More Than a Decade of Iodine Prophylaxis Is Needed to Eradicate Goiter Among School Age Children in a Moderately Iodine-Deficient Region

Erdoğan, Murat Faik; Demir, Özgür; Emral, Rıfat; Kamel, A N; Erdoğan, Gürbüz

doi:10.1089/thy.2008.0253

Cited by 43 publications

(41 citation statements)

References 11 publications

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“…Furthermore, in 1999, an obligatory model of iodine prophylaxis was initiated with iodization of household salt. The area is mildly iodine deficient (average urinary iodine concentration 92 mg/l) at the moment (17,18).…”

Section: Thyroid Function and Morphologymentioning

confidence: 99%

Metabolic syndrome and its components are associated with increased thyroid volume and nodule prevalence in a mild-to-moderate iodine-deficient area

Ayturk

Gürsoy

Kut

et al. 2009

European Journal of Endocrinology

182

146

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Objective: Metabolic syndrome (MetS) is a cluster of metabolic abnormalities with insulin resistance (IR) as a major component. It has been recently questioned whether MetS and its related components are associated with functional and morphological alterations of the thyroid gland. The aim of our study is to examine thyroid volume and nodule prevalence in a case-control study of patients with MetS in a mild-to-moderate iodine-deficient area. Design: Two hundred and seventy-eight patients with MetS were randomly matched for age, gender, and smoking habits with 261 subjects without MetS. Serum TSH, free tri-iodothyronine and thyroxine, and the level of IR, which was estimated by the homeostasis model assessment for IR, as well as other MetS parameters were evaluated. Thyroid ultrasonography was performed in all subjects. All subjects with thyroid nodules O1 cm were offered to undergo thyroid fine needle aspiration biopsy. Results: TSH was significantly positively correlated with the presence of MetS diagnosis. There was no association between free thyroid hormone levels and MetS and its related components. Mean thyroid volume was significantly higher in patients with MetS than in controls (17.5G5.5 vs 12.2G4.2 ml, P!0.0001). Also the percentage of patients with thyroid nodules was significantly higher in patients with MetS (50.4 vs 14.6%, P!0.0001). Subjects were also divided into two groups according to the presence of IR. The group of subjects with IR had increased thyroid volume and nodule formation. The odds ratio for the development of thyroid nodule in the presence of IR was 3.2. TSH as well as all MetS components were found to be independent predictors for thyroid volume increase. IR but not TSH was found to be correlated with thyroid nodule formation. Thyroid cancer was diagnosed in 3 out of 38 patients with MetS who agreed to have a biopsy (7.9%). None of the subjects in the control group was diagnosed to have thyroid cancer. Conclusions:The results suggest that patients with MetS have significantly increased thyroid volume and nodule prevalence. Multivariate regression analysis model demonstrated that the presence of IR contributed substantially to this increased risk. Our data provide the first evidence that IR is an independent risk factor for nodule formation in an iodine-deficient environment.

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Section: Thyroid Function and Morphologymentioning

confidence: 99%

Metabolic syndrome and its components are associated with increased thyroid volume and nodule prevalence in a mild-to-moderate iodine-deficient area

Ayturk

Gürsoy

Kut

et al. 2009

European Journal of Endocrinology

182

146

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“…In a recent study evaluating goitre prevalence in school age children in Ankara, it was shown that the iodine sufficiency was reached within 7 years of initiation of countrywide prophylaxis. 11,12 In the present study, we aimed to evaluate a possible relationship of serum zinc levels with thyroid hormones, thyroid volume, anti-thyroglobulin (anti-TG) and anti-thyroid peroxidase (anti-TPO) antibodies (Ab) in subjects with either normal thyroid, autoimmune thyroid disease (AITD) or nodular goitre in the Turkish population of Ankara following successful iodine supplementation.…”

Section: Introductionmentioning

confidence: 99%

Relationship between serum zinc levels, thyroid hormones and thyroid volume following successful iodine supplementation

Ertek¹,

Cicero²,

Çağlar³

et al. 2010

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ObJEcTIVE: Zinc is essential for many biochemical processes and also for cell proliferation. Thyroid hormones influence zinc metabolism by affecting zinc absorption and excretion. Additionally, zinc deficiency affects thyroid function. The aim of the present study was to evaluate a possible association of zinc levels with thyroid volume, thyroid hormones and thyroid autoantibody levels in healthy subjects, patients with autoimmune thyroid disease (AITD) and patients with nodular goitre following successful iodine supplementation. This is a cross-sectional study in which 201 subjects who were not under medical treatment and did not have previous thyroid surgery or radio-iodine treatment were evaluated. seventy patients had nodular goitre, 67 AITD and 64 had normal thyroid. Thyroid volume was calculated by ultrasonographic measurements. serum free T4, T3, TsH, anti-thyroglobulin and anti-thyroid peroxidase levels were determined by appropriate methodology.REsULTs: In patients with normal thyroid, zinc levels were significantly positively correlated with free T3 levels (p<0.001). In the nodular goitre group, thyroid volume was negatively correlated with TsH and circulating zinc levels (p=0.014 and p=0.045, respectively). In the AITD group, thyroid autoantibodies and zinc were significantly positively correlated. Multiple regression analysis revealed a significant relationship between thyroid volume and zinc only in the patients with nodular goitre (p=0.043). cONcLUsION: There was significant correlation of serum zinc levels with thyroid volume in nodular goitre patients, with thyroid autoantibodies in AITD and with free T3 in patients with normal thyroid.

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“…Second national survey was performed in 2002 and the result demonstrated an obvious improvement, yet it was not optimal for elimination of IDD; median UIC was 53 µg/L [11]. Third survey implemented in the same area in 2007 and the results demonstrated a gradual improvement in the country; median UIC was 130 µg/L [1].…”

Section: Discussionmentioning

confidence: 99%

“…Erdogan et al conducted serial national surveys to determine iodine status before and after mandatory iodization in Turkey [1,[9][10][11]. First study conducted between 1997 and 1999 just before the mandatory iodization, and published in 2002.…”

Section: Discussionmentioning

confidence: 99%

“…Turkey has been considered iodine sufficient since mandatory iodination of table salt in 1998. In 2007, national survey results demonstrated a gradual improvement (median urinary iodine concentration (UIC) 130µ/L) in the country [1]. However, today iodized table salt intake accounts for small amount of daily salt intake, cause of public health messages that have encouraged reductions in salt intake, and a general lack of awareness within the population about the importance of iodine in the diet and desire of natural food consumption have also led people to use Himalayan salt and rock salt etc.…”

Section: Introductionmentioning

confidence: 99%

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Iodine deficiency has recurred in Istanbul, Turkey

Gökçel¹

2017

EMIJ

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Background: Iodine status of Turkish people improved after mandatory iodination of table salt; however there is a contrary results and difference between regions and age groups. Aim:The aim of the present study was to assess iodine status in people living in Istanbul, Turkey.Methods: This was a single center, retrospective study on subjects who attended to Acibadem Labmed Clinical Laboratories between January 2009 and December 2013 for the measurement of urinary iodine concentration (UIC). Subjects with UI and thyroid stimulating hormone (TSH) levels were included. Data on UIC was available for 1933 subjects (1629 women and 304 men).Results: Mean UIC was 123, 2 µg/g creatinine (µg/gCr) and mean age of the subjects was 36, 58 ± 0, 33 years. Mean UIC of men were lower than women (101, 55 ± 3, 95 vs 127, 24 ± 2, 22 µg/gCr; p<0.001). Totally 917 (47, 4%) of the subjects were iodine deficient (UIC < 100 µg/gCr). Men were more iodine deficient than women (59, 5% vs 45, 2%; p<0.001). Younger subjects were more iodine deficient than the older ones (p<0.001). TSH levels of iodine deficient and sufficient subjects were not different (3, 34 ± 0, 24 vs 3, 19 ± 0, 22 mIU/L; p>0, 05). There was a positive correlation between iodine level and age (r = 0, 149; p<0.03), but there was no correlation between iodine and TSH levels (p>0.05). Conclusion:A considerable number of subjects in our study had UIC below the normal ranges for adults, demonstrating that iodine deficiency continues to be a major healthcare concern in Turkey. At least, mild iodine deficiency has recurred in people living in Istanbul. The results emphasize the need for continuous monitoring in all regions, even in a country with iodine sufficiency. Keywords: Material and MethodsThis was a single center, retrospective study on subjects who attended to Acibadem Labmed Clinical Laboratories between January 2009 and December 2013 for the measurement of UIC. The Acibadem University Ethics Committee for Human Studies approved the study protocol. Subjects with urinary iodine (UI) and thyroid stimulating hormone (TSH) levels were included.Data on UIC was available for 1933 subjects (1629 women and 304 men). Data on UIC and TSH were available for 212 of these subjects. UIC were determined according to previously described method [5]. UI levels greater than 700 µg/g creatinine were eliminated from analysis because it was unclear if these samples were a result of contamination or toxicity. TSH levels were measured in C8000 Modular Analytics by using reagents from Roche Diagnostics. Repeatability CV and intermediate precision CV were determined to be ≤3,0 % and ≤ 7,2 % respectively by the manufacturer.Descriptive statistics were presented as mean ± standard error mean (SEM) for normally distributed data, and as counts and percentages for categorical data. The relationship between the categorical variables was examined using the Pearson Chisquare test; otherwise Fisher's exact test was used. The t-test or one-way Anova test was used to compare independent variables ...

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More Than a Decade of Iodine Prophylaxis Is Needed to Eradicate Goiter Among School Age Children in a Moderately Iodine-Deficient Region

Cited by 43 publications

References 11 publications

Metabolic syndrome and its components are associated with increased thyroid volume and nodule prevalence in a mild-to-moderate iodine-deficient area

Metabolic syndrome and its components are associated with increased thyroid volume and nodule prevalence in a mild-to-moderate iodine-deficient area

Relationship between serum zinc levels, thyroid hormones and thyroid volume following successful iodine supplementation

Iodine deficiency has recurred in Istanbul, Turkey

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