Startseite Thyroid volume in Turkish school-age children living in an iodine-sufficient region
Artikel
Lizenziert
Nicht lizenziert Erfordert eine Authentifizierung

Thyroid volume in Turkish school-age children living in an iodine-sufficient region

  • Reyhan Deveci Sevim ORCID logo , Mustafa Gök ORCID logo , Sercan Öztürk ORCID logo , Özge Çevik ORCID logo , Ömer Erdoğan ORCID logo , Sebla Güneş ORCID logo , Tolga Ünüvar ORCID logo und Ahmet Anık ORCID logo EMAIL logo
Veröffentlicht/Copyright: 19. Februar 2024

Abstract

Objectives

We aimed to obtain local normative data on thyroid volume evaluated by ultrasonography and iodine status by measuring urine iodine levels in school-age children living in Aydın province.

Methods

In this cross-sectional study, a sample comprising 1,553 cases was meticulously selected from a total cohort of 170,461 children aged 6–17, drawn from 21 distinct educational institutions located within the Aydın region, as participants in the investigation. Those with a known chronic disease or thyroid disease were excluded from the study. The children underwent physical examinations and ultrasonography imaging of the thyroid gland, and urine samples were collected to measure urinary iodine concentration (UIC).

Results

The median UIC was 189.5 (IQR=134.4) μg/L, which was optimal according to WHO criteria. Thyroid volume was found to be 4.6 (IQR=3.5) mL in girls and 4.2 (IQR=4.0) mL in boys (p=0.883). The thyroid volumes in our study were found to be smaller when compared to the WHO. According to WHO age and body surface area criteria, thyroid volume was over 97 % in 0.9 % (n=15) of cases. Thyroid volume was found to have a positive correlation with age, height, weight, body mass index (BMI), and body surface area (BSA) in both genders (p<0.001). However, there was no significant correlation between thyroid volume and UIC.

Conclusions

This cross-sectional study provides normative data on thyroid volume and iodine status in school-age children in iodine-sufficient population, revealing a low prevalence of goiter and correlations between thyroid volume and anthropometric measures.


Corresponding author: Prof. Dr. Ahmet Anık, Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Aydın Adnan Menderes University, Aydın, Turkiye, Phone: +90532 5684340, E-mail:

Award Identifier / Grant number: TPF-21022

Acknowledgments

We are grateful to Utku Agca for his contribution to the study.

  1. Research ethics: The study was conducted in accordance with the Declaration of Helsinki and was approved by the non-interventional ethics committee of Aydın Adnan Menderes University (Ethics no: 2021/147). Participants were informed about the purpose of the study and gave their consent for the utilization of their medical data and those of their children for research purposes.

  2. Informed consent: Informed consent in this study was taken from all participants.

  3. Author contributions: Reyhan DEVECİ SEVİM collected the data and wrote the manuscript; Mustafa GÖK performed ultrasonographic imaging of the thyroid and wrote the manuscript; Sercan ÖZTÜRK collected the data and made statistical analysis; Özge ÇEVİK and Ömer ERDOĞAN made laboratory analyses; Sebla GÜNEŞ collected the data; Tolga ÜNÜVAR read and approved manuscript; Ahmet ANIK designed research and edited the manuscript; all authors read and approved manuscript.

  4. Competing interests: The authors state no conflict of interest.

  5. Research funding: The work was supported by the Aydın Adnan Menderes University Scientific Projects Unit (grant number TPF-21022). The funding organization played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

  6. Data availability: Not applicable.

References

1. Eastman, CJ, Zimmermann, MB. The iodine deficiency disorders. Endotext [Internet]. MDText. com, Inc.; 2018.10.1007/978-3-319-49505-7_5Suche in Google Scholar

2. Pharoah, P, Buttfield, I, Hetzel, B. Neurological damage to the fetus resulting from severe iodine deficiency during pregnancy. Int J Epidemiol 2012;41:589–92. https://doi.org/10.1093/ije/dys070.Suche in Google Scholar PubMed

3. UNICEF. Guidance on the monitoring of salt iodization programmes and determination of population iodine status; 2018. https://www.ign.org/p142003099.html [Accessed 7 Oct 2021].Suche in Google Scholar

4. Pearce, EN, Zimmermann, MB. The prevention of iodine deficiency: a history. Thyroid 2023;33:143–9. https://doi.org/10.1089/thy.2022.0454.Suche in Google Scholar PubMed

5. Kağızmanlı, G, Demir, K. Interpretation, differential diagnosis, and clinical implications of abnormal thyroid function tests in children. Trends Pediatr 2023;4:61–71. https://doi.org/10.59213/tp.2023.53215.Suche in Google Scholar

6. Cesar, JA, Santos, IS, Black, RE, Chrestani, MAD, Duarte, FA, Nilson, EAF. Iodine status of Brazilian school-age children: a national cross-sectional survey. Nutrients 2020;12:1077. https://doi.org/10.3390/nu12041077.Suche in Google Scholar PubMed PubMed Central

7. Erdoğan, G, Erdoğan, M, Emral, R, Baştemir, M, Sav, H, Haznedaroğlu, D, et al.. Iodine status and goiter prevalence in Turkey before mandatory iodization. J Endocrinol Invest 2002;25:224–8. https://doi.org/10.1007/bf03343994.Suche in Google Scholar

8. Erdoğan, M, Ağbaht, K, Altunsu, T, Özbaş, S, Yücesan, F, Tezel, B, et al.. Current iodine status in Turkey. J Endocrinol Invest 2009;32:617–22. https://doi.org/10.1007/bf03346519.Suche in Google Scholar

9. Vural, M, Koc, E, Evliyaoglu, O, Acar, HC, Aydin, AF, Kucukgergin, C, et al.. Iodine status of Turkish pregnant women and their offspring: a national cross-sectional survey. J Trace Elem Med Biol 2021;63:126664. https://doi.org/10.1016/j.jtemb.2020.126664.Suche in Google Scholar PubMed

10. Zimmermann, MB, Hess, SY, Molinari, L, De Benoist, B, Delange, F, Braverman, LE, et al.. New reference values for thyroid volume by ultrasound in iodine-sufficient schoolchildren: a world health organization/nutrition for health and development iodine deficiency study group report. Am J Clin Nutr 2004;79:231–7. https://doi.org/10.1093/ajcn/79.2.231.Suche in Google Scholar PubMed

11. Johnson, A, Edwards, C, Reddan, T. A review of sonographic thyroid volume and iodine sufficiency in children: an Australian perspective. Australas J Ultrasound Med 2020;23:33–8. https://doi.org/10.1002/ajum.12189.Suche in Google Scholar PubMed PubMed Central

12. Zou, Y, Ding, G, Lou, X, Zhu, W, Mao, G, Zhou, J, et al.. Factors influencing thyroid volume in Chinese children. Eur J Clin Nutr 2013;67:1138–41. https://doi.org/10.1038/ejcn.2013.173.Suche in Google Scholar PubMed PubMed Central

13. Chen, H, Zhang, H, Tang, W, Xi, Q, Liu, X, Duan, Y, et al.. Thyroid function and morphology in overweight and obese children and adolescents in a Chinese population. J Pediatr Endocrinol Metab 2013;26:489–96. https://doi.org/10.1515/jpem-2012-0299.Suche in Google Scholar PubMed

14. Sari, R, Balci, MK, Altunbas, H, Karayalcin, U. The effect of body weight and weight loss on thyroid volume and function in obese women. Clin Endocrinol 2003;59:258–62. https://doi.org/10.1046/j.1365-2265.2003.01836.x.Suche in Google Scholar PubMed

15. Licenziati, MR, Valerio, G, Vetrani, I, De Maria, G, Liotta, F, Radetti, G. Altered thyroid function and structure in overweight and obese children and adolescents: reversal after weight loss. J Clin Endocrinol Metab 2019;104:2757–65. https://doi.org/10.1210/jc.2018-02399.Suche in Google Scholar PubMed

16. Muc Da Encarnacao, M, Collaboration NRF. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults. Lancet 2017;390:2627–42.Suche in Google Scholar

17. Alper, Z, Ercan, İ, Uncu, Y. A meta-analysis and an evaluation of trends in obesity prevalence among children and adolescents in Turkey: 1990 through 2015. J Clin Res Pediatr Endocrinol 2018;10:59. https://doi.org/10.4274/jcrpe.5043.Suche in Google Scholar PubMed PubMed Central

18. Aydıner, Ö, Aydıner, EK, Akpınar, İ, Turan, S, Bereket, A. Normative data of thyroid volume-ultrasonographic evaluation of 422 subjects aged 0–55 years. J Clin Res Pediatr Endocrinol 2015;7:98. https://doi.org/10.4274/jcrpe.1818.Suche in Google Scholar PubMed PubMed Central

19. Çolak, E, Özkan, B, Genç, S, Polat, B. Ultrasonographic determination of thyroid volume in infants and children from Aegean region of Turkey and comparison with national and international references. J Pediatr Endocrinol Metab 2021;34:457–64. https://doi.org/10.1515/jpem-2020-0514.Suche in Google Scholar PubMed

20. Hampl, SE, Hassink, SG, Skinner, AC, Armstrong, SC, Barlow, SE, Bolling, CF, et al.. Clinical practice guideline for the evaluation and treatment of children and adolescents with obesity. Pediatrics 2023;151:e2022060640. https://doi.org/10.1542/peds.2022-060640.Suche in Google Scholar PubMed

21. Lass, N, Barth, A, Reinehr, T. Thyroid volume and thyroid function parameters are independently associated with weight status in overweight Children. Horm Res Paediatr 2020;93:279–86. https://doi.org/10.1159/000509786.Suche in Google Scholar PubMed

22. Neyzi, O, Bundak, R, Gökçay, G, Günöz, H, Furman, A, Darendeliler, F, et al.. Reference values for weight, height, head circumference, and body mass index in Turkish children. J Clin Res Pediatr Endocrinol 2015;7:280. https://doi.org/10.4274/jcrpe.2183.Suche in Google Scholar PubMed PubMed Central

23. Organization WH, Disorders ICfCoID. Recommended normative values for thyroid volume in children aged 6–15 years. Bull World Health Organ 1997;75:95.Suche in Google Scholar

24. The Iodine Global Network. Global scorecard of iodine nutrition in 2019 based on median urinary iodine concentration (MUIC) in school-age children (SAC). https://www.ign.org/cm_data/Global_Scorecard_2019_SAC.pdf. [Accessed 26 Nov 2019].Suche in Google Scholar

25. De Angelis, S, Bagnasco, M, Moleti, M, Regalbuto, C, Tonacchera, M, Vermiglio, F, et al.. Obesity and monitoring iodine nutritional status in schoolchildren: is body mass index a factor to consider? Thyroid 2021;31:829–940. https://doi.org/10.1089/thy.2020.0189.Suche in Google Scholar PubMed

26. Liu, L, Qian, T, Sun, R, Du, Y, Li, M, Liu, L, et al.. Comparative analysis of five correction methods for thyroid volume by ultrasound and their recommended reference values in Chinese children aged 8–10 years. Br J Nutr 2023;129:301–11. https://doi.org/10.1017/s0007114522001003.Suche in Google Scholar PubMed

27. Kotnik, P, Širca Čampa, A, Zupančič, M, Štimec, M, Smole, K, Mis, NF, et al.. Goiter prevalence and urinary iodine concentration in Slovenian adolescents. Thyroid 2006;16:769–73. https://doi.org/10.1089/thy.2006.16.769.Suche in Google Scholar PubMed

28. Gyamfi, D, Wiafe, YA, Ofori Awuah, E, Adu, EA, Boadi, EK. Goitre prevalence and urinary iodine concentration in school-aged children in the Ashanti region of Ghana. Int J Endocrinol 2020;3759786. https://doi.org/10.1155/2020/3759786.Suche in Google Scholar PubMed PubMed Central

29. Farebrother, J, Zimmermann, MB, Andersson, M. Excess iodine intake: sources, assessment, and effects on thyroid function. Ann N. Y Acad Sci 2019;1446:44–65. https://doi.org/10.1111/nyas.14041.Suche in Google Scholar PubMed

30. Katagiri, R, Yuan, X, Kobayashi, S, Sasaki, S. Effect of excess iodine intake on thyroid diseases in different populations: a systematic review and meta-analyses including observational studies. PLoS One 2017;12:e0173722. https://doi.org/10.1371/journal.pone.0173722.Suche in Google Scholar PubMed PubMed Central

Received: 2023-10-05
Accepted: 2024-01-12
Published Online: 2024-02-19
Published in Print: 2024-03-25

© 2024 Walter de Gruyter GmbH, Berlin/Boston

Heruntergeladen am 14.9.2025 von https://www.degruyterbrill.com/document/doi/10.1515/jpem-2023-0442/html
Button zum nach oben scrollen