Improved legislation (1989, 1993), as well as education of the public, are likely to improve the iodine supply for the German population. Children and adolescents will be the first to profit. We investigated thyroid size and urinary iodine excretion in a total of 2906 students aged 10 to 18 in Mecklenburg-West-Pomerania in 1993, 1995, and 1997. The median urinary iodine excretion rose from 73 microg/g creatinine in 1993 to 133 microg/g in 1997. The prevalence of goiter, according to the reference range of Gutekunst, dropped from 33% to 10% over the same interval, and the median thyroid size declined from 11 ml to 6 ml. While only 6% of the test subjects excreted more than 150 microg iodine per g creatinine in 1993, this figure rose to 33% in 1997. The improved alimentary iodine supply is due to the increased use of iodine enriched salt by the food industry, food factories and in common food supply services.
We investigated the goiter prevalence and the urinary iodine excretion of 2,109 young people between 10 and 18 years in the district of Mecklenburg-Vorpommern, Germany in 1995/96. The thyroid volume was determined by ultrasound (7.5 MHz), the iodine excretion by a modified cer-arsenit method. The daily iodine excretion as related to the body surface area and the age related creatinine excretion per 24 h were measured. The results were compared with those of a similar study from 1993 in the same region and the same range of age. The goiter prevalence in 1997 amounted to 18.5%. Among the studied persons 3.6% showed one or more nodules within their thyroid gland. The iodine excretion increased from 70 micrograms in 1993 to 95 micrograms in 1997. There were no changes in the individual nutritional habits (especially iodine-containing foods, using iodized salt etc.). We believe that the raised iodine intake is the result of a higher iodine supply in the commercially produced foodstuffs and animal products due to an increased incorporation of iodine in manufacture of food products.
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