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Persistence of goitre in the post-iodization phase: micronutrient deficiency or thyroid autoimmunity?

BACKGROUND & OBJECTIVES: Despite years of salt iodization, goitre continues to be a major public health problem worldwide. We examined the prevalence of goitre in the post-iodization phase and the relationship of goitre with micronutrient status and thyroid autoimmunity in school children of Cha...

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Autores principales: Das, Sambit, Bhansali, Anil, Dutta, Pinaki, Aggarwal, Arun, Bansal, M.P., Garg, Dinesh, Ravikiran, Muthuswamy, Walia, Rama, Upreti, Vimal, Ramakrishnan, Santosh, Sachdeva, Naresh, Bhadada, Sanjay K.
Formato: Texto
Lenguaje:English
Publicado: Medknow Publications 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3100137/
https://www.ncbi.nlm.nih.gov/pubmed/21321427
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author Das, Sambit
Bhansali, Anil
Dutta, Pinaki
Aggarwal, Arun
Bansal, M.P.
Garg, Dinesh
Ravikiran, Muthuswamy
Walia, Rama
Upreti, Vimal
Ramakrishnan, Santosh
Sachdeva, Naresh
Bhadada, Sanjay K.
author_facet Das, Sambit
Bhansali, Anil
Dutta, Pinaki
Aggarwal, Arun
Bansal, M.P.
Garg, Dinesh
Ravikiran, Muthuswamy
Walia, Rama
Upreti, Vimal
Ramakrishnan, Santosh
Sachdeva, Naresh
Bhadada, Sanjay K.
author_sort Das, Sambit
collection PubMed
description BACKGROUND & OBJECTIVES: Despite years of salt iodization, goitre continues to be a major public health problem worldwide. We examined the prevalence of goitre in the post-iodization phase and the relationship of goitre with micronutrient status and thyroid autoimmunity in school children of Chandigarh, north India. METHODS: Two phase study; in the first phase, 2148 children of 6 to 16 yr were screened for goitre by two independent observers as per the WHO grading system. In the second phase, a case-control study, 191 children with goitre and 165 children without goitre were compared with respect to urinary iodine, iodine content of salt, serum levels of T(3), T(4), TSH, anti-TPO (thyroid peroxidase) antibody, haemoglobin, ferritin and selenium. RESULTS: Prevalence of goitre in the studied subjects was 15.1 per cent (13.9% in 6 to 12 yr and 17.7% in 13 to 16 yr age group, P= 0.03). Median urinary iodine excretion in both the groups was sufficient and comparable (137 and 130 µg/l). 3.2 per cent children with goitre and 2.4 per cent without goitre had hypothyroidism (subclinical and clinical) and only one child with goitre had subclinical hyperthyroidism. Nine (4.9%) children in the goitre group and 3 (1.9%) in control group had anti-TPO antibody positivity. The median serum selenium levels were not different in both the groups (181.9 and 193.5 µg/l). Seventy one (37.4%) of the goitrous children had anaemia (haemoglobin <12 g/dl) as compared to 41 (24.8%) of the control group (P <0.01). More number of goitrous children (39, 20.6%) were depleted of tissue iron stores (serum ferritin <12 µg/l) as compared to controls (11, 6.4%; P<0.001). Serum ferritin level negatively correlated with the presence of goitre (r = - 0.22, P =0.008) and had an OR of 2.8 (CI 1.20 - 6.37, P =0.017). INTERPRETATION & CONCLUSIONS: There was a high prevalence of goitre in young children despite iodine repletion and low thyroid autoimmunity. The concurrent iron deficiency correlated with the presence of goiter. However, the cause and effect relationship between iron deficiency state and goitre requires further elucidation.
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spelling pubmed-31001372011-06-08 Persistence of goitre in the post-iodization phase: micronutrient deficiency or thyroid autoimmunity? Das, Sambit Bhansali, Anil Dutta, Pinaki Aggarwal, Arun Bansal, M.P. Garg, Dinesh Ravikiran, Muthuswamy Walia, Rama Upreti, Vimal Ramakrishnan, Santosh Sachdeva, Naresh Bhadada, Sanjay K. Indian J Med Res Original Article BACKGROUND & OBJECTIVES: Despite years of salt iodization, goitre continues to be a major public health problem worldwide. We examined the prevalence of goitre in the post-iodization phase and the relationship of goitre with micronutrient status and thyroid autoimmunity in school children of Chandigarh, north India. METHODS: Two phase study; in the first phase, 2148 children of 6 to 16 yr were screened for goitre by two independent observers as per the WHO grading system. In the second phase, a case-control study, 191 children with goitre and 165 children without goitre were compared with respect to urinary iodine, iodine content of salt, serum levels of T(3), T(4), TSH, anti-TPO (thyroid peroxidase) antibody, haemoglobin, ferritin and selenium. RESULTS: Prevalence of goitre in the studied subjects was 15.1 per cent (13.9% in 6 to 12 yr and 17.7% in 13 to 16 yr age group, P= 0.03). Median urinary iodine excretion in both the groups was sufficient and comparable (137 and 130 µg/l). 3.2 per cent children with goitre and 2.4 per cent without goitre had hypothyroidism (subclinical and clinical) and only one child with goitre had subclinical hyperthyroidism. Nine (4.9%) children in the goitre group and 3 (1.9%) in control group had anti-TPO antibody positivity. The median serum selenium levels were not different in both the groups (181.9 and 193.5 µg/l). Seventy one (37.4%) of the goitrous children had anaemia (haemoglobin <12 g/dl) as compared to 41 (24.8%) of the control group (P <0.01). More number of goitrous children (39, 20.6%) were depleted of tissue iron stores (serum ferritin <12 µg/l) as compared to controls (11, 6.4%; P<0.001). Serum ferritin level negatively correlated with the presence of goitre (r = - 0.22, P =0.008) and had an OR of 2.8 (CI 1.20 - 6.37, P =0.017). INTERPRETATION & CONCLUSIONS: There was a high prevalence of goitre in young children despite iodine repletion and low thyroid autoimmunity. The concurrent iron deficiency correlated with the presence of goiter. However, the cause and effect relationship between iron deficiency state and goitre requires further elucidation. Medknow Publications 2011-01 /pmc/articles/PMC3100137/ /pubmed/21321427 Text en © The Indian Journal of Medical Research http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Das, Sambit
Bhansali, Anil
Dutta, Pinaki
Aggarwal, Arun
Bansal, M.P.
Garg, Dinesh
Ravikiran, Muthuswamy
Walia, Rama
Upreti, Vimal
Ramakrishnan, Santosh
Sachdeva, Naresh
Bhadada, Sanjay K.
Persistence of goitre in the post-iodization phase: micronutrient deficiency or thyroid autoimmunity?
title Persistence of goitre in the post-iodization phase: micronutrient deficiency or thyroid autoimmunity?
title_full Persistence of goitre in the post-iodization phase: micronutrient deficiency or thyroid autoimmunity?
title_fullStr Persistence of goitre in the post-iodization phase: micronutrient deficiency or thyroid autoimmunity?
title_full_unstemmed Persistence of goitre in the post-iodization phase: micronutrient deficiency or thyroid autoimmunity?
title_short Persistence of goitre in the post-iodization phase: micronutrient deficiency or thyroid autoimmunity?
title_sort persistence of goitre in the post-iodization phase: micronutrient deficiency or thyroid autoimmunity?
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3100137/
https://www.ncbi.nlm.nih.gov/pubmed/21321427
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