New Reference Values for Thyroid Volume and a Comprehensive Assessment for Influencing Factors in Chinese Adults with Iodine Sufficiency

Guo, Wenxing; Tan, Lei; Dong, Siming; Jin, Yifeng; Zhu, Mei; H, Wei; Chen, Yanting; Fan, Lili; Du, Cong; Zhang, Wanqi

doi:10.1159/000513494

Cited by 10 publications

(8 citation statements)

References 36 publications

(53 reference statements)

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“…We also found a significant negative correlation between TSH and thyroid volume, with the greatest effect on the upper thyroid volume limit in women. This is consistent with the results of several recent studies [ 12 , 13 , 23 ]. The French study also found a positive regulatory effect of FT4 on thyroid volume, while several earlier studies did not find a correlation between TSH and thyroid volume [ 17 , 43 , 44 ].…”

Section: Discussionsupporting

confidence: 94%

“…Since the implementation of the salt iodization policy in Denmark, the thyroid goiter rate and the volume of the thyroid gland have decreased in all age groups, particularly in areas with moderate iodine deficiency [ 16 ]. At the same time, previous studies suggest that the median value of thyroid volume is universal in different areas where iodine is sufficient [ 13 ]. Therefore, we propose a new reference value standard for thyroid volume.…”

Section: Discussionmentioning

confidence: 99%

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Influencing Factors and New Reference Intervals of Adult Thyroid Volume in Iodine-Sufficient Areas of China

Lin¹,

Lu²,

Teng³

et al. 2023

Biol Trace Elem Res

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The diagnosis of goiter is based on the thyroid volume measured by ultrasound in which iodine plays an important role. The purpose of this study was to evaluate the factors that affect thyroid volume and update the reference range of thyroid volume to provide a new basis for the diagnosis and treatment of goiter. A study population from mainland China was evaluated in the Thyroid disorders, Iodine status and Diabetes Epidemiological (TIDE) study. Thyroid size was measured by ultrasound, and thyroid volume was calculated. A quantile regression model was used to analyze the influence of related factors on the thyroid volume at each percentile. The median urinary iodine concentration (UIC) was 185.54 μg/l. The quantile regression model suggested that body surface area (BSA) and thyroid-stimulating hormone (TSH) were positive and negative factors for thyroid volume, respectively (p < 0.01). Excess iodine reduces the median and lower limits of thyroid volume. In iodine-sufficient areas, smoking is no longer a risk factor. The reference value range of thyroid volume stratified by sex was 3.92–19.06 ml for males and 3.1–16.17 ml for females. The maximum reference ranges for stratification by sex and BSA were 4.25–20.98 ml for men and 3.44–18.31 ml for women. The iodine nutrition level of the population in mainland China is sufficient. Iodine has the potential to alter the effect of certain factors on thyroid volume and effect is not regional. The new reference interval of adult thyroid volume based on sex and BSA has been updated, which can be used as a reliable reference for updating the diagnostic criteria of endemic goiter.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Influencing Factors and New Reference Intervals of Adult Thyroid Volume in Iodine-Sufficient Areas of China

Lin¹,

Lu²,

Teng³

et al. 2023

Biol Trace Elem Res

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“…In addition, our screening program is a fee-based examination that includes a wide variety of test items; as a result, the surveyed population may be biased toward economically affluent and health-conscious individuals. Several studies have reported differences in TSH level, CT density, and thyroid volume according to ethnicity, region, diet, and other factors [13,30,[35][36][37][38]. Therefore, it is unclear whether or not the present findings are generalizable to other populations.…”

Section: Discussionmentioning

confidence: 68%

Relationship between Thyroid CT Density, Volume, and Future TSH Elevation: A 5-Year Follow-Up Study

Kikuchi,

Hanaoka,

Nakao

et al. 2023

Life

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This study aimed to explore the relationship between thyroid-stimulating hormone (TSH) elevation and the baseline computed tomography (CT) density and volume of the thyroid. We examined 86 cases with new-onset hypothyroidism (TSH > 4.5 IU/mL) and 1071 controls from a medical check-up database over 5 years. A deep learning-based thyroid segmentation method was used to assess CT density and volume. Statistical tests and logistic regression were employed to determine differences and odds ratios. Initially, the case group showed a higher CT density (89.8 vs. 81.7 Hounsfield units (HUs)) and smaller volume (13.0 vs. 15.3 mL) than those in the control group. For every +10 HU in CT density and −3 mL in volume, the odds of developing hypothyroidism increased by 1.40 and 1.35, respectively. Over the course of the study, the case group showed a notable CT density reduction (median: −8.9 HU), whereas the control group had a minor decrease (−2.9 HU). Thyroid volume remained relatively stable for both groups. Higher CT density and smaller thyroid volume at baseline are correlated with future TSH elevation. Over time, there was a substantial and minor decrease in CT density in the case and control groups, respectively. Thyroid volumes remained consistent in both cohorts.

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“…However, this pattern is also observed for girls, with a decelerating trend occuring at advanced ages. This finding is reflected by studies in (young) adults, which showed an increase in Tvol up to the age of 30 years in Caucasian 30 and up to the age of 50 years in non-Caucasian populations 31 . Additionally, although girls have a larger Tvol during early pubertal ages, boys have a larger Tvol during advanced ages.…”

Section: Discussionmentioning

confidence: 76%

New Reference Values for Thyroid Volume by Ultrasound in German Children and Adolescents Under Iodine-Sufficient Conditions from a Population-Based Study

Hirtz,

Thamm,

Kuhnert

et al. 2024

Preprint

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ContextReliable reference values for thyroid ultrasound measurements are essential to effectively guide individual diagnostics and direct health care measures at the population level, such as iodine fortification programs. However, the latest reference values for total thyroid volume (Tvol) provided by the WHO in 2004 only apply to the 6 to 12-year-old age group and are limited to countries with a long history of iodine sufficiency, which does not reflect the situation in most European countries, including Germany.ObjectiveThe present aims to derive up to date thyroid volume ultrasound reference values in German children and adolescents.DesignData from the baseline assessment of a nationwide study in German children and adolescents (KiGGS) conducted between 2003 and 2006 were used to determine sex-specific reference values for Tvol in thyroid-healthy participants aged 6 to 17 years by age and body surface area (BSA) according to the Lambda-Mu-Sigma (LMS) method.ResultsData from 5559 participants were available for reference chart construction (girls: 2509 (45.1%)). On average, the 97th percentile is 33.4% and 28.5% higher than the corresponding WHO’s reference values for boys and girls, respectively. These findings are consistent with most other studies in German and European children and adolescents at a similar time of investigation. Notably, the sample used for this study was iodine-sufficient according to WHO criteria.ConclusionsThe reference values provided by the WHO are overly conservative for this population and could potentially apply to apply to other European countries with a similar history of iodine supply.

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New Reference Values for Thyroid Volume and a Comprehensive Assessment for Influencing Factors in Chinese Adults with Iodine Sufficiency

Cited by 10 publications

References 36 publications

Influencing Factors and New Reference Intervals of Adult Thyroid Volume in Iodine-Sufficient Areas of China

Influencing Factors and New Reference Intervals of Adult Thyroid Volume in Iodine-Sufficient Areas of China

Relationship between Thyroid CT Density, Volume, and Future TSH Elevation: A 5-Year Follow-Up Study

New Reference Values for Thyroid Volume by Ultrasound in German Children and Adolescents Under Iodine-Sufficient Conditions from a Population-Based Study

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