Measurement of serum TSH level by ultrasensitive method in inhabitants of endemic goiter area supplied with iodized salt for 25 years.

Recently, we surveyed thyroid function and TSH concentration of villagers in an endemic goiter area where iodized salt had been supplied for 25 years; it was found that the serum FT3 and TSH levels determined with immunoradiometric analysis (IRMA) were higher and the FT4 level was lower than that of the controls. It was shown that the inhabitants of the endemic goiter area had subclinical hypothyroidism based on the "ultrasensitive" method for TSH assay. We suggest that the best biochemical techniques for monitoring the iodized salt prophylaxis program and the physiological response of the villagers to iodine should be the periodical measurement of serum TSH level using ultrasensitive assay and determination of FT4 level.

Serum TSH, FT3, and FT4 levels in inhabitants of an endemic goiter area in China supplied iodized salt for twenty-five years.

The thyroid function and TSH concentration of villagers in an endemic goiter area in China where iodized salt had been supplied for twenty-five years were surveyed. We found that the serum FT3 and TSH (IRMA) levels of villagers were higher and the FT4 levels was lower than those of the controls, which suggested that the inhabitants of the endemic goiter area had subclinical hypothyroidism based on the ultrasensitive method for TSH assay. Therefore, we suggest that the best biochemical techniques for monitoring the iodized salt prophylaxis program and the physiological response of villagers to iodine are measurements of serum TSH level and FT4 level periodically.

Thyroid function of subjects with goitre and cretinism in an endemic goitre area of rural China after use of iodized salt.

Endemic goitre and cretinism are still a public health problem in China. An epidemiological survey showed that about 5% of the inhabitants in Daxin village, Henan province, had goitre or cretinism after an iodized salt prevention programme had been carried out for two decades. The main food for the inhabitants of this area has an iodine content less than 30 nmol/kg and the water for cooking and drinking has an iodine concentration between 7-12 nmol/l. We studied thyroid function in subjects of this village. There were 42 with grade 0 goitre (males 29, females 13), 42 grade I (males 23, females 19), 27 grade II (males 9, females 18), 31 grade III (males 14, females 17) and 34 cretinism patients (males 30, females 4) diagnosed and classified according to WHO criteria. Serum T4, free T4, T3, free T3, T3 uptake, TSH and thyroglobulin were measured in these subjects. The patients with goitre or cretinism had significantly decreased serum free T4 and increased serum T3 and free T3 levels compared with those of controls. Thyroid size was positively correlated with age and serum thyroglobulin concentrations. Serum thyroglobulin was significantly increased even in the grade 0 goitre subjects. The percentages of subjects with serum free T4 less than 12 nmol/l, T3 greater than 2.5 nmol/l, free T3 greater than 5.2 pmol/l, TSH greater than 3.5 mU/l, T3/T4 ratio greater than 0.03 and free T3/free T4 ratio greater than 0.36 were significantly higher among goitre and cretinism patients than among controls. The data suggest that there is partial compensation for a marginal deficiency of iodine in the inhabitants of this village.