RESEARCH PAPER
Can thyroid size still be considered as a useful tool for assessing iodine intake?
 
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1
Polish Mother’s Memorial Hospital – Research Institute, Lodz, Poland
 
2
Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Poland
 
3
Department of Pediatric Cardiology and Rheumatology, Medical University of Lodz, Poland
 
4
Department of Oncological Endocrinology, Chair of Oncological Endocrinology, Medical University of Lodz, Poland
 
 
Ann Agric Environ Med. 2015;22(2):301-306
 
KEYWORDS
ABSTRACT
Introduction:
It has always been very difficult to precisely define a goitre. For years, the borderline values have been sought which could be universally used in such evaluations. However, presented reference values were very often disappointing as they proved to be either too restrictive or too liberal.

Objective:
The aim of the study was to assess the two methods of goitre evaluation: 1) traditional, based on ultrasound reference ranges for the thyroid size, 2) based on the analysis of thyroid volume (V) referred to the body surface area (BSA).

Material and Methods:
For this purpose, the study was conducted to evaluate the incidence of goitre and ioduria among 102 school-aged children in Opoczno, Poland. The study group comprised 59 girls and 43 boys; age range: 8–12 years.

Results:
The incidence of goitre among the examined children varied from 1.0–11.8% in relation to the age, and from 0–14.5% in relation to the BSA, depending on the references ranges used.

Conclusions:
Analysis of V/BSA ratio is a better estimation of the size of the thyroid gland than the evaluation of thyroid size based on traditional ultrasound reference values. Summing up, relating the size of the thyroid gland to BSA is a good, sensitive tool for such analysis, and can be used for comparisons of different populations, as well as surveys conducted at different time points.

ACKNOWLEDGEMENTS
The study was supported by the statutory funds (No. 2013/ IV/40) from the Polish Mother’s Memorial Hospital – Research Institute, Lodz, Poland.
REFERENCES (25)
1.
Perez C, Scrimshaw NS, Munoz JA. Classification of goitre and technique of endemic goitre surveys. Bull World Health Organ. 1958; 18: 217–232.
 
2.
Perez C, Scrimshaw NS, Munoz JA. Technique of endemic goiter surveys. In Endemic Goiter. WHO, Geneva 1960. pp. 369–383.
 
3.
WHO, UNICEF & ICCIDD. Indicators for assessing iodine deficiency disorders and their control through salt iodization. WHO/NUT/94.6. WHO, Geneva 1994.
 
4.
Delange F, Bastani S, BenMiloud M. Definitions of endemic goiter and cretinism, classification of goiter size and severity of endemias, and survey techniques. In: Dunn JT, Pretell EA, Daza CH, Viteri FE (eds.). Towards the eradication of endemic goiter, cretinism, and iodine deficiency. Pan American Health Organization, Washington, DC 1986.p.373–376.
 
5.
Peterson S, Sanga A, Eklöf H, Bunga B, Taube A, Gebre-Medhin M, Rosling H. Classification of thyroid size by palpation and ultrasonography in field surveys. Lancet. 2000; 355: 106–110.
 
6.
Zimmermann MB, Molinari L, Spehl M, Weidinger-Toth J, Podoba J, Hess S, Delange F. Toward a concensus on reference values for thyroid volume in iodine-replete schoolchildren: results of a workshop on inter-observer and inter-equipment variation in sonographic measurement of thyroid volume. Eur J Endocrinol. 2001; 144: 213–220.
 
7.
World Health Organization, United Nations Children’s Fund, International Council for the Control of Iodine Deficiency Disorders. Assessment of iodine deficiency disorders and monitoring their elimination. 3 rd ed. Geneva, WHO, 2007.
 
8.
Zimmermann M, Saad A, Hess S, Torresani T, Chaouki N. 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. Eur J Endocrinol. 2000; 143: 727–731.
 
9.
World Health Organization: Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser. 1995; 854: 1–452.
 
10.
Brunn J, Block U, Ruf G, Bos I, Kunze WP, Scriba PC. Volumetric analysis of thyroid lobes by real-time ultrasound. Dtsch Med Wochenschr. 1981;106: 1338–1340.
 
11.
Zimmermann MB, Hess SY, Molinari L, De Benoist B, Delange F, Braverman LE, Fujieda K, Ito Y, Jooste PL, Moosa K, Pearce EN, Pretell EA, Shishiba Y. New reference values for thyroid volume by ultrasound in iodinesufficient schoolchildren: a World Health Organization/Nutrition for Health and Development Iodine Deficiency Study Group Report. Am J Clin Nutr. 2004; 79: 231–227.
 
12.
Szybiński Z, Trofimiuk-Müldner M, Buziak-Bereza M, Walczycka L, Hubalewska-Dydejczyk A. Reference values for thyroid volume established by ultrasound in Polish schoolchildren. Endokrynol Pol. 2012; 63: 104–109.
 
13.
Delange F, Benker G, Caron P, Eber O, Ott W, Peter F, Podoba J, Simescu M, Szybinsky Z, Vertongen F, Vitti P, Wiersinga W, Zamrazil V. Thyroid volume and urinary iodine in European schoolchildren: standardization of values for assessment of iodine deficiency. Eur J Endocrinol. 1997; 136: 180–187.
 
14.
Zygmunt A, Adamczewski Z, Wojciechowska-Durczyńska K, Cyniak-Magierska A, Krawczyk-Rusiecka K, Zygmunt A, Karbownik-Lewińska M, Lewiński A. Evaluation of efficacy of iodine prophylaxis in Poland based on the examination of schoolchildren living in Opoczno Town (Lodz Voivodship). Thyroid Res. 2012; 5: 23.
 
15.
Sandell EB, Kolthoff IM. Microdetermination of iodine by catalytic method. Microchim Acta. 1937; 1: 9–25.
 
16.
Gaitan E. Environmental natural goitrogens. In: Peter F, Wiersinga W, Hostalek U (eds.). The Thyroid and environment. Schattauer, Stuttgart, 2000.pp.69–78.
 
17.
Ermans AM, Delange F, Van der Velden M, Kinthaert J. Possible role of cyanide and thiocyanate in the etiology of endemic cretinism. Adv Exp Med Biol. 1972; 30: 455–486.
 
18.
Nagataki S. The average of dietary iodine intake due to the ingetion of seaweeds is 1.2 mg/day in Japan. Thyroid 2008; 18: 667–668.
 
19.
Dunn JT. Sources of dietary iodine in industrialized countries. In: Delange F, Dunn JT, Glinoer D (ed.). Iodine Deficiency in Europe. A Continuing Concern. Plenum Press, New York, 1993.pp.17–21.
 
20.
Zygmunt A, Koptas W, Skowronska-Jozwiak E, Wiktorska J, Karbownik M, Lewinski A. Efficacy of iodine prophylaxis evaluated on the basis of goiter incidence and urine iodide concentrations in schoolchildren (age: 6–15 years) from Opoczno Town (the Lodz Voivodships). Endokrynol Pol. 2001, 52: 413–425.
 
21.
Lewinski A, Zygmunt A, Karbownik-Lewinska M, Slowinska-Klencka D, Popowicz B, Klencki M. Detrimental Effects of Increasing Iodine Supply: Iodine-Induced Hyperthyroidism, Following Iodine Prophylaxis. In: Preedy VR, Burrow GN, Watson R. Comprehensive handbook of Iodine. Nutritional, biochemical, pathological and therapeutic aspects. Oxford, Elsevier Inc Academic Press, 2009.pp.871–875.
 
22.
Li M, Eastman C, Waite KV, Ma G, Zacharin MR, Topliss DJ, Harding PE, Walsh JP, Ward LC, Mortimer RH, Mackenzie EJ, Byth K, Doyle Z. Are Australian children iodine deficient? Results of the Australian National Iodine Nutrition Study. Med J Aust. 2006; 184: 165–169.
 
23.
Andersson M, de Benoist B, Darnton-Hill I, Delange F. WHO: Iodine Deficiency in Europe: A continuing public health problem. WHO Press, 2007.
 
24.
WHO: Reducing Salt Intake in populations. Report of a WHO Forum and Technical meeting; 5–7 October 2006, Paris, France. WHO Press, 2007.
 
25.
Zimmermann MB, Andersson M. Assessment of iodine nutrition in populations: past, present, and future. Nutr Rev. 2012; 70: 553–570.
 
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