Abstract
BackgroundThyroid volume (Tvol) is associated with many factors, but the current reference values for Tvol in children with sufficient iodine intake are inappropriate and need to be updated. Moderate changes in thyroid morphology and accentuated increases in body fat percentage occur during puberty as an adaption of the body and sexual development occurs. This study aimed to evaluate the influences of physical growth on Tvol and propose an easily applicable method for conducting Tvol assessments in pubertal girls with sufficient iodine intake.MethodsA cohort study was conducted on 481 pubertal girls in East China from 2017 to 2019. B-ultrasound was used to assess Tvol. Multiple linear regression models were used to estimate the associations of Tvol enlargement (dTvol) with changes in height (dH), weight (dW), waist circumference (dW), body mass index (dBMI), and body surface area (dBSA). Thyroid volume indexes (TVIs), including height thyroid volume index (HVI), weight and height thyroid volume index (WHVI), body mass index thyroid index (BMIV), and body surface area thyroid index (BSAV), were calculated to explore an appropriate method for Tvol assessments by Spearman correlation analyses.ResultsTvol, height, weight, BMI, and BSA increased significantly from baseline to follow-up (P<0.001). The associations between dTvol and physical growth were only observed in the 13 to 14-year-old group. dH, dW,dBMI, and dBSA were positively related to dTvol, with the maximum β of 5.74 (95%CI: 2.54 to 8.94) on dBSA, while dWC was negatively related to dTvol (β= -0.05, 95%CI: -0.08 to -0.03). Both dHVI and dBSAV were not associated with dH, dW, dBMI, or dBSA in both age groups (P>0.05).ConclusionsThyroid volume was associated with physical growth in pubertal girls in East China, both age and anthropometric measurements must be comprehensively considered to establish the reference values for Tvol. HVI, and BSAV may be better indicators for Tvol assessments in pubertal girls.
Highlights
Goiter is considered one of the most common thyroid disorders in children and adolescents [1]
There exist many controversial issues in defining the reference values for Thyroid volume (Tvol) in children, several studies have reported that the goiter rates were widely divergent when assessed both by using the regional reference values and the World Health Organization (WHO) reference values [11, 12], which were established in 2004 based on 3529 children living in areas with long-standing iodine sufficiency after adjustment for age and body surface index (BSA) [13]
After being adjusted for age, changes in puberty development, and urine iodine levels, the results of multiple linear regression analyses suggested that the influence of anthropometric indexes changes on dTvol were observed in girls in the 13 to 14-year-old group
Summary
Goiter is considered one of the most common thyroid disorders in children and adolescents [1]. Moderate changes in thyroid morphology and accentuated increases in body fat percentage occur during puberty as an adaption to the body and sexual development [6]. The current Chinese official reference values for Tvol in children are inappropriate. They were updated in 2007 but only considered age, ignoring physical growth factors [15] more reasonable reference values for Tvol in children are warranted. Thyroid volume (Tvol) is associated with many factors, but the current reference values for Tvol in children with sufficient iodine intake are inappropriate and need to be updated. Moderate changes in thyroid morphology and accentuated increases in body fat percentage occur during puberty as an adaption of the body and sexual development occurs. This study aimed to evaluate the influences of physical growth on Tvol and propose an applicable method for conducting Tvol assessments in pubertal girls with sufficient iodine intake
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