campaigns (through radio and television) with regard to iodine utilization and its benefits in pregnancy are still recommended among Ghanaian pregnant women.

Continuously sustained elimination of iodine deficiency: a quarter of a century success in the Islamic Republic of Iran.

BACKGROUND: Iodine deficiency and related disorders were very common in Iran prior to 1996, when universal salt iodization (USI) was implemented and in 2000 Iran was declared iodine deficiency disorders (IDD) free. The aim of this study was to evaluate the adequacy of iodine intake by Iranian households in all 30 provinces of Iran, a quarter of a century after the intervention. METHODS: A total of 18,000 school-aged children (8-10 years with mean 8.7 ± 1 year) were included in this study. Urine samples were collected from all children for measurement of urinary iodine excretion and 1800, 210 and 3000 salt samples were randomly collected from the family kitchen, production site of 73 salt factories and distribution circles of 30 provinces, respectively. RESULTS: The median urinary iodine concentration (UIC) of participants was 161 µg/L. The proportion of children with UIC of, 20-49, 50-99 and ≥ 100 µg/L were 10.3, 15.9 and 73.7%, respectively. The mean (± SD) and median salt iodine values were 28.2 (± 12.6) and 31.7 ppm, at the production site, and 31.5 (± 13.6) and 29.6 ppm at the distribution circles, respectively. About 80% of factory salts had more than 20 ppm iodine. 98% of households consumed iodized salt, 80% had appropriate salt storage, and 83% of the household salts contained ≥ 20 ppm. CONCLUSIONS: Based on the results of this study, Iranian populations are consuming adequate iodine. The well-maintained and monitored USI program has improved the dietary iodine intakes of the population, and the country has achieved all criteria of a well-controlled IDD program.

Has iodized salt reduced iodine-deficiency disorders among school-aged children in north-west Iran? A 9-year prospective study.

OBJECTIVE: Low iodine intakes are associated with goitre and other iodine-deficiency disorders (IDD) that have affected billions of people worldwide. We aimed to assess total goitre rate (TGR) and urinary iodine concentration (UIC) in schoolchildren between 2007 and 2015, percentage of iodized salt consumption by households, and salt iodine content at production, distribution and household levels in north-west Iran. Design/Setting/Subjects UIC assessed among schoolchildren in nine consecutive years; 240 schoolchildren aged 8-10 years selected by systematic random sampling each year in the West Azerbaijan Province. RESULTS: Median UIC was >100 µg/l in all years. More than 50 % of children had iodine deficiency (UIC≤99 µg/l) in 2010 and 2011, while this rate was approximately 15-35 % in other years. Proportion with UIC below 50 µg/l was <20 % in all years except 2010 and 2011. Excessive UIC (≥300 µg/l) rate was between 5·4 and 27·5 %. TGR decreased from 44 % in 1996 to 7·6 % and 0·4 % in 2001 and 2007, respectively. Regular surveys from 2002 to 2015 showed that 98 % or more of households consumed iodized salt. Iodine level ≥20 ppm was observed in 87·5, 83 and 73 % of salt at production, distribution and household level, respectively (data from national study in 2007). The last national study in 2014 showed that median iodine level in household salt was 27 ppm. CONCLUSIONS: Our focused data suggest that the universal salt iodization programme is improving the iodine status of schoolchildren in the West Azerbaijan Province of Iran. Reduction of TGR to less than 5 % in schoolchildren indicates successful elimination of IDD as a major public health problem.

ASSESSMENT OF ADEQUATE IODINE AVAILA-BILITY TO THE POPULATION OF WEST KAZAKHSTAN BASED ON THE DATA OF INORGANIC IODINE IN URINARY EXCRETION.

Aim of research - to study the iodine supply of the region according to the degree of urinary iodine excretion in the West region of the Republic of Kazakhstan. Of 6493 schoolchildren participating in the study of the frequency of goiter, random sampling was applied to select 884 children to determine UIC. To establish the excretion of inorganic iodine in a single portion of urine in the field, express diagnostics, the "Iodine test" kits (manufactured in Ukraine), was applied. The collection of urine for the determination of UIC was carried out in disposable cups, hermetically sealed with stoppers to prevent the entry of iodine vapors into the test samples. The test was carried out immediately after urine collection. The concentration of iodine in the urine was expressed in µg/l. The method is semiquantitative and makes it possible to distinguish urine samples with iodine content below 70, from 70 to 100, from 100 to 300 and above 300 µg/L. The obtained data on the study of UIC in schoolchildren in the West Kazakhstan showed that the proportion of children with optimal urinary excretion of iodine (100-300 µg/L) is 62.67% (95% CI: 59.48-65.86%). Indices ranging from 100 to 200 µg/L were detected in 27.15% (95% CI: 24.22-30.08%, more than 200 µg/L and up to 300 µg/L - in 35.52% (95% CI: 32.37-38.68%) of schoolchildren. UIC exceeds 300 µg/L - in 18.89% (95% CI: 16.31-21.47%) of schoolchildren. Concentration of iodine in the urine of more than 400 µg/L was determined in 1.81% (95% CI: 0.93-2.69%) of children. Low excretion rates of iodine, less than 70 µg/L, were detected in 2.83 % (95% CI: 1.74-3.92%) of schoolchildren, and from 70 µg/L to 100 µg/L - in 13.8 % (95% CI: 11.53-16.07%). Thus, in 62.67% (95% CI: 59.48-65.86%) there is an optimal allocation of iodine in the urine, it can be considered that iodine status of the population of West Kazakhstan is adequate. In West Kazakhstan, in the absence of iodine deficiency, a strained goiter endemia remains.The formation of goiter endemia in the region does not exclude the influence of other strumogenic factors, which need further study.

[The iodine intake in a female population of an Apennine valley (Italy) in years 2003-2013]. / L'assunzione di iodio in una popolazione femminile di una valle appenninica negli anni 2003-2013.

OBJECTIVES: to assess if the iodine intake of pregnant women had increased or not after the introduction of Law no. 55 of March 2005 («Provisions aimed at the prevention of endemic goitre and other diseases from iodine deficiency¼) and if it reached the levels recommended by the World Health Organisation (WHO). DESIGN: evaluation of ioduria values in the female local population enrolled. SETTING AND PARTICIPANTS: in 4 different years, 100 women per year (400 women in all) were enrolled in this study. All women were residing in the same Apennine valley; 200 of them were pregnant, the other 200 were in childbearing age but not pregnant. MAIN OUTCOME MEASURES: comparison of the median values of ioduria among the 4 groups of women examined. RESULTS: in 2003, in blood-donor women examined for ioduria the median value was 68.48 µg/L; in blood-donor women examined in 2013 the median value for ioduria was 130 µg/L; the difference between the two groups is statistically significant. In the 100 pregnant women examined in the middle of 2011 the median value for ioduria was 64 µg/L, while for those recruited in the middle of 2013 it was 107 µg/L; the difference is statistically significant. CONCLUSIONS: from the introduction of the Law No. 55/2005 the median value of ioduria is strongly increased in all groups examined. It should be noted that in 2013 fertile non-pregnant women have attained a median that falls within the range recommended by WHO, while pregnant women in the first trimester have not yet reached the median recommended by WHO, although attaining a significant increase compared to the middle of 2011.

Goiter prevalence, urinary iodine, and salt iodization level in sub-Himalayan Darjeeling district of West Bengal, India.

National iodine deficiency disorders control program needs to be continuously monitored. Hence, a cross-sectional study was conducted during the period from April-May 2011 to assess the prevalence of goiter, status of urinary iodine excretion (UIE) level and to estimate iodine content of salts at the household level in Darjeeling district, West Bengal. Study subjects were 2400 school children, aged 8-10 years selected through "30 cluster" sampling methodology. Goiter was assessed by standard palpation technique, UIE was estimated by wet digestion method and salt samples were tested by spot iodine testing kit. Overall goiter prevalence rate was 8.7% (95% confidence intervals = 7.6-9.8) and goiter prevalence was significantly different with respect to gender. Median UIE level was 15.6 mcg/dL (normal range: 10-20 mcg/dL). About 92.6% of the salt samples tested had adequate iodine content of ≥15 ppm. Findings of the present study indicate that the district is in a transition phase from iodine-deficiency to iodine sufficiency.

Clinical assessment of goiter and low urinary iodine concentration depict presence of severe iodine deficiency in pregnant Ethiopian women: a cross-sectional study in rural Sidama, southern Ethiopia.

BACKGROUND: Maternal iodine nutrition during pregnancy is critical and deficiency during this period may compromise optimal fetal development. OBJECTIVE: To determine iodine status and knowledge of iodine deficiency disorders (IDD) of pregnant women in rural Sidama, southern Ethiopia. METHODS: A cross-sectional community-based study was conducted in three kebeles which were selected randomly from the eight kebeles in the study area using probability proportional to size methods. Data were collected in January, 2009, from 172 pregnant women. Main outcome measures were urinary iodine concentration (UIC), % of population with UIC < 20 microg/L, % of households using iodized salt, iodine content of salt and total goiter rate (TGR). RESULTS: Median UIC was only 15 microg/L compared to the 150 microg/L minimum recommendation from WHO/UNICEF/ ICCIDD for pregnant women. The UIC of 60% of the women was < 20 microg/L. More than 90% of households were not using iodized salt and median salt iodine content was almost zero compared to the recommended 15-40 mg/kg. TGR was 49% (95% CI: 42, 56) which is much higher than the 5% TGR cut-off signifying a problem of public health significance. In addition, > 90% of participants didn't know about IDD, about the cause of goiter or why iodized salt is important. CONCLUSION: Results indicated the presence of severe iodine deficiency in the study population; urgent intervention, through universal salt iodization, and iodine supplementation to high risk groups is required.

Iodine status and fish intake of Sudanese schoolchildren living in the Red Sea and White Nile regions.

OBJECTIVE: To investigate iodine status and fish consumption of schoolchildren living in the Red Sea and White Nile regions of Sudan. DESIGN: Cross-sectional study to determine urinary iodine concentration, visible goitre rate, iodine content of salt and fish consumption. SETTING: Port Sudan (Red Sea) and Jabal Awliya (White Nile), Sudan. SUBJECTS: Two hundred eighty (n 280) children aged 6-12 years (142 boys, 138 girls). RESULTS: The median urinary iodine concentration in children from Port Sudan and Jabal Awliya was 553 and 160 µg/l, respectively. Goitre was detected in 17.1 % of children from Port Sudan but only in 1.4 % from Jabal Awliya, The salt samples from Port Sudan contained 150-360 mg iodine (KOI3)/kg salt, whereas those from Jabal Awliya had levels below the detection limit. Despite consuming salt devoid of iodine, children from Jabal Awliya had optimal iodine status. It is plausible that consumption of Nile fish from Jabal Awliya Reservoir, which is a good source of iodine and favoured by the locals, might have provided sufficient iodine. In contrast, children from Port Sudan were at higher risk of iodine-induced hyperthyroidism resulting from consumption of excessively iodised salt. CONCLUSIONS: The findings of the study clearly demonstrated that (i) Sudan still has a problem with iodine nutrition and quality control and monitoring of salt iodisation and (ii) including fish in the diet could provide a sufficient amount of iodine for schoolchildren.

Geographical distribution of drinking-water with high iodine level and association between high iodine level in drinking-water and goitre: a Chinese national investigation.

Excessive iodine intake can cause thyroid function disorders as can be caused by iodine deficiency. There are many people residing in areas with high iodine levels in drinking-water in China. The main aim of the present study was to map the geographical distribution of drinking-water with high iodine level in China and to determine the relationship between high iodine level in drinking-water and goitre prevalence. Iodine in drinking-water was measured in 1978 towns of eleven provinces in China, with a total of 28,857 water samples. We randomly selected children of 8-10 years old, examined the presence of goitre and measured their urinary iodine in 299 towns of nine provinces. Of the 1978 towns studied, 488 had iodine levels between 150 and 300 µg/l in drinking-water, and in 246 towns, the iodine level was >300 µg/l. These towns are mainly distributed along the original Yellow River flood areas, the second largest river in China. Of the 56 751 children examined, goitre prevalence was 6.3 % in the areas with drinking-water iodine levels of 150-300 µg/l and 11.0 % in the areas with drinking-water iodine >300 µg/l. Goitre prevalence increased with water and urinary iodine levels. For children with urinary iodine >1500 µg/l, goitre prevalence was 3.69 times higher than that for those with urinary iodine levels of 100-199 µg/l. The present study suggests that drinking-water with high iodine levels is distributed in eleven provinces of China. Goitre becomes more prevalent with the increase in iodine level in drinking-water. Therefore, it becomes important to prevent goitre through stopping the provision of iodised salt and providing normal drinking-water iodine through pipelines in these areas in China.

High (but not low) urinary iodine excretion is predicted by iodine excretion levels from five years ago.

BACKGROUND: It has not been investigated whether there are associations between urinary iodine (UI) excretion measurements some years apart, nor whether such an association remains after adjustment for nutritional habits. The aim of the present study was to investigate the relation between iodine-creatinine ratio (ICR) at two measuring points 5 years apart. METHODS: Data from 2,659 individuals from the Study of Health in Pomerania were analyzed. Analysis of covariance and Poisson regressions were used to associate baseline with follow-up ICR. RESULTS: Baseline ICR was associated with follow-up ICR. Particularly, baseline ICR >300 µg/g was related to an ICR >300 µg/g at follow-up (relative risk, RR: 2.20; p < 0.001). The association was stronger in males (RR: 2.64; p < 0.001) than in females (RR: 1.64; p = 0.007). In contrast, baseline ICR <100 µg/g was only associated with an ICR <100 µg/g at follow-up in males when considering unadjusted ICR. CONCLUSIONS: We detected only a weak correlation with respect to low ICR. Studies assessing iodine status in a population should take into account that an individual with a low UI excretion in one measurement is not necessarily permanently iodine deficient. On the other hand, current high ICR could have been predicted by high ICR 5 years ago.

The goiter prevalence and urinary iodine levels among adolescents.

Endemic goiter and iodine deficiency are among the worldwide major public health problems of today. We aimed to research the goiter prevalence and the urinary iodine level of school children. In this descriptive study, 1,847 school children in Konya aged between 10 and 18 years were included. Urinary iodine level was measured. The mean value of iodine excretion in urine was 198 +/- 46.61 microg/L. In 40 students (2.2%), the urinary iodine level was < 100 microg/L. Six of these students (0.3%) had moderate iodine deficiency. Thyroid hyperplasia was found with palpation method in 128 students (6.9%). Ultrasonographically, five female students had solid nodule, and one male student had multiple nodules. In our study, no severe iodine deficiency was found. According to the results of our study, the mandatory iodization program in Konya has been conducted successfully.

Relationship between urinary iodine and goiter prevalence: results of the Chinese national iodine deficiency disorders survey.

BACKGROUND: In 1984, Yu Zhiheng proposed the "U-curve" regularity between urinary iodine (UI) and goiter prevalence (GP). However, along with the adjustment of salt iodine and iodine deficiency disorders (IDD), and surveys followed, some defects were found in the research. As a result, it is time to test and enrich the theory as a series of large sample survey data from China would be helpful. AIM: To test and enrich the theory of "U-curve" relationship between UI and GP. SUBJECTS AND METHODS: Based on the Chinese national IDD surveys (1999, 2002, 2005), the High Water Iodine survey of 2005, and the High Risk endemias survey of 2007, this article analyzed the relationship between UI and GP. The UI was grouped according to the World Health Organization (WHO) standard, self-defined (5 microg/l), and Yu Zhiheng's level, separately, the GP was calculated for population with different UI level, the tendency curve was drawn and the fitting curve model was estimated by SPSS. RESULTS: For the 2005 Chinese national survey and 2005 High Water Iodine survey, we finally got the fitting curves and corresponding UI reference limits. CONCLUSIONS: The UI and GP formed a "U curve" relationship. It varied with some reasons and fell into an accurate U shape step by step. For High Water Iodine endemias survey, the relationship changed to "power curve". Regarding the WHO recommended GP<5%, the UI range of school-age children in normal district should be 110-315 microg/l, whereas, in high water iodine district should be <80 microg/l.

Association between serum ferritin and goitre in Iranian school children.

Despite long-standing supplementation of iodine in Iran, the prevalence of goitre among general people remains high in some regions. The study investigated the role of iron status in the aetiology of goitre in school children in Isfahan, Iran. Two thousand three hundred and thirty-one school children were selected by multi-stage random sampling. Thyroid size was estimated by inspection and palpation. Urinary iodine concentration (UIC) and serum ferritin (SF) were measured. Overall, 32.9% of the children had goitre. The median UIC was 195.5 microg/L. The mean +/- SD of SF in the goitrous and non-goitrous children was 47.65 +/- 42.51 and 44.55 +/- 37.07 microg/L respectively (p=0.52). The prevalence of iron deficiency in goitrous and non-goitrous children was 9.6% and 3.1% respectively (p=0.007). Goitre is still prevalent in school children of Isfahan. However, their median UIC was well in the accepted range. Iron deficiency is associated with goitre in a small group of goitrous children. The role of goitrogens should also be investigated in this region.

[Influence of iodine saturation on thyreopathy incidence in selected regions of the Czech Republic]. / Vliv saturace jódem na výskyt tyreopatií ve vybraných regionech u dospelé populace Ceské republiky.

Thyreopathy--a disorder of thyroid gland--is, together with diabetes, one of the most common endocrine diseases and, similarly to other endocrinopathies, higher prevalence is seen in women than in men. When eliminating iodine deficiency, it should to be taken into account that the mean ioduria in the general population reaches 100-200 microg/l, just 1.3% of the population does not reach ioduria of 50 microg/l and the prevalence of goitre in school children declines below 5%. The 1991 and 1997 period was a period of slight iodine deficiency (ioduria < 100 microg/I) and was followed, between 1998 and 2006, by a period of optimum iodine saturation (ioduria > 100 microg/l). Median ioduria observed over one year follow up differed in different age groups, highest values were seen in the 18-35 age group and declined with age. Median iodinuria depended on the year of follow up, age and gender (p < 0.0000). Thyroid gland hypofunction was more frequent in women and ioduria levels > 100 microg/I, thyroid gland hyperfunction was also more frequent in women but with ioduria levels < 100 microg/l. Hypofunction, subclinical hypofunction, hyperfunction and subclinical hyperfunction were more frequent in women. Of unexplained laboratory findings, isolated hypothyroxinemia was more frequent in women and isolated hyperthyroxinemia was more frequent in men. Euthyreosis was more frequent in men than women.

Iodine status of pregnant women from central Poland ten years after introduction of iodine prophylaxis programme.

INTRODUCTION: Until 1997, Poland was one of the European countries suffering from mild/moderate iodine deficiency. In 1997, a national iodine prophylaxis programme was implemented based on mandatory iodisation of household salt with 30 ± 10 mg KI/kg salt, obligatory iodisation of neonatal formula with 10 µg KI/100 mL and voluntary supplementation of pregnant and breast-feeding women with additional 100-150 µg of iodine. Our aim in this study was to evaluate the iodine status of pregnant women ten years after iodine prophylaxis was introduced. MATERIAL AND METHODS: A cross-sectional study was undertaken in 100 healthy pregnant women between the fifth and the 38th week of gestation with normal thyroid function, singleton pregnancy, normal course of gestation, without drugs known to influence thyroid function except iodine. Serum TSH, fT(4), fT(3), thyroglobulin (TG), anti-peroxidase antibodies (TPO-Ab), anti-thyroglobulin antibodies (TGAb) and urinary iodine concentration (UIC) were determined. Thyroid volume and structure were evaluated by ultrasonography. RESULTS: Fifty nine per cent of studied pregnant women had a diet rich with iodine carriers and 35% obtained iodine supplements. Twenty eight per cent appeared to have a goitre: 11 diffuse and 17 a nodular one, median goitre volume was 18.7 mL (range 6.8-29.0 mL). Median UIC was 112.6 µg/L (range 36.3-290.3 µg/L), only 28% of women had UIC ≥ 150 µg/L. Median UIC was significantly higher in the group receiving iodine supplements than in the group without iodine supplements: 146.9 µg/L v. 97.3 µg/L respectively, p 〈 0.001. Serum TSH, fT(3) and fT(3)/fT(4) molar ratio increased significantly during pregnancy while fT(4) declined. Median serum TG was normal: 18.3 ng/mL (range 0.4-300.0 ng/mL) and did not differ between trimesters. Neonatal TSH performed on the third day of life as a neonatal screening test for hypothyroidism was normal in each case: median value was 1.49 mIU/L (range 0.01-7.2 mIU/L). Less than 3% (2 out of 68) of results were 〉 5 mIU/L. CONCLUSION: Iodine supplements with 150 µg of iodine should be prescribed for each healthy pregnant woman according to the assumptions of Polish iodine prophylaxis programme to obtain adequate iodine supply. (Pol J Endocrinol 2010; 61 (6): 646-651).

A national study of iodine status in Albania.

OBJECTIVE: The aim of the study was to determine the iodine status in Albania following 11 yr of iodine prophylaxis and to evaluate factors influencing the outcome. DESIGN: Eight hundred and forty children, aged 6-13 yr, living in 4 different regions and 365 pregnant women living in the same areas, were enrolled for the study. The prevalence of goiter was assessed by palpation and ultrasound imaging and the urinary iodine and the iodine concentration in the salt of different commercial brands were evaluated. Presence of goiter in the family and their eating habits were also investigated as well as the use of iodized salt in the household. MAIN OUTCOME: In children, the prevalence of goiter was 57.6% by palpation and 24.4% by ultrasound imaging. Median urinary iodine was 86.2 microg/l, with pronounced geographical variations (range 3.52-1079 microg/l). In particular, 29.1% of the children had urinary iodine <50 microg/l and 57.1% <100 microg/l. In pregnant women, the median urinary iodine was 85 microg/l. Median iodine concentration in household iodized salt was 21.2 mg/kg, with 60.3% of the brands being adequately and 39.7% non-adequately iodized. Almost all families (99.6%) claimed to use iodized salt. CONCLUSION: Despite the introduction of iodine prophylaxis, there is still a mild iodine deficiency in Albania, particularly in the inner mountainous areas.

Goiter Prevalence and Interrelated Components from Coastal Karnataka.

OBJECTIVE: To assess prevalence of goiter and associated factors among school going children in Udupi district. METHODS: A school based cross-sectional survey was conducted among 6-12 year old children. A sample of 30 villages was selected from the entire district by probability proportionate to size. One school was then randomly selected from each of the 30 villages. Goiter was assessed clinically and was graded as per the recommended criteria of World Health Organization (WHO)/ United Nations Children's Fund (UNICEF)/ International Council for the Control of Iodine Deficiency Disorders (ICCIDD). Salt and urine samples were collected from a subsample for iodine estimation. RESULTS: A total of 2703 children were examined. The mean (±SD) age of the participants was 9.6 y (±1.9). The overall prevalence of goiter in Udupi district was found to be 9.3% with 7.0% and 2.3% having grade 1 and grade 2 goiter respectively. Prevalence of goiter was significantly higher among females [153(11.1%)] as compared to males [98(7.4%)] (p = 0.001). Of the 543 salt samples analyzed, 379 (69.8%) salt samples had adequate salt iodine content (> 15 ppm); while among the children with goiter 32 (8.4%) had inadequate salt iodine. Median iodine value was 202.12 mcg/l among the 270 urine samples tested for iodine levels. CONCLUSION: Goiter prevalence at 9.3% in the coastal district contributes to the endemicity of the public health problem. The district had adequate iodine nutrition based on median urinary iodine levels. Hence, other contributing factors for the persistence of endemic goiter need to be explored.