ECE2018 Oral Communications Benign thyroid diseases (5 abstracts)
The impact of obligatory iodine prophylaxis on thyroid volume in schoolchildren
Malgorzata Trofimiuk-Muldner 1 , Zbigniew Szybinski 2 , Monika Buziak-Bereza 1 , Grzegorz Sokolowski 3 , Andrzej Lewinski 4 , Arkadiusz Zygmunt 4 , Krzysztof Sworczak 5 , Marek Ruchala 6 , Elzbieta Bandurska-Stankiewicz 7 , Filip Golkowski 1 & Alicja Hubalewska-Dydejczyk 1
1Chair and Department of Endocrinology, Jagiellonian University, Medical College, Krakow, Poland; 2Polish Council for Control of Iodine Deficiency Disorders, Krakow, Poland; 3Endocrinology Department, University Hospital in Krakow, Krakow, Poland; 4Department of Endocrinology and Metabolic Diseases, The Polish Mother’s Memorial Hospital- Research Institute, Lodz, Poland; 5Chair and Department of Endocrinology and Internal Diseases, Medical University of Gdansk, Gdansk, Poland; 6Chair and Department of Endocrinology, Metabolism, and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland; 7Chair of Endocrinology, Diabetology, and Internal Diseases, Faculty of Medical Sciences, University of Warmia and Mazury, Olsztyn, Poland.
Poland was considered as a mild-to-moderate iodine deficiency area according to results of a nation-wide survey conducted in early 1990-ties. The obligatory iodine prophylaxis program based on iodization of house-hold salt (30 mg of iodide/1 kg of salt) was therefore introduced in 1997.
The aim of the study was to assess the real impact of the Polish iodine prophylaxis model on thyroid volume in schoolchildren.
Material and methods: The study included 9210 Polish schoolchildren (4731 girls, 4479 boys) aged 6–12 years, examined between 1999 and 2011. The informed written parental consent for participation in the survey was obtained for each child. 3803 of children (1909 girls and 1894 boys) were born at least one year after introduction of the iodine prophylaxis (after 12/31/1997), which meant that their mothers were using iodized salt while being pregnant. In each child TV was assessed by ultrasound (7.5 MHz linear probe) and calculated according to Brunn’s formula. Body surface area (BSA) was calculated according to the following formula: weight (kg)0.425 * height (cm)0.725 * 71.84 * 10−4. Thyroid volume was then standardized to body surface area (TV in ml divided by BSA in m2) to minimize the influence of child age. Urinary iodine concentration (UCI) in urine casual sample was measured by Sandell-Kolthoff method.
Results: The median standardized thyroid volume (TVs) was 3.96 ml/m2 (LQ – 3.12 ml/m2, UQ – 4.91 ml/m2, respectively). The median UCI was 96.2 mcg/l (LQ – 64.0 mcg/l, UQ – 142.6 mcg/l, respectively). UCI was significantly higher in children born after introduction of obligatory iodine prophylaxis (mean 118.23±74.68 mcg/l vs 104.59±66.80 mcg/l, P<0.001, Mann-Whitney U test). Age, ultrasonographic thyroid autoimmunity features, gender, UIC and date of birth (before vs. after introduction of obligatory iodine prophylaxis) were significant, independent predictors of TVs in multiple stepwise regression model.
Conclusions: Iodine prophylaxis based on iodization of household salt is effective in reduction of thyroid volume in children living in an area previously considered mildly-to-moderate iodine deficient.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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