Small thyroid volumes and normal iodine excretion in Berlin schoolchildren indicate full normalization of iodine supply
Small thyroid volumes and normal iodine excretion in Berlin schoolchildren indicate full normalization of iodine supply
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DOI：
10.1055/s-0029-1211932
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发表时间：
1997-01-01
影响因子：
1.8
通讯作者：
Grüters, A
中科院分区：
文献类型：
--
作者：
Liesenkötter, KP;Kiebler, A;Grüters, A
碘缺乏是婴儿和儿童甲状腺体积增加的主要原因。在这项实地研究中，我们监测了碘供应及其对柏林市东部和西部青春期前和青春期儿童甲状腺体积的影响，迄今为止，该地区被认为是碘缺乏的边缘。超声测量甲状腺体积1080例（f = 552，m = 528）例3-15岁儿童，年龄、体表面积、晨尿碘排泄量与碘浓度呈显著正相关，平均碘浓度为115.8 μ g碘/g肌酐（12.2微克碘/dl尿），东部地区之间无显著差异，碘为114.5 μ g/g肌酐（12.3 μ g碘/dl尿）与城市西部的116.7 μ g碘/g肌酐（12.0 μ g碘/dl尿）。与以前在儿童和成人中进行的研究相比，儿童的这种良好碘供应令人惊讶。此外，儿童甲状腺体积较小反映了碘排泄的正常化。发现体积随年龄增加，青春期前儿童为2.4 +/- 1.1 ml（Prader和Largo：f小于或等于10.9 vs. m小于或等于11.5 ys），而青春期儿童为4.3 +/-1.7 ml。根据这一数据计算的甲状腺肿患病率低于5%。在所有儿童中，只有11名儿童（8-13岁）的甲状腺超声检查结果异常：6个小结节，1个女孩的甲状腺囊肿，2个女孩有不均匀的回声结构和2个女孩提出了一个半甲状腺。本研究表明，与先前发表的德国儿童甲状腺体积相比，柏林儿童的碘供应得到改善，导致甲状腺体积变小（Muller-Leisse 1988; Klingmuller，1991; Menken，1992），但它们与碘供应充足的国家所描述的体积相当。
Iodine deficiency is the major cause of an increase in thyroid gland volume in infants and children. In this field study we monitored the iodine supply and its effect on the thyroid gland volume in prepubertal and pubertal children in the eastern and western parts of the city of Berlin, so far considered as an area with borderline iodine deficiency. The thyroid gland volume was determined by ultrasound in 1080 (f = 552, m = 528) children aged 3-15 years, and was correlated to age, body-surface area and iodine excretion, which was measured in a first-morning spot urine.The mean iodine concentration was 115.8 mu g iodine/g creatinine (12.2 mu g iodine/dl urine), with no significant differences between eastern parts with 114.5 mu g iodine/g creatinine (12.3 mu g iodine/dl urine) vs 116.7 mu g iodine/g creatinine (12.0 mu g iodine/dl urine) in the western parts of the city. This good iodine supply of the children was surprising compared to former studies in children and adults. Moreover this normalization of the iodine excretion was reflected by smaller thyroid gland volumes in the children. The volume was found to increase with age and was 2.4 +/- 1.1 ml in prepubertal (Prader and Largo: f less than or equal to 10.9 vs. m less than or equal to 11.5 ys) children, compared to 4.3 +/- 1,7 ml in pubertal children. The goiter prevalence, calculated on this data was below 5%. Among all children there were only 11 (aged 8-13 ys) with abnormal findings of the thyroid gland on ultrasound: 6 with small nodules, 1 girl with a thyroid-cyst, 2 girls had an inhomogenous echo structure and 2 girls presented with a hemithyroidea. This study shows that the iodine supply of the children in Berlin has improved, resulting in smaller sized thyroid glands, compared to those which have been previously published for Germany (Muller-Leisse 1988; Klingmuller, 1991; Menken, 1992), but they correspond well to volumes described in countries with sufficient iodine supply.