scholarly journals Thyroid ultrasound compared with World Health Organization 1960 and 1994 palpation criteria for determination of goiter prevalence in regions of mild and severe iodine deficiency

2000 ◽  
pp. 727-731 ◽  
Author(s):  
M Zimmermann ◽  
A Saad ◽  
S Hess ◽  
T Torresani ◽  
N Chaouki
Keyword(s):  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Thyroid Volume ◽  
Classification Systems ◽  
World Health ◽  
Urinary Iodine Concentration ◽  
Thyroid Ultrasound ◽  
Iodine Deficiency Disorders ◽  
Goiter Prevalence

OBJECTIVES: In 1994, WHO/International Council for the Control of Iodine Deficiency Disorders recommended replacing the WHO 1960 four-grade goiter classification with a simplified two-grade system. The effect of this change in criteria on the estimation of goiter prevalence in field studies is unclear. In areas of mild iodine deficiency disorders (IDD) where goiters are small, ultrasound is preferable to palpation to estimate goiter prevalence. However, in areas of moderate to severe IDD, goiter screening by palpation may be an acceptable alternative to thyroid ultrasound. To address these two issues, we compared WHO 1960 and 1994 criteria with thyroid ultrasound for determination of goiter prevalence in areas of mild and severe IDD in Morocco. DESIGN: A cross-sectional study of 400 six- to 13-year-old children from two mountain villages (Ait M'hamed and Brikcha) in rural Morocco was carried out. METHODS: Urinary iodine concentration (UI), whole blood TSH and serum thyroxine were measured. Thyroid size was graded by inspection and palpation by two examiners using both WHO 1960 and 1994 criteria. Thyroid volume was determined by ultrasound. Variation between examiners and examination methods was assessed. Sensitivity and specificity of the two classification systems compared with ultrasound were calculated. RESULTS: Median UIs in Ait M'hamed and Brikcha were 183 and 24 microg/l respectively. In Ait M'hamed, using 1960 and 1994 criteria, goiter prevalence was 21 and 26% respectively, compared with 13% by ultrasound. In Brikcha, with 1960 and 1994 criteria, goiter prevalence was 64 and 67% respectively, compared with 64% by ultrasound. Agreement between observers was better with the 1994 criteria than with the 1960 criteria in Ait M'hamed (kappa=0.53 and 0.47 respectively), while in Brikcha observer agreement was similar with the two systems (kappa=0.67). Using either the 1994 or 1960 criteria, agreement with ultrasound was only moderate in Ait M'hamed (kappa=0.41-0.44), but good in Brikcha (kappa=0.55-0.64). Overall, compared with ultrasound, sensitivity increased 3-4% using 1994 criteria, while specificity decreased 4-5%. CONCLUSIONS: The WHO 1994 criteria are simpler to use than the 1960 criteria and provide increased sensitivity with only a small reduction in specificity. Agreement between observers is better with the 1994 criteria than with the 1960 criteria, particularly in areas of mild IDD. Like the 1960 criteria, the 1994 criteria overestimate goiter prevalence in areas of mild IDD, compared with ultrasound. However, the 1994 palpation criteria provide an accurate estimate of goiter prevalence in areas of severe IDD, and may be an acceptable and affordable alternative to thyroid ultrasound in these areas.

scholarly journals Thyroid volumes in a national sample of iodine-sufficient swiss school children: comparison with the World Health Organization/International Council for the control of iodine deficiency disorders normative thyroid volume criteria

2000 ◽  
pp. 599-603 ◽  
Author(s):  
SY Hess ◽  
MB Zimmermann
Keyword(s):  
Iodine Deficiency ◽  
Reference Data ◽  
Urinary Iodine ◽  
Thyroid Volume ◽  
Iodine Concentration ◽  
National Sample ◽  
World Health ◽  
Normative Values ◽  
Urinary Iodine Concentration ◽  
Iodine Deficiency Disorders

OBJECTIVE: The determination of goiter prevalence in children by thyroid ultrasound is an important tool for assessing iodine deficiency disorders. The current World Health Organization/International Council for the Control of Iodine Deficiency Disorders (WHO/ICCIDD) normative values, based on thyroid volume in iodine-sufficient European children, have recently been questioned, as thyroid volumes in iodine-sufficient children from the USA and Malaysia are smaller than the WHO/ICCIDD reference data. Our objective was to describe ultrasonographic thyroid volumes in a representative national sample of iodine-sufficient Swiss school children, and to compare these with the current reference data for thyroid volume. DESIGN AND METHODS: A 3-stage, probability proportionate-to-size cluster sampling method was used to obtain a representative national sample of 600 Swiss children aged 6-12 years. The following data were collected: thyroid size by ultrasound, urinary iodine concentration, weight, height, sex and age. RESULTS: The median urinary iodine concentration (range) of the children was 115 microgram/l (5-413). Application of the WHO/ICCIDD thyroid volume references to the Swiss children resulted in a prevalence of 0%, using either age/sex-specific or body surface area (BSA)/sex-specific cut-off values. Upper limits of normal (97th percentile) of thyroid volume from Swiss children calculated using BSA, sex and age were similar to those reported in iodine-sufficient children in the USA, but were 20-56% lower than the corresponding WHO/ICCIDD references. CONCLUSIONS: Swiss children had smaller thyroids than the European children on which the WHO/ICCIDD references are based, perhaps due to a residual effect of a recent past history of iodine deficiency in many European regions. However, there were sharp differences between our data and a recent set of thyroid volume data in Swiss children produced by the operator and equipment that generated the WHO/ICCIDD reference data. This suggests that interobserver and/or interequipment variability may contribute to the current disagreement on normative values for thyroid size by ultrasound in iodine-sufficient children.

scholarly journals Iodine Deficiency and Goiter Prevalence of the Adult Population in Erzurum

2005 ◽  
Vol 48 (1) ◽  
pp. 39-42 ◽  
Author(s):  
Ersin Akarsu ◽  
Güngör Akçay ◽  
Ilyas Çapoğlu ◽  
Necdet Ünüvar
Keyword(s):  
Iodine Deficiency ◽  
Adult Population ◽  
National Level ◽  
Urinary Iodine ◽  
Thyroid Volume ◽  
Well Being ◽  
Iodine Concentration ◽  
Etiologic Factor ◽  
Urinary Iodine Concentration ◽  
Goiter Prevalence

It is believed that total goiter prevalence in Turkey is as high as 30.5%. The iodine deficiency is the distinct etiologic factor in the development of goiter. The aim of this study was to determine goiter prevalence and iodine deficiency in adults living in Erzurum (1659 m above sea level) for at least 10 year. The study involved 340 people (192 females, 148 males). The median age was 38.5 year (ranging from 20 to 76 years). Ultrasound-measured thyroid volume (TV) for men (TV > 25 ml) and for women (TV > 18 ml) was considered goiter indicator. By this evaluation, goiter was diagnosed in 94 (27.6 %) cases, whereas the goiter prevalence, based on the palpation method, was 5.6%. Urinary iodine concentration (UIC) was measured by ammonium persulfate method. UIC in subjects with goiter was significantly lower than that of the others (median values 5.0 vs 7.8 μg/dl, p < 0.0001). While the value of UIC ≥ 10 μg/dl (no. 121, 36.6%) was accepted normal, the extent of iodine deficiency in other subjects was classified as severe (UIC < 2.0 μg/dl, no.53, 15.6%), moderate (UIC = 2.0–4.9 μg/dl, no.75, 22%) and mild (UIC = 5.0–9.9 μg/dl, no.91, 26.8%). TV values were found to be significantly different among the four groups (p < 0.05). TV values were significantly correlated with body surface area and UIC (r = 0.15 and r = -0.16, respectively, p < 0.005). Also, the prevalence of thyroid nodules was estimated as 2.1% by palpation and 18% by ultrasonography. We conclude that goiter originating from iodine deficiency has been an important health problem in Erzurum. Besides taking measures at national level, local factors and risks which interfere with the nationwide efforts should also be dealt with for the eradication of the iodine deficiency problem. In the region, periodical evaluation of iodine level and iodine related disorders will guide the measures to be taken for the well being of people’s general health.

scholarly journals Evaluating of significance of thyroglobulin (Tg) level in blood as a biomarker of iodine deficiency disorders severity in Uzbekistan

2017 ◽  
Vol 13 (1) ◽  
pp. 20-25 ◽  
Author(s):  
Saydiganikhodja I. Ismailov ◽  
Murod M. Rashitov ◽  
Nusrat A. Alimdjanov ◽  
Kamil K. Uzbekov ◽  
Muhammadjon Kh. Vakkasov ◽  
...  
Keyword(s):  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Iodine Concentration ◽  
Urinary Iodine Concentration ◽  
International Studies ◽  
Iodine Deficiency Disorders ◽  
Goiter Prevalence ◽  
Diffuse Goiter ◽  
Thyroglobulin Level ◽  
Thyroglobulin Concentration

Iodine deficiency has serious adverse effects on growth and development of humans, such as mental impairment. It is known, that thyroglobulin level in blood is promising biomarker that can determine iodine deficiency disorders severity in a given region. The Aim of study: Evaluating of significance of thyroglobulin level in blood as a biomarker of iodine deficiency disorders severity in Uzbekistan.. Materials and Methods: We evaluated thyroglobulin level in blood in schoolchildren of Uzbekistan. In this purpose we studied 366 schoolchildren in 8-12 age group, of that 163 boys and 203 girls living in Tashkent city, Fergana, Samarkand, Bukhara, Kashkadarya, Khoresm and Republic of Karakalpakistan. Such parameters as urinary iodine concentration, diffuse goiter plasma TSH, fT4 were analyzed too. Results: Diffuse goiter prevalence was 27 % among children, the overall mean thyroglobulin concentration was 12,8 ± 10.4 ng/ml, the overall median urinary iodine concentration (UIC) was 120.27 μg/L indicating iodine sufficiency. Plasma TSH was 2.75 ± 1.69 mIU/l and plasma fТ4 14.48 ± 3,96 pmol/l.  Thyroglobulin level depended on goiter size, so that in children without goiter (grade 0) mean thyroglobulin concentration was 11,9 ± 7.9 ng/ml, in children with goiter grade 1 mean thyroglobulin concentration was 14,24 ± 13.5 ng/ml and in children with goiter grade 2 mean thyroglobulin concentration was 18,82±18,3 ng/ml. Overall mean thyroglobulin concentration of goitrous children (grade 1 and 2) was 16,4±10,5 ng/ml. Conclusions: Though international studies in school-aged children showed that iodine-sufficient children typically had a median Tg <13 ng/ml, our investigation showed that while study group’s  UIC was 120.27 μg/L and overall mean thyroglobulin concentration was 12,8 ± 10.4 ng/ml, that is equal to median thyroglobulin concentration – 11,73 ng/ml, 39% of children in this group still have UIC below 100 μg/L.

Iodized salt prophylaxis of endemic goiter: an experience in Toscana (Italy)

1993 ◽  
Vol 129 (6) ◽  
pp. 497-500 ◽  
Author(s):  
F Aghini-Lombardi ◽  
A Pinchera ◽  
L Antonangeli ◽  
T Rago ◽  
GF Fenzi ◽  
...  
Keyword(s):  
Iodine Deficiency ◽  
Endemic Goiter ◽  
Urinary Iodine ◽  
Thyroid Volume ◽  
Iodized Salt ◽  
Urinary Iodine Excretion ◽  
Goiter Prevalence ◽  
Iodine Excretion ◽  
Health Organization ◽  
Legislative Measures

It is well established that iodine supplementation is effective in correcting iodine deficiency and reducing goiter prevalence. In Italy, legislation has allowed the production of iodized salt since 1972, but its consumption is on a voluntary basis. In the present study, the efficacy of legislative measures that made compulsory the availability of iodized salt in foodstores has been evaluated. Urinary iodine excretion and thyroid size, scored according to Pan American Health Organization recommendations, were determined prior to (1981) and 10 years after (1991) the introduction of legislative measures in the whole schoolchildren population residing in a restricted area of the Tuscan Appennines. Moreover, in 1991, thyroid volume was determined by ultrasonography. In 1981, mean urinary iodine excretion was 47.1±22.4 mg/kg creatinine (0.412 μmol/l) and goiter prevalence was 60%, indicating a moderate iodine deficiency. Eighty of the families subsequently used iodized salt on a regular basis; as a result of this excellent compliance, in 1991 the mean urinary iodine excretion increased to 129.7±73 mg/kg creatinine (1.24 μmol/l) and goiter prevalence dropped to 8.1%. The results of this study underline the effectiveness of iodine prophylaxis in correcting iodine deficiency and abating endemic goiter in schoolchildren, and suggest that implementation of measures that make compulsory the availability of iodized salt in foodstores overcomes the fact that there is no law governing the exclusive production and trading of iodized salt.

Study of Urinary Iodine Level Assessment and its Relation to Thyroid Function during Pregnancy

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Magda Shoukry Mohamed ◽  
Merhan Samy Nasr ◽  
Salah Hussien El-Halawany ◽  
Ahmed Mohamed Abbas ◽  
Salma Said Hassan Tayeh
Keyword(s):  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Thyroid Volume ◽  
Significant Negative Correlation ◽  
Iodine Deficiency Disorders ◽  
Iodine Excess ◽  
Salt Iodization ◽  
Excess Iodine ◽  
Iodine Supplementation ◽  
Iodine Level

Abstract Background The global effort to prevent iodine deficiency disorders through iodine supplementation, such as universal salt iodization, has achieved impressive progress during the last few decades. However, iodine excess, due to extensive environmental iodine exposure in addition to poor monitoring, is currently a more frequent occurrence than iodine deficiency. Iodine excess is a precipitating environmental factor in the development of autoimmune thyroid disease. Aim of the study to evaluate the urinary iodine level as a marker of iodine status in pregnant women in 3rd trimester and assess its relation to thyroid functions. Patients and Methods This Cross Sectional Study was conducted on 100 subjects with their ages ranging from 18-35 years old, pregnant females, at the third trimester, selected from Obstetric Out- patient Clinic of Ain shams University Hospitals. Samples were collected from participants in cairo, during the Spring and Summer from March to August. Results in our study, there was a significant negative correlation between Urinary Iodine level and TSH as Iodine difficient group has the Highest TSH, and the Highest Thyroid Volume, as there was a significant negative correlation between Urinary Iodine level and Thyroid Volume. Conclusion TSH level and Thyroid Volume were global effort to prevent iodine deficiency disorders through iodine supplementation, such as universal salt iodization, has achieved impressive progress during the last few decades. However, iodine excess, due to extensive environmental iodine exposure in addition to significantly higher in Iodine difficient group than Excess iodine group, And FT4 level was lower in Iodine difficient group than excess iodine group.

Iodine nutrition status of women after 10 years of Lipiodol supplementation: a cross-sectional study in Xinjiang, China

2020 ◽  
pp. 1-13
Author(s):  
Lixiang Liu ◽  
Peng Liu ◽  
Qin Lin ◽  
Xiaohui Su ◽  
Jia Huang ◽  
...  
Keyword(s):  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Thyroid Volume ◽  
Nutrition Status ◽  
Thyroid Peroxidase ◽  
Urinary Iodine Concentration ◽  
Free Triiodothyronine ◽  
Iodine Nutrition ◽  
Detection Rates ◽  
Status Of Women

Abstract This study examined the contribution of long-term use of Lipiodol capsules, as a supplement to iodised salt to the control of iodine deficiency disorders among women in Xinjiang of China. A total of 1220 women across Kashgar, Aksu, Turpan and Yili Prefectures were surveyed in 2017. Lipiodol capsules were administered twice yearly in Kashgar and once yearly in Aksu and Turpan, but not in Yili. Urinary iodine concentration (UIC), free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), thyroglobulin antibody, thyroid peroxidase antibody and thyroid volume values were assessed. All the women in the four areas were in a state of non-iodine deficiency by UIC. The UIC were higher than adequate in Kashgar and Aksu (619·4 v. 278·6 μg/l). Thyroid hormone levels differed significantly in Turpan and Yili (FT3: 4·4 v. 4·6 pmol/l, FT4: 13·8 v. 14·2 pmol/l, TSH: 2·0 v. 2·7 mIU/l), but did not differ significantly in Kashgar, Aksu and Yili. The four areas did not differ significantly with regard to thyroid nodules, autoimmune thyroiditis or goitre. However, the detection rates of subclinical hypothyroidism (16·6 %) and total thyroid dysfunction (25·4 %) were higher among women in Yili. The supplementation with Lipiodol capsules had improved the iodine nutrition status of women in iodine-deficient areas of Xinjiang since 2006. To avoid negative effects of excess iodine, we suggest a gradual discontinuation of Lipiodol capsules in women with special needs based on the existing iodine nutrition level of local women.

scholarly journals The assessment of iodine status – populations, individuals and limitations

2018 ◽  
Vol 56 (1) ◽  
pp. 7-14 ◽  
Author(s):  
Patrick Wainwright ◽  
Paul Cook
Keyword(s):  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Population Level ◽  
Iodine Concentration ◽  
Epidemiological Studies ◽  
Health Concern ◽  
Urinary Iodine Concentration ◽  
Iodine Status ◽  
The Uk

Iodine deficiency is a significant global health concern, and the single greatest cause of preventable cognitive impairment. It is also a growing public health concern in the UK particularly among pregnant women. Biomarkers such as urinary iodine concentration have clear utility in epidemiological studies to investigate population-level iodine status, but determination of iodine status in individuals is much more problematic with current assays. This article reviews the available biomarkers of iodine status and their relative utility at the level of both populations and individuals for the investigation of iodine deficiency and iodine excess.

scholarly journals Assessment of the iodine nutritional status among Chinese school-aged children

2020 ◽  
Vol 9 (5) ◽  
pp. 379-386
Author(s):  
Ning Yao ◽  
Chunbei Zhou ◽  
Jun Xie ◽  
Xinshu Li ◽  
Qianru Zhou ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Urinary Iodine ◽  
Thyroid Volume ◽  
Iodine Content ◽  
Iodine Concentration ◽  
Iodine Intake ◽  
Iodized Salt ◽  
Urinary Iodine Concentration ◽  
School Aged Children ◽  
Goiter Prevalence

Objective The remarkable success of iodine deficiency disorders (IDD) elimination in China has been achieved through a mandatory universal salt iodization (USI) program. The study aims to estimate the relationship between urinary iodine concentration (UIC) and iodine content in edible salt to assess the current iodine nutritional status of school aged children. Methods A total of 5565 students from 26 of 39 districts/counties in Chongqing participated in the study, UIC and iodine content in table salt were measured. Thyroid volumes of 3311 students were examined by ultrasound and goiter prevalence was calculated. Results The overall median UIC of students was 222 μg/L (IQR: 150-313 μg/L). Median UIC was significantly different among groups with non-iodized salt (iodine content <5 mg/kg), inadequately iodized salt (between 5 and 21 mg/kg), adequately iodized (between 21 and 39 mg/kg) and excessively iodized (>39 mg/kg) salt (P < 0.01). The total goiter rate was 1.9% (60/3111) and 6.0% (186/3111) according to Chinese national and WHO reference values, respectively. Thyroid volume and goiter prevalence were not different within the three iodine nutritional status groups (insufficient, adequate and excessive, P > 0.05). Conclusions The efficient implementation of current USI program is able to reduce the goiter prevalence in Chongqing as a low incidence of goiter in school aged children is observed in this study. The widened UIC range of 100–299 μg/L indicating sufficient iodine intake is considered safe with a slim chance of causing goiter or thyroid dysfunction. Further researches were needed to evaluate the applicability of WHO reference in goiter diagnose in Chongqing or identifying more accurate criteria of normal thyroid volume of local students in the future.

scholarly journals High prevalence of iodine deficiency in pregnant women living in adequate iodine area

2018 ◽  
Vol 7 (5) ◽  
pp. 762-767 ◽  
Author(s):  
Verônica Carneiro Borges Mioto ◽  
Ana Carolina de Castro Nassif Gomes Monteiro ◽  
Rosalinda Yossie Asato de Camargo ◽  
Andréia Rodrigues Borel ◽  
Regina Maria Catarino ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Thyroid Volume ◽  
Adverse Outcomes ◽  
Urinary Iodine Concentration ◽  
Serum Thyroglobulin ◽  
Cross Sectional ◽  
Iodine Status

Objectives Iodine deficiency during pregnancy is associated with obstetric and neonatal adverse outcomes. Serum thyroglobulin (sTg) and thyroid volume (TV) are optional tools to urinary iodine concentration (UIC) for defining iodine status. This cross-sectional study aims to evaluate the iodine status of pregnant women living in iodine-adequate area by spot UIC and correlation with sTg, TV and thyroid function. Methods Two hundred and seventy-three pregnant women were evaluated at three trimesters. All had no previous thyroid disease, no iodine supplementation and negative thyroperoxidase and thyroglobulin antibodies. Thyroid function and sTg were measured using electrochemiluminescence immunoassays. TV was determined by ultrasonography; UIC was determined using a modified Sandell–Kolthoff method. Results Median UIC was 146 µg/L, being 52% iodine deficient and only 4% excessive. TSH values were 1.50 ± 0.92, 1.50 ± 0.92 and 1.91 ± 0.96 mIU/L, respectively, in each trimester (P = 0.001). sTg did not change significantly during trimesters with median 11.2 ng/mL and only 3.3% had above 40 ng/mL. Mean TV was 9.3 ± 3.4 mL, which positively correlated with body mass index, but not with sTg. Only 4.5% presented with goitre. When pregnant women were categorized as iodine deficient (UIC < 150 µg/L), adequate (≥150 and <250 µg/L) and excessive (≥250 µg/L), sTg, thyroid hormones and TV at each trimester showed no statistical differences. Conclusions Iodine deficiency was detected frequently in pregnant women living in iodine-adequate area. sTg concentration and TV did not correlate to UIC. Our observation also demonstrated that the Brazilian salt-iodization programme prevents deficiency, but does not maintain iodine status within adequate and recommended ranges for pregnant women.

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