scholarly journals Evolution of thyroid autoimmunity during iodine prophylaxis--the Sri Lankan experience

2003 ◽  
pp. 103-110 ◽  
Author(s):  
G Mazziotti ◽  
LD Premawardhana ◽  
AB Parkes ◽  
H Adams ◽  
PP Smyth ◽  
...  
Keyword(s):  
Thyroid Autoimmunity ◽  
Urinary Iodine ◽  
Thyroid Volume ◽  
Urinary Iodine Excretion ◽  
Thyroid Peroxidase ◽  
Sri Lankan ◽  
Anthropometric Measures ◽  
Thyroid Autoantibody ◽  
Iodine Prophylaxis ◽  
Goitre Prevalence

OBJECTIVE: To study the evolution of thyroid autoimmunity, in relation to the change in goitre prevalence, during 3 Years of iodine prophylaxis in Sri Lanka. METHODS: Two groups of Sri Lankan schoolgirls between the ages of 10.8 and 17.5 Years were studied in 1998 (401 girls) and 2001 (282 girls). A prospective study was performed in 42 schoolgirls who were thyroid autoantibody (Ab)-positive (+ve) in 1998. Anthropometric measures, urinary iodine excretion (UIE), thyroid Volume, free thyroxine, free tri-iodothyronine, TSH, and thyroglobulin (Tg) and thyroid peroxidase (TPO) Ab were evaluated in all 683 girls. RESULTS: Goitre prevalence was significantly lower in 2001 compared with 1998 related to age (2.9% compared with 20.2%) and body surface area (11.6% compared with 40.8%), although UIE was unchanged. Prevalence of thyroid Ab in 2001 was also lower (23.4% compared with 49.9%); among those with the Ab, 34.8% had TgAb alone and 46.9% had a combination of TgAb+TPOAb, compared with 82.0% TgAb alone in 1998. In 2001, subclinical hypothyroidism was more frequent in Ab+ve (6.3%) than Ab-negative girls (1.0%). A cohort of 42 Ab+ve schoolgirls in 1998 (34 with TgAb alone, eight with TgAb+TPOAb) were evaluated again in 2001. Only 10 of them (23.8%) remained Ab+ve (mostly TPOAb+/-TgAb) in 2001. CONCLUSIONS: This study demonstrates that: (1) in 2001, goitre prevalence and thyroid autoimmunity rates were significantly lower than in 1998; (2) the pattern of thyroid Ab was different in the two surveys; (3) in 2001 alone, the occurrence of hypothyroidism was correlated with the presence of thyroid autoimmunity. These results indicate an evolution of thyroid autoimmune markers during the course of iodine prophylaxis, which has not been described before.

scholarly journals NEW DATA ON SUBCLINICAL MANIFESTATIONS OF SIDEROPENIC SYNDROME IN ADOLESCENT GIRLS

2019 ◽  
Vol 22 (4) ◽  
pp. 226-230
Author(s):  
Natalya R. Peretyagina ◽  
E. F. Turovinina
Keyword(s):  
Iron Deficiency ◽  
Adolescent Girls ◽  
Iron Metabolism ◽  
Urinary Iodine ◽  
Significant Risk ◽  
Thyroid Volume ◽  
Significant Risk Factor ◽  
Thyroid Stimulating Hormone ◽  
Urinary Iodine Excretion ◽  
Thyroid Peroxidase

To determine the functional state of the pituitary-thyroid system in conditions of iron deficiency in 371 girls aged 12-17 years was examined. The data of clinical blood tests, biochemical indices of iron metabolism, urinary iodine excretion, thyroid structure, and function are presented. Analysis of the seven-years observation in adolescent girls revealed a significant prevalence of iron deficiency conditions and euthyroid goiter. The iron deficiency in girls was found to increase the risk for euthyroid goiter formation by 10 times. Significant correlations were determined between thyroid volume indices, levels of thyroid-stimulating hormone (TSH), free thyroxine (cT4), the titer of antibodies to thyroid peroxidase (A-TPO) in blood plasma, changes in hemogram and iron metabolism. Violations of thyroid status and iron metabolism are subclinical manifestations of latent iron deficiency in adolescent girls, which are a risk group for the development of iron deficiency conditions. Iron deficiency has been proven to be a significant risk factor for the formation of euthyroid goiter in girls. In iron deficiency conditions in adolescent girls, structural and functional disorders of the thyroid gland should be excluded and its damage should be prevented.

Thyroid volume and goitre prevalence in the elderly as determined by ultrasound and their relationships to laboratory indices

1991 ◽  
Vol 124 (1) ◽  
pp. 12-18 ◽  
Author(s):  
Gerhard Hintze ◽  
Jürgen Windeler ◽  
Jörg Baumert ◽  
Herbert Stein ◽  
Johannes Köbberling
Keyword(s):  
Thyroid Hormone ◽  
Urinary Iodine ◽  
Thyroid Volume ◽  
The Elderly ◽  
Elderly Subjects ◽  
Entire Group ◽  
Urinary Iodine Excretion ◽  
High Prevalence ◽  
Iodine Excretion ◽  
Goitre Prevalence

Abstract. In 569 unselected elderly subjects over 60 years from the general population of an iodine-deficient area, a palpation and an ultrasound investigation of the thyroid were performed. Additionally, thyroid hormone values were determined in 466 of the 569 subjects (81.9%) and urinary iodine excretion in 491 subjects (86.3%). By palpation, no thyroid enlargement was noticed in 302 subjects (54.2%), goitre Ia in 98 (17.6%), goitre lb in 94 (16.9%), goitre II in 53(9.5%), and goitre III in 10(1.8%). The thyroid volumes (medians) by ultrasound were 18.6 ml in the entire group, in women (N=489) 19.2 ml, and in men (N=80) 16.6 ml. One hundred and one subjects had a thyroid nodule (17.6%), 43 persons cystic lesions (7.6%). If, according to the literature, a goitre is defined as a thyroid enlargement of more than 18 ml in women and more than 25 ml in males, a goitre prevalence of 54.2% in females and of 22.5% in males was obtained. The goitre prevalence in the entire group was calculated as 49.7%. Thyroid hormone measurements showed in subjects with goitre a significant lower TSH value (p<0.001) and a higher thyroglobulin value (p<0.001). In summary, the study shows a high prevalence of goitre in elderly subjects, a high prevalence of nodules in these thyroids, a negative correlation of goitre volume with TSH, and a positive correlation of goitre volume with the thyroglobulin concentration.

Earliest prevention of endemic goiter by iodine supplementation during pregnancy

1996 ◽  
Vol 134 (4) ◽  
pp. 443-448 ◽  
Author(s):  
Klaus Peter Liesenkötter ◽  
Wolfgang Göpel ◽  
Ulrich Bogner ◽  
Barbara Stach ◽  
Annette Grüters
Keyword(s):  
Thyroid Function ◽  
Iodine Deficiency ◽  
Endemic Goiter ◽  
Urinary Iodine ◽  
Thyroid Volume ◽  
Urinary Iodine Excretion ◽  
Thyroid Peroxidase ◽  
Iodine Supplementation ◽  
Iodine Excretion ◽  
Maternal Thyroid

Liesenkötter KP, Göpel W, Bogner U, Stach B, Grüters A. Earliest prevention of endemic goiter by iodine supplementation during pregnancy. Eur J Endocrinol 1996;134:443–8. ISSN 0804–4643 During pregnancy complex changes of maternal thyroid function occur and they are influenced by the maternal iodine supply. It has been demonstrated that with decreasing iodine supply maternal goiter and hypothyroxinemia as well as fetal and neonatal hypothyroidism become more prevalent. Therefore iodine supplementation during pregnancy is now strongly recommended also in areas of moderate iodine deficiency. To monitor the success of iodine supplementation and its theoretical risk of increasing the frequency of thyroid autoantibodies, we have investigated the thyroid volume, thyroid function, urinary iodine excretion and antibodies to thyroid peroxidase at 10–12 weeks of gestation and postpartum in 38 mothers receiving 300 μg potassium iodide/day and in 70 mothers without iodine supplementation. In all of their newborns thyroid volume was determined by ultrasound. The thyrotropin (TSH) levels and antibodies to thyroid peroxidase (TPO-ab) in the neonates were measured in dried blood spots on filter paper from their newborn screening. Urinary iodine excretion was increased significantly after iodine supplementation in mothers (p < 0.001) and their newborns (<0.05). No hypo- or hyperthyroidism was observed in the mothers or newborns. Interestingly, no difference of maternal thyroid volumes was observed between the two groups after pregnancy, but the volumes of the thyroid glands in newborns of mothers who received iodine were significantly (p < 0.004) lower (0.7 ± 0.4 ml) than in the control group (1.5 ± 1.1 ml). There was no change in the frequency of TPO-ab in either group after pregnancy. In four mothers transplacental passage of these antibodies was documented by positive measurement in the blood sample of the newborn. This study documents that iodine supplementation during pregnancy in an area of moderate iodine deficiency results in a lower size of neonatal thyroid volume and that this supplementation was not accompanied by an increase in the frequency of TPO-ab. Klaus Peter Liesenkötter, Kinderklinik Kaiserin Auguste Victoria Haus (KAVH), Virchow-Klinikum der Medizinische Fakultät der Humboldt-Universität zu Berlin, Heubnerweg 6, 14059 Berlin, Germany

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.

scholarly journals Impact of removing iodised salt on children's goitre status in areas with excessive iodine in drinking-water

2014 ◽  
Vol 113 (1) ◽  
pp. 114-119 ◽  
Author(s):  
Shengmin Lv ◽  
Dong Xu ◽  
Yuchun Wang ◽  
Zhao Jun ◽  
Lihui Jia ◽  
...  
Keyword(s):  
Urinary Iodine ◽  
Thyroid Volume ◽  
Iodine Content ◽  
Hebei Province ◽  
Age Group ◽  
Iodised Salt ◽  
Excessive Iodine ◽  
Before And After ◽  
Goitre Prevalence ◽  
The Impact

The impact of removing iodised salt on children's goitre status in a high-iodine area (HIA) remains unclear. The aim of the present study was to explore the changes in the prevalence of goitre in children after removing iodised salt from their diet. For this purpose, three towns with the median water iodine content of 150–300 μg/l were selected randomly in Hengshui City, Hebei Province, China. A total of 452 and 459 children were randomly selected from the three towns in order to measure thyroid volume by ultrasound before and after removing iodised salt, respectively. Their goitre status was judged using the criteria of age-specific thyroid volume recommended by the WHO. After removing iodised salt, the overall median urinary iodine content (MUIC) of children decreased from 518 (interquartile range (IQR) 347–735) to 416 (IQR 274–609) μg/l. The MUIC of children across sex and age group decreased significantly except for the age group of 9 years. The overall prevalence of goitre in the three towns significantly decreased from 24·56 % (n 111/452) to 5·88 % (n 27/459) (P< 0·001). Goitre prevalence in children aged 8–10 years decreased from 33·70 % (n 31/92), 23·32 % (n 45/193) and 20·96 % (n 35/167) to 6·10 % (n 10/164), 5·52 % (n 9/163) and 6·06 % (n 8/132), respectively. Goitre prevalence in boys and girls decreased from 27·05 % (n 66/244) and 21·63 % (n 45/208) to 6·66 % (n 15/226) and 5·15 % (n 12/233), respectively. The decreases in the prevalence of goitre in children across sex and age group were all statistically significant. The present study revealed that goitre prevalence in children decreased significantly after removing iodised salt from their diet for about 1·5 years in the HIA in Hebei Province.

scholarly journals Chronic iodine excess does not increase the incidence of hyperthyroidism: a prospective community-based epidemiological survey in China

2007 ◽  
Vol 156 (4) ◽  
pp. 403-408 ◽  
Author(s):  
Fan Yang ◽  
Zhongyan Shan ◽  
Xiaochun Teng ◽  
Yushu Li ◽  
Haixia Guan ◽  
...  
Keyword(s):  
Urinary Iodine ◽  
Iodine Intake ◽  
Urinary Iodine Excretion ◽  
Thyroid Peroxidase ◽  
Community Based ◽  
Iodine Excess ◽  
Iodine Supplementation ◽  
Excessive Iodine ◽  
Iodine Excretion ◽  
Excessive Iodine Intake

Objective: An increasing incidence of hyperthyroidism has been observed when iodine supplementation has been introduced to an iodine-deficient population. Moreover, the influence of chronic more than adequate or excessive iodine intake on the epidemiological features of hyperthyroidism has not been widely and thoroughly described. To investigate the influences of different iodine intake levels on the incidence of hyperthyroidism, we conducted a prospective community-based survey in three communities with mild-deficient, more than adequate (previously mild deficient iodine intake), and excessive iodine intake. Subjects and methods: In three rural Chinese communities, a total of 3761 unselected inhabitants aged above 13 years participated in the original investigation and 3018 of them received identical examinations after 5 years. Thyroid function, levels of thyroid peroxidase antibody (TPOAb), thyroglobulin antibody and urinary iodine excretion were measured and thyroid ultrasound examination was also performed. Results: In three communities, median urinary iodine excretion was 88, 214, and 634 μg/l (P<0.05) respectively. The cumulative incidence of hyperthyroidism was 1.4, 0.9, and 0.8% (P>0.05) respectively. Autoimmune hyperthyroidism was predominant in thyroid hyperfunction in all the three cohorts. Either positive TPOAb (>50 U/ml) or goiter in original healthy participants was associated with the occurrence of unsuspected hyperthyroidism in 5 years (logistic regression, OR=4.2 (95% CI 1.7–8.8) for positive TPOAb, OR=3.1 (95% CI 1.4–6.8) for goiter). Conclusion: Iodine supplementation may not induce an increase in hyperthyroidism in a previously mildly iodine-deficient population. Chronic iodine excess does not apparently increase the risk of autoimmune hyperthyroidism, suggesting that excessive iodine intake may not be an environmental factor involved in the occurrence of autoimmune hyperthyroidism.

Endemic goitre in Senegal—thyroid function etiological factors and treatment with oral iodized oil

1992 ◽  
Vol 126 (2) ◽  
pp. 149-154 ◽  
Author(s):  
John H Lazarus ◽  
Arthur B Parkes ◽  
Rhys John ◽  
Makhtar N'Diaye ◽  
Suzanne G Prysor-Jones
Keyword(s):  
Iodine Deficiency ◽  
Geographical Area ◽  
Urinary Iodine ◽  
Thyroid Peroxidase ◽  
Serum Selenium ◽  
Endemic Goitre ◽  
Iodized Oil ◽  
Short Term ◽  
Etiological Factors ◽  
Goitre Prevalence

Endemic goitre and its response to orally administered iodized oil has been studied in seven villages 25–30 km south of Velingara, Eastern Casamance, Senegal. In 502 adults aged > 15 years goitre prevalence was 62% with 18.2% having goitre grade 2 or 3. Mean free T4 (FT4) was 11.9±3.5 (sd) pmol/l and iodine deficiency was confirmed by noting median urinary I of 0.079 μmol/l (14.9 μmol 1/mol creatinine) with elevated free T3 (FT3)FT4 ratios. Serum selenium concentrations were normal. The response to 480 mg of oral iodized oil assessed at 6 and 12 months was characterized by a 35.8% increase in FT4, a 25% decrease in FT3 and a 50% decrease in TSH (all p<0.01) at 12 months associated with a significant decrease in goitre size measured in 70 persons when compared to 65 controls not receiving iodine. Urinary iodine rose from 0.071 μmol/l to 0.189 μmol/l (p <0.01) during this time and no adverse effects on thyroid antibodies (anti-thyroid peroxidase and anti-thyroglobulin) were observed. A variation in goitre prevalence between villages was noted which, in such a small geographical area, suggests that etiological factors in addition to iodine deficiency may be important in goitre pathogenesis. Oral iodized oil administration is an effective treatment for iodine deficiency goitre in the short term.

scholarly journals Increased prevalence of thyroglobulin antibodies in Sri Lankan schoolgirls--is iodine the cause?

2000 ◽  
pp. 185-188 ◽  
Author(s):  
LD Premawardhana ◽  
AB Parkes ◽  
PP Smyth ◽  
CN Wijeyaratne ◽  
A Jayasinghe ◽  
...  
Keyword(s):  
Iodine Deficiency ◽  
Age Groups ◽  
Thyroid Volume ◽  
Thyroid Peroxidase ◽  
Sri Lankan ◽  
Free T4 ◽  
Thyroglobulin Antibodies ◽  
Age Related ◽  
High Prevalence ◽  
Urine Iodine

OBJECTIVE: Iodine deficiency was the likely cause of a high prevalence of goitre previously in Sri Lankan schoolchildren. Salt iodination was made compulsory in 1993 but there has been no recent study, using modern techniques, of its benefits or harmful effects. METHODS: Three hundred and sixty-seven schoolgirls between the ages of 11 and 16 years had ultrasound thyroid volume, free thyroxine (T4), free tri-iodothyronine (T3), thyrotrophin (TSH), anti-thyroglobulin (TgAb) and thyroid peroxidase (TPOAb) antibodies, and urine iodine concentrations measured. RESULTS: Median ultrasound thyroid volume ranged from 4.8 ml (11-year-old girls) to 8.6 ml (16-year-old girls) with an age-related increase. Median urine iodine concentrations ranged from 105 to 152 microg/l. Free T4 and free T3 were normal in all, but TSH was elevated in four subjects (5. 53-41.29 mU/l). However, the prevalence of TgAb was markedly raised, ranging between 14.3% (11-year-old girls) and 69.7% (16-year-old girls) (P<0.03). In contrast, the prevalence of TPOAb was 10% or less in all age groups. CONCLUSIONS: Normal median thyroid volumes, iodine concentrations and thyroid function would indicate that iodine deficiency is not a major problem in this group. The high prevalence of TgAb, hitherto unreported, most likely reflects excessive iodination of Tg resulting in increased immunogenicity. There is an urgent need to continuously monitor the adequacy and risks of iodination in this population.

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