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Deveci Sevim R, Gök M, Öztürk S, Çevik Ö, Erdoğan Ö, Güneş S, Ünüvar T, Anık A. Thyroid volume in Turkish school-age children living in an iodine-sufficient region. J Pediatr Endocrinol Metab 2024; 37:228-235. [PMID: 38366903 DOI: 10.1515/jpem-2023-0442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/12/2024] [Indexed: 02/18/2024]
Abstract
OBJECTIVES We aimed to obtain local normative data on thyroid volume evaluated by ultrasonography and iodine status by measuring urine iodine levels in school-age children living in Aydın province. METHODS In this cross-sectional study, a sample comprising 1,553 cases was meticulously selected from a total cohort of 170,461 children aged 6-17, drawn from 21 distinct educational institutions located within the Aydın region, as participants in the investigation. Those with a known chronic disease or thyroid disease were excluded from the study. The children underwent physical examinations and ultrasonography imaging of the thyroid gland, and urine samples were collected to measure urinary iodine concentration (UIC). RESULTS The median UIC was 189.5 (IQR=134.4) μg/L, which was optimal according to WHO criteria. Thyroid volume was found to be 4.6 (IQR=3.5) mL in girls and 4.2 (IQR=4.0) mL in boys (p=0.883). The thyroid volumes in our study were found to be smaller when compared to the WHO. According to WHO age and body surface area criteria, thyroid volume was over 97 % in 0.9 % (n=15) of cases. Thyroid volume was found to have a positive correlation with age, height, weight, body mass index (BMI), and body surface area (BSA) in both genders (p<0.001). However, there was no significant correlation between thyroid volume and UIC. CONCLUSIONS This cross-sectional study provides normative data on thyroid volume and iodine status in school-age children in iodine-sufficient population, revealing a low prevalence of goiter and correlations between thyroid volume and anthropometric measures.
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Affiliation(s)
- Reyhan Deveci Sevim
- Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Aydın Adnan Menderes University, Aydın, Turkiye
| | - Mustafa Gök
- Department of Radiology, Faculty of Medicine, Aydın Adnan Menderes University, Aydın, Turkiye
- Research Affiliate in Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Sercan Öztürk
- Department of Pediatrics, Faculty of Medicine, Aydın Adnan Menderes University, Aydın, Turkiye
| | - Özge Çevik
- Department Biochemistry, Faculty of Medicine, Aydın Adnan Menderes University, Aydın, Turkiye
| | - Ömer Erdoğan
- Department Biochemistry, Faculty of Medicine, Aydın Adnan Menderes University, Aydın, Turkiye
| | - Sebla Güneş
- Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Aydın Adnan Menderes University, Aydın, Turkiye
| | - Tolga Ünüvar
- Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Aydın Adnan Menderes University, Aydın, Turkiye
| | - Ahmet Anık
- Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Aydın Adnan Menderes University, Aydın, Turkiye
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Xie Q, Zhang X, Ma J, Lu X, Zhang Y, Tong N. Effect of iodine nutritional status on the recurrence of hyperthyroidism and antithyroid drug efficacy in adult patients with Graves' disease: a systemic review. Front Endocrinol (Lausanne) 2023; 14:1234918. [PMID: 37900151 PMCID: PMC10600371 DOI: 10.3389/fendo.2023.1234918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 09/25/2023] [Indexed: 10/31/2023] Open
Abstract
Aim To probe the appropriate iodine nutritional status for patients with Graves'disease (GD) hyperthyroidism and on antithyroid drugs (ATD) or after drugwithdrawal. Method Studies were retrieved from three databases (Embase, Medline, and Cochrane Library) and were screened and evaluated using predefined criteria. The risk of bias of each trial was assessed using a tool from Cochrane. The iodine nutritional status of the subjects was redefined according to the World Health Organization (WHO) criteria and classified as insufficient/adequate/above requirements/excessive iodine intake. Result Two randomized controlled trials (RCTs) and 3 observational studies were selected from the 376 retrieved papers, which had different degrees of risk of bias in study design. The heterogeneity among them prevented us from further synthesizing effect indicators and subsequent statistical analyses. Two RCTs with high quality showed that insufficient or above requirements iodine intake was detrimental for ATD-treated GD patients; adequate iodine intake was associated with a lower risk of recurrence and better efficacy in controlling thyrotoxicosis. It could be speculated from three low-quality observational studies that excessive iodine intake may be associated with higher (or similar) recurrence rates and lower remission rates compared to above requirements iodine intake in these patients, but none of them could answer the question of the effect of insufficient or adequate iodine intake on this issue. Conclusion Although the available evidence is suboptimal, this systematic review tentatively suggests that in adult patients with GD hyperthyroidism receiving ATDs and according to WHO criteria for iodine nutritional status, adequate iodine intake is associated with a lower recurrence rate, a higher remission rate and a better efficacy to control thyrotoxicosis than insufficient, above requirement, or excessive iodine intake. Future RCTs with large samples are expected to elucidate the actual impact of different iodine nutritional statuses on the recurrence rate of hyperthyroidism and the efficacy of ATD to control thyrotoxicosis in these patients. Systematic review registration identifier CRD42022359451.
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Affiliation(s)
| | | | | | | | | | - Nanwei Tong
- Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research, Laboratory of Diabetes and Islet Transplantation Research, West China Hospital of Sichuan University, Chengdu, China
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Ejiri H, Asano M, Nakahata N, Suzuki S, Sato A, Nagamine N, Takahashi C, Yamaya Y, Iwadate M, Matsuzuka T, Ohira T, Yasumura S, Suzuki S, Furuya F, Shimura H, Suzuki S, Yokoya S, Ohto H, Kamiya K. Ultrasonography-based reference values for the cross-sectional area of the thyroid gland in children and adolescents: The Fukushima Health Management Survey. Clin Pediatr Endocrinol 2023; 32:52-57. [PMID: 36761492 PMCID: PMC9887296 DOI: 10.1297/cpe.2022-0057] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 09/19/2022] [Indexed: 11/06/2022] Open
Abstract
We previously described the thyroid volume, which was calculated by measuring the thyroid width, thickness, and longitudinal length using ultrasonography, in children and adolescents. We have proposed a simplified method for quantitatively assessing the thyroid size, to overcome the inaccuracy and challenges in measuring the longitudinal length of the thyroid. Based on measurements of 317,847 (girls: 156,913, boys: 160,934) children and adolescents, we calculated sex-specific means and standard deviations of thyroid width and thickness, and of the cross-sectional area computed by multiplying them, for every age and 0.1 m2 of body surface area, after ensuring normal distribution with Box-Cox transformation. Multivariate regression analysis revealed that female sex, age, and body surface area were independently associated with areas of each thyroid lobe. Our novel method may be useful in quantitatively assessing the thyroid size, and appropriately diagnosing pathological conditions, such as hypoplasia, atrophy, and enlargement of the thyroid gland, in children and adolescents.
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Affiliation(s)
- Haruka Ejiri
- Radiation Medical Science Center for the Fukushima Health
Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Mahiro Asano
- Radiation Medical Science Center for the Fukushima Health
Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Nana Nakahata
- Radiation Medical Science Center for the Fukushima Health
Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Satoshi Suzuki
- Radiation Medical Science Center for the Fukushima Health
Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Thyroid and Endocrinology, Fukushima Medical
University School of Medicine, Fukushima, Japan
| | - Ayako Sato
- Radiation Medical Science Center for the Fukushima Health
Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Natsuki Nagamine
- Radiation Medical Science Center for the Fukushima Health
Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Chisato Takahashi
- Radiation Medical Science Center for the Fukushima Health
Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Laboratory Medicine, Fukushima Medical
University School of Medicine, Fukushima, Japan
| | - Yukie Yamaya
- Radiation Medical Science Center for the Fukushima Health
Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Manabu Iwadate
- Department of Surgery, Minamisoma Municipal General Hospital,
Fukushima, Japan
| | - Takashi Matsuzuka
- Department of Head and Neck Surgery and Otolaryngology, Asahi
University Hospital, Gifu, Japan
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health
Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Epidemiology, Fukushima Medical University
School of Medicine, Fukushima, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health
Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Public Health, Fukushima Medical University
School of Medicine, Fukushima, Japan
| | - Satoru Suzuki
- Radiation Medical Science Center for the Fukushima Health
Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Thyroid and Endocrinology, Division of Internal
Medicine, Fukushima Medical University Hospital, Fukushima, Japan
| | - Fumihiko Furuya
- Radiation Medical Science Center for the Fukushima Health
Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Thyroid and Endocrinology, Fukushima Medical
University School of Medicine, Fukushima, Japan
| | - Hiroki Shimura
- Radiation Medical Science Center for the Fukushima Health
Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Laboratory Medicine, Fukushima Medical
University School of Medicine, Fukushima, Japan
| | - Shinichi Suzuki
- Department of Thyroid Therapeutic Surgery, Fukushima Medical
University, Fukushima, Japan
| | - Susumu Yokoya
- Thyroid and Endocrine Center, Fukushima Global Medical
Science Center, Fukushima Medical University, Fukushima, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health
Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health
Management Survey, Fukushima Medical University, Fukushima, Japan,Research Institute for Radiation Biology and Medicine,
Hiroshima University, Hiroshima, Japan
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Jeddi M, Habib A, Salehi A. Sustained Elimination of Iodine Deficiency Within the Third Decade After Compulsory Iodine Supplementation Policy in the South of Iran: A Population-Based Cross-Sectional Study. Curr Dev Nutr 2023; 7:100013. [PMID: 37181119 PMCID: PMC10100933 DOI: 10.1016/j.cdnut.2022.100013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 10/28/2022] [Accepted: 11/22/2022] [Indexed: 12/24/2022] Open
Abstract
Objectives Recently, some studies in Iran have shown mild to moderate iodine concentrations in adult and pregnant women populations despite iodine sufficiency in children. This study aimed to evaluate the urine iodine status and salt intake among adult households in the city of Sadra, Fars province in southern Iran, and to assess its possible influencing factors. Method Participant households for this cross-sectional study were selected using randomized cluster sampling in the city of Sadra, Fars province, southern Iran from 1 February, 2021 to 30 November, 2021. Two subjects >18 y of age from each household were invited. Ninety-two subjects (24 men, 68 women) were enrolled. The participants were asked to collect their 24 h urine. They were then examined for thyroid disorders and subjected to thyroid ultrasonography and thyroid function tests. Urine samples were tested for iodine, sodium, and creatinine concentrations. Household salt intake was also estimated. Results Median urine iodine content (UIC) in the participants was 175 (IQR: 117, 250) μg/L, whereas the median salt consumption per person per day was 9.6 (IQR, 7.3-14.5) g. Sex, methods of salt storage, presence of goiter or thyroid nodules, the addition of salt in the cooking stage, and subclinical hypothyroidism had no effect on UIC, whereas individuals with hypertension and lower education had significantly lower iodine concentrations. UIC had a significant positive correlation with urine sodium and thyroid stimulating hormones (TSH) concentrations (P < 0.001, 0.046) and a negative correlation with thyroid volume and T4 (P = 0.029, 0.018). Conclusion Iodine status in the adult population of Sadra city was categorized as sufficient, although the iodine concentrations reported in Tehran were insufficient. The contributing factor can be higher salt consumption or possible higher environmental iodine concentrations in Sadra city than Tehran.
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Affiliation(s)
- Marjan Jeddi
- Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ashkan Habib
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Salehi
- MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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