Association Between Thyroid Hormone Status and Trace Elements in Serum of Patients with Nodular Goiter

The present study investigated the status of calcium and magnesium as well as essential trace elements including iodine, selenium, copper, iron, and zinc in adults residing in the Zhytomyr region of Ukraine. In addition, the relative risk of goiter occurrence was evaluated. In this comparative study, 40 adults without goiter (control group) and 16 adults with diagnosed nodular goiter (NG) were examined. Inductively coupled plasma optical emission spectrometry (ICP-OES) was used for the measurements of Mg, Ca, Se, Zn, Cu, and Fe in serum of patients with NG and control group. Patients with nodular goiter had lower serum values of Ca, Mg, Se, Cu, Fe, and Zn than those in the control group. The presence of mild iodine deficiency was evident in both groups with the median urinary iodine excretion (UIE) 80.5 μg/L in the control group and 64.5 μg/L in goiter group. There was a positive association between goiter presence and low concentration of Ca in serum (odds ratio (OR) = 2.29 (1.26-3.55), p < 0.05) in the NG group. High relative risk of goiter was observed at low concentrations of magnesium (OR = 3.33 (1.39-7.62), p < 0.05) and selenium (OR = 1.63, (1.16-1.78), p < 0.05) in comparison with OR values in the control group. Low concentrations of Ca, Mg, Zn, and Se in serum combined with reduced UIE resulted in the highest risk of goiter (OR = 12.5, (2.15-79.42), p < 0.01). This study proved that Thyroglobulin concentration in serum is the reliable indicator of nodular goiter. We also suggest that a combination of low concentrations of Ca, Mg, Zn, Cu, and Se in blood serum, and reduced iodine concentration in urine resulted in the highest risk of nodular goiter development.

[The study of iodine sufficiency in children of Kiev]

A total of 576 pupils in different age groups of a school in Kiev were examined. Determined in the above pupils by palpation and echography were sizes of the thyroid gland, urine excretion of iodine. Thyroid enlargement was identified in nearly 30 percent of the examined children, nodal pathology of the gland was in 0.52 percent. It was only in 34 percent of the examinees that the level of iodine excretion was more than 100 mcgrm/l, i.e. did not deviate from the norm; 5.3% of children had ioduria indices < 20 mcgrm/l, which observation suggested a severe iodine deficiency. In the major proportion of children the level of ioduria ranged from 50 up to 100 mcgrm/l, the median value for the group of children as a whole came up to 62.9 mcgrm/l. According to results of the studies made on goiter rates among children and on the level of urine excretion of iodine, the population are in want of bodily iodine, and Kiev falls in to a zone of mild iodine deficiency.

[Monitoring of iodine supply of the population of Kiev and Kiev region (according to the observation of representative groups)]

720 women and children living in Kiev and Kiev region have been observed to detect iodine supply of people. The authors revealed iodine deficit of mild degree in both groups. The women had median of urine iodine excretion equal to 85.9 microg/l and children--96.8 microg/l. The great frequency of cases of diffuse enlargement of the thyroid gland shows also the presence of iodine endemic disease: 61.2% of Kiev schoolboys and schoolgirls and 40.8% of children of Kiev region had exceeding volume of the thyroid comparing age norms. The autors showed the necessity of introduction of the programm of global rodine prophylaxy by iodating salt.