The role of thiocyanate in the etiology of goiter in an industrial metropolitan area

Objective: Thiocyanate (SCN−) has concentration dependent antithyroid properties and a role in the etiology of goiter has been suggested in several studies. In 1991 an epidemiological survey conducted in the region of Halle/Leipzig (Saxony), an area with significant air pollution, suggested an inverse relationship between urinary iodine (I−)/SCN− excretion and goiter prevalence. 10 years later, we reinvestigated the same industrial area to clarify if the situation has changed after the elimination of most industrial waste products and moreover, if SCN− excretion levels alone or in combination with air pollution or smoking as a SCN− source are critical for thyroid function. Design and methods: We investigated a cohort of 708 probands for I−, SCN− and creatinine excretion in spot urine samples and determined the prevalence of goiter and thyroid nodules by high resolution ultrasonography. Results: Probands with goiter (n = 79, 11%) had significantly higher urinary SCN− excretions than probands without (3.9 ± 2.8 vs 3.1 ± 3.4 mg SCN−/g creatinine) and significantly lower urinary I−/SCN− ratios than patients without thyroid disorders (41 ± 38 vs 61 ± 71 μg I−/mg SCN−/l). Mean urinary I− excretions were not different between probands with or without goiter. Smokers showed significantly elevated urinary SCN−/creatinine ratios in comparison to non-smokers (4.3 ± 4.3 vs 2.4 ± 2.1 mg SCN−/g creatinine). ANOVA revealed a prediction of thyroid volume through age (P < 0.001), gender (P < 0.001), body weight (P < 0.05) and smoking (P < 0.05). Conclusions: In our investigation, age, gender and smoking (raising SCN− levels by CN− inhalation) were predictive for thyroid volume and the urinary I−/SCN− ratios were able to detect probands with an increased risk of developing goiter in contrast to urinary I− excretion levels alone. These data suggest, that in an era and area of decreased cyanide pollution, SCN− may remain a cofactor in the multifactorial aetiology of goiter.

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Selenium and goiter prevalence in borderline iodine sufficiency

Acta Endocrinologica ◽

10.1530/eje.1.02302 ◽

2006 ◽

Vol 155 (6) ◽

pp. 807-812 ◽

Cited By ~ 31

Author(s):

Volker F H Brauer ◽

Ulrich Schweizer ◽

Josef Köhrle ◽

Ralf Paschke

Keyword(s):

Racial Differences ◽

Dietary Habits ◽

Urinary Iodine ◽

Thyroid Volume ◽

Nodular Goiter ◽

Normal Thyroid ◽

Spot Urine ◽

Glutathione Peroxidases ◽

High Resolution Ultrasonography ◽

Iodine Sufficiency

Design: Selenium (Se) is required for the biosynthesis of selenocysteine-containing proteins. Several selenoenzymes, e.g. glutathione peroxidases and thioredoxin reductases, are expressed in the thyroid. Selenoenzymes of the deiodinase family regulate the levels of thyroid hormones. For clinical investigators, it is difficult to determine the role of Se in the etiology of (nodular-)goiter, because there are considerable variations of Se concentrations in different populations as reflected by dietary habits, bioavailability of Se compounds, and racial differences. Moreover, most previous clinical trials which investigated the influence of Se on thyroid volume harbored a bias due to the coexistence of severe iodine deficiency in the study populations. Methods: Therefore, we investigated the influence of Se on thyroid volume in an area with borderline iodine sufficiency. First, we investigated randomly selected probands for urinary iodine (UI) and creatinine excretion in spot urine samples and determined the prevalence of goiter and thyroid nodules by high-resolution ultrasonography. After this, we determined urinary Se excretion (USe) in probands with goiter as well as in matched probands without goiter. Adjustments between the two compared groups were made for age, gender, history of thyroid disorders, smoking, and UI excretion. Results: The mean USe and UI rates of all 172 probands were 24 μg Se/l or 27 μg Se/g creatinine and 96 μg I/l or 113 μg I/g creatinine indicating borderline selenium (20–200 μg/l) and iodine (100–200 μg/l) sufficiency of the study population. Probands with goiter (n=89) showed significantly higher USe levels than probands with normal thyroid volume (n=83; P < 0.05). USe rates were not influenced by present smoking or pregnancy. Conclusions: In our investigation, USe was not an independent risk factor for the development of goiter. The higher USe in probands with goiter in comparison with probands with normal thyroid volume is most likely a coincidence. Se does not significantly influence thyroid volume in borderline iodine sufficiency because the iodine status is most likely the more important determinant.

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

Acta Endocrinologica ◽

10.1530/acta.0.1290497 ◽

1993 ◽

Vol 129 (6) ◽

pp. 497-500 ◽

Cited By ~ 16

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.

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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

Acta Endocrinologica ◽

10.1530/eje.0.1430727 ◽

2000 ◽

pp. 727-731 ◽

Cited By ~ 62

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.

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Association of selenium with thyroid volume and echostructure in 35- to 60-year-old French adults

Acta Endocrinologica ◽

10.1530/eje.0.1480309 ◽

2003 ◽

pp. 309-315 ◽

Cited By ~ 86

Author(s):

H Derumeaux ◽

P Valeix ◽

K Castetbon ◽

M Bensimon ◽

MC Boutron-Ruault ◽

...

Keyword(s):

Alcohol Consumption ◽

Menopausal Status ◽

Thyroid Tissue ◽

Urinary Iodine ◽

Thyroid Volume ◽

Alpha Tocopherol ◽

Inverse Association ◽

Selenium Status ◽

Cross Sectional ◽

Increased Risk

OBJECTIVE: To investigate the relationship between selenium status, thyroid Volume and gland echostructure. DESIGN: Cross-sectional. METHODS: In 792 men (45-60 Years) and 1108 women (35-60 Years) from the SU.VI.MAX study, thyroid Volume and gland echostructure were determined ultrasonographically. At baseline, thyrotropin, free thyroxine, selenium, zinc, alpha-tocopherol, beta-carotene, retinol, urinary iodine and thiocyanate concentrations were measured. Alcohol consumption, smoking, and menopausal status were assessed by a questionnaire. A stepwise linear and a logistic regression model were used, adjusting for antioxidant vitamins, trace elements status and age. RESULTS: In women, there was an inverse association between selenium status and thyroid Volume (P=0.003). A protective effect of selenium against goiter (odds ratio (OR)=0.07, 95% confidence interval (CI)=0.008-0.6) and thyroid tIssue damage (OR=0.2, 95% CI=0.06-0.7) was observed. There was no evidence of an association between menopausal status and other antioxidant elements, thyroid Volume or thyroid hypoechogenicity. Smoking, but not alcohol consumption, was associated with an increased risk of thyroid enlargement in women (OR=3.94, 95% CI=1.64-9.48). No association between thyroid Volume, thyroid structure or selenium was found in men. CONCLUSION: Our findings suggest that selenium may protect against goiter. Selenium was related to thyroid echostructure, suggesting it may also protect against autoimmune thyroid disease.

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

Endocrine Connections ◽

10.1530/ec-19-0568 ◽

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.

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The association of milk and dairy consumption with iodine status in pregnant women in Oporto region

British Journal Of Nutrition ◽

10.1017/s000711452100009x ◽

2021 ◽

pp. 1-9

Author(s):

Pedro Ferreira ◽

Cátia Pinheiro ◽

Cláudia Matta Coelho ◽

Juliana Guimarães ◽

Gonçalo Pereira ◽

...

Keyword(s):

Pregnant Women ◽

Multinomial Logistic Regression ◽

Dairy Product ◽

Urinary Iodine ◽

Urinary Iodine Concentration ◽

Milk Consumption ◽

Iodine Status ◽

Spot Urine ◽

Dairy Consumption ◽

Increased Risk

Abstract The role of milk and dairy products in supplying iodine to pregnant women is unknown in Portugal. The aim of this study was to evaluate the association between milk and dairy product consumption and the iodine status of pregnant women in the IoMum cohort of the Oporto region. Pregnant women were recruited between 10 and 13 weeks of gestation, when they provided a spot urine sample and information on lifestyle and intake of iodine-rich foods. Urinary iodine concentration (UIC) was determined by inductively coupled plasma MS. A total of 468 pregnant women (269 iodine supplement users and 199 non-supplement users) were considered eligible for analysis. Milk (but not yogurt or cheese) intake was positively associated with UIC, in the whole population (P = 0·02) and in the non-supplement users (P = 0·002), but not in the supplement users (P = 0·29). In non-supplement users, adjusted multinomial logistic regression analysis showed that milk consumption <3 times/month was associated with a five times increased risk of having UIC < 50 µg/l when compared with milk consumption ≥2 times/d (OR 5·4; 95 % CI 1·55, 18·78; P = 0·008). The highest UIC was observed in supplement users who reported consuming milk once per d (160 µg/l). Milk, but not yogurt or cheese, was positively associated with iodine status of pregnant women. Despite the observed positive association, daily milk consumption may not be sufficient to ensure adequate iodine intake in this population.

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Trimester-Specific Thyroid Function in Pregnant Women with Different Iodine Statuses

Annals of Nutrition and Metabolism ◽

10.1159/000506276 ◽

2020 ◽

Vol 76 (3) ◽

pp. 165-174

Author(s):

Wenxing Guo ◽

Wei Wang ◽

Ya Jin ◽

Wen Chen ◽

Lu Chen ◽

...

Keyword(s):

Pregnant Women ◽

Thyroid Function ◽

Urinary Iodine ◽

Thyroid Volume ◽

First Trimester ◽

Urinary Iodine Concentration ◽

Free Triiodothyronine ◽

Cross Sectional ◽

Iodine Status ◽

Spot Urine

Objectives: To explore trimester-specific thyroid function changes under different iodine statuses throughout pregnancy. Methods: A cross-sectional study was conducted to assess the pregnancy iodine status, and 2,378 healthy pregnant women covering all 3 trimesters were recruited. Urinary iodine concentration (UIC) was measured by collecting spot urine samples. Blood samples were collected to evaluate thyroid function. Thyroid B-ultrasonography was conducted to measure the thyroid volume (Tvol). Results: The median UIC was 168 μg/L (111–263 μg/L). The UIC, free triiodothyronine (FT3), and free thyroxine (FT4) were significantly decreased as the pregnancy progressed (p < 0.001, p for trend <0.001), while Tvol increased (p < 0.001, p for trend <0.001). Thyrotropin (TSH) was significantly different between the 3 trimesters and showed an upward trend (p < 0.001), but the p for trend was not significant (p for trend = 0.88). After stratification by UIC, there were no significant differences in serum TSH, FT4, or FT3 level between UIC groups. Tvol was significantly higher in the UIC ≥500 μg/L group in the first trimester (β: 2.41, 95% CI: 1.09–3.72, p <0.001), as well as in the 250 ≤ UIC < 500 μg/L group (β: 1.65, 95% CI: 0.61–2.70, p < 0.001) and UIC ≥500 μg/L group (β: 3.35, 95% CI: 1.96–4.74, p < 0.001) in the third trimester. Conclusions: No difference was observed in TSH, FT3, or FT4 among the different iodine status groups throughout pregnancy. Tvol increased as the pregnancy progressed, and it was especially higher in the UIC ≥500 μg/L group in the first and third trimesters.

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Iodine Deficiency and Goiter Prevalence of the Adult Population in Erzurum

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2018.27 ◽

2005 ◽

Vol 48 (1) ◽

pp. 39-42 ◽

Cited By ~ 7

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.

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Nativer 99mTc-Uptake in der Differentialdiagnostik von unauffälliger Schilddrüse, Struma mit Euthyreose und Schilddrüsenautonomie in einem Jodmangelgebiet

Nuklearmedizin ◽

10.1055/s-0038-1629519 ◽

1990 ◽

Vol 29 (03) ◽

pp. 113-119

Author(s):

C. R. Pickardt ◽

K. Horn ◽

G. Bechtner ◽

C. Vaitl ◽

C. M. Kirsch ◽

...

Keyword(s):

Urinary Iodine ◽

Inverse Correlation ◽

Iodine Concentration ◽

Urinary Iodine Excretion ◽

Large Scatter ◽

Spot Urine ◽

Iodine Supply ◽

Iodine Contamination ◽

Iodine Excretion ◽

Overt Hyperthyroidism

Global TcTU was determined in 568 patients without any specific thyroid drug intake - 54 with normal thyroid, 274 with goitre and euthyroidism and 240 with thyroid autonomy. 57 patients with autonomy and overt hyperthyroidism were the only group with TcTU values significantly higher than normals. Common to all groups was a large scatter of the TcTU values. In 332, the effects of individual iodine supply were studied by measuring the iodine concentration in spot urine samples. There was a significant inverse correlation between the TcTU values and the urinary iodine excretion in the groups of normal thyroids and of goitres with euthyroidism. In the group with autonomy an effect of iodine supply could only be seen in cases of greatly increased urinary iodine excretion, resulting in very low TcTU values. Out of 20 patients with autonomy and iodine contamination, only 4 showed overt hyperthyroidism. The large scatter of TcTU values in all groups may be explained by the persistent iodine deficiency as well as by the frequent exposure to unknown amounts of iodine in patients with thyroid disease. Therefore, the spontaneous TcTU alone cannot identify a small group of patients with autonomy and high risk of iodine-induced hyperthyroidism, from a very large group of patients with goitre.

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