Iodine-deficient Areas Research Articles

Salivary iodine concentrations can estimate iodine intake and diagnose abnormal thyroid function: a cross-sectional study in pregnant and lactating women in iodine-deficient areas.

Salivary iodine concentrations (SIC) and urinary iodine concentrations are correlated. This study aimed to verify the use of SIC as a biomarker for estimating iodine intake in pregnant and lactating women and to diagnose abnormal thyroid function. A cross-sectional study was conducted in northern Xinjiang, China. Participants provided venous blood, random urine, saliva and milk samples. A total of 607 pregnant and 171 lactating women volunteered to participate in the study. The average daily iodine intake was calculated for each participant. Pregnant women were divided according to trimester. The median daily iodine intake was 436·41 μg/d in the first trimester, 425·83 μg/d in the second trimester and 430·56 μg/d in the third trimester. The average daily iodine intake in lactating women was 416·16 μg/d. Different indicators were used to diagnose excessive iodine intake (> 500 μg/d). Among pregnant women, SIC had an AUC of 0·62 (P < 0·01), sensitivity of 51·75 % and specificity of 65 %. Among lactating women, SIC had an AUC of 0·63 (P = 0·03), sensitivity of 43·52 % and specificity of 85 %. SIC was an effective biomarker for diagnosing abnormal thyroid function (P = 0·03). In conclusion, this study demonstrated that SIC is a reliable biomarker for evaluating both iodine nutrition status and abnormal thyroid function in pregnant and lactating women.

Characteristics of exposure to radioactive iodine during a nuclear incident.

During a nuclear accident, numerous products of nuclear fission are released, including isotopes of radioactive iodine. Among them is iodine-131, with a half-life of 8.02 days, which emits β radiation. For decades, it has been effectively and safely used in medicine. However, in the event of a nuclear accident, uncontrolled exposure can have harmful biological effects. The main sources of internal contamination with iodine-131 are contaminated air, food and water. The most exposed organ is the thyroid gland, where radioactive iodine accumulates via the Na+/I- symporter (NIS). NIS does not distinguish between radioactive iodine isotopes and the stable isotope iodine-127, which is essential for the synthesis of thyroid hormones. Exposure to radioactive iodine during a nuclear accident is primarily associated with papillary thyroid cancer, whose incidence begins to increase a few years after exposure. Children and adolescents are at the highest risk, and the risk is particularly significant for individuals living in iodine-deficient areas. Ensuring an adequate iodine supply is therefore crucial for lowering the risk of the harmful effects of exposure to radioactive iodine at the population level. Protecting the thyroid with potassium iodide tablets significantly reduces radiation exposure, as stable iodine prevents the entry of radioactive iodine into the thyroid. Such protection is effective only within a narrow time window - a few hours before and after the exposure and is recommended only for those under 40 years of age, as the risks of excessive iodine intake outweigh the potential benefits in older individuals.

Diffuse Enlargement of the Thyroid Gland as a Result of the Impact of Adverse Factors on the Pituitary-thyroid Cystem of Children

The problem of diffuse goiter has attracted the attention of many researchers in recent years. The main reason for the formation of endemic goiter is iodine deficiency in the environment. Epidemiological studies conducted in recent years have shown that almost all regions of Kazakhstan are regions of endemic goiter with natural iodine deficiency. Some of them are characterized by an increase in the severity of endemic goiter. The reasons contributing to the progression of goiter endemicity are the cessation of iodine prophylaxis, the deterioration of the environmental situation and the social situation of a significant part of the population. The purpose of this work was to study the features of thyroid status in children with diffuse goiter. Material and methods There were 38 children under our supervision, 20 (main group) had diffuse (endemic) goiter (5 boys and 15 girls), 18 children (control group) - 5 boys and 13 girls, children in the control group were considered healthy. Results As a result of comparing indicators of the functional state of the pituitary-thyroid system in patients with diffuse goiter, a relatively increased level of thyroid-stimulating hormone is noted, which indicates the negative impact of diffuse goiter on the thyroid status of children. Conclusions As a result of the manifestation of diffuse goiter in children, metabolic disorders of the pituitary-thyroid system occur. Signs of thyroid deficiency are most often observed in children living in iodine-deficient areas. Bangladesh Journal of Medical Science Vol. 23 No. 04 October’24 Page : 1213-1218

The Causes of Thyrotoxicosis, Clinical Features, and Treatment Strategies in a Former Iodine Deficient Area

Thyrotoxicosis is a hypermetabolic condition caused by excess thyroid hormones in the circulation with/without increased production from the thyroid gland. In this prospective study, we aimed to investigate the causes of thyrotoxicosis, clinical features, and treatment strategies in a former iodine-deficient area. Thyroid function tests, antithyroid and antithyroid receptor antibodies, and routine thyroid ultrasonography was obtained, and a thyroid scintigraphy/radioactive iodine uptake test was performed on need. A statistically significant difference was found between toxic multinodular goiter (TMNG) and Graves’ disease (GD) groups when mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) values were analyzed. TSH levels were significantly lower in GD patients compared to those in TMNG and TNG patients, but free triiodothyronine (FT3) and free thyroxine (FT4) values were higher. A high level of TSH receptor antibody (TRAb) was observed in patients with normal antithyroid peroxidase (Anti-TPO). TRAb levels were found to be high. Anti-TPO and anti-thyroglobulin (Anti-Tg) levels were observed to be positively correlated with sT3 and sT4 levels. TMNG is the leading cause of thyrotoxicosis; despite sufficient iodide intake in our former iodine-deficient region, TMNG is characteristically seen in older patients with much lower thyroid hormone levels than GD. According to the study results, the diagnosis of patients with thyrotoxicosis, their clinical presentation, the treatment they will receive, early detection of postoperative complications were predicted

Ecological monitoring of iodine in pastoral ecosystems

The problem of iodine deficiency is relevant in many countries, including Ukraine, and has serious health consequences due to the insufficient iodine content in food. In order to overcome iodine deficiency, it is important to be based on monitoring the iodine content in food and water in the relevant area. An excessive increase in iodine in salt can cause hyperthyroidism. Monitoring iodine-deficient areas in rural areas becomes especially important, as plants grown on soils with low iodine content may contain insufficient amounts of this element, which can lead to severe iodine deficiency among the population. Iodine is also important for animal health and can improve animal performance. Some plants accumulate iodine from the soil, which can improve their resistance to diseases and negative factors, and the interaction of iodine with other chemical elements is also important. The article summarizes scientific data on the peculiarities of the iodine cycle in the soil-plant-animal chain in pastoral ecosystems, develops recommendations for assessing and overcoming iodine deficiency in ecosystems of this type. The iodine content was determined by a method based on the oxidation of iodide to iodine with the subsequent addition of NH2CONH2 to destroy excess nitrite. The subject of the study were soils., plants of pastoral ecosystems and milk. In the mountainous zone of pastoral ecosystems, a significant iodine deficiency in soils was detected, due to the iodine-deficient nature of the territory. A similar, but less pronounced deficit is observed in the foothills and plains of Northern Bukovina. The iodine content in the green mass of plants does not have general patterns and is not confined to natural zones. The lowest iodine content was found in Plantago major L. Iodine deficiency in milk is more pronounced and decreases from the plain to the mountainous zone. A close correlation was established between the iodine content in the soil and the density of livestock, as well as the indicators of pasture digression. A high correlation between the iodine content in milk and its content in plants was found. Crops adapted to iodine deficiency conditions cannot withstand the effects of recommended iodine concentrations, which can adversely affect yields. However, lower iodine concentrations can stimulate seed germination.

Causal relationship between rheumatoid arthritis and hypothyroid state in young females in iodine deficiency area

Causal relationship between rheumatoid arthritis and hypothyroid state in young females in iodine deficiency area

Exploring Salivary Iodine Concentration as a Biomarker for Iodine Status and Thyroid Nodules in Females From Different Water Iodine Areas: a Cross-sectional Study

BackgroundIt is unclear whether salivary iodine concentration (SIC) can assess iodine status in females from different water iodine regions. ObjectivesThrough a cross-sectional study, we explored the feasibility of SIC as a biomarker to assess iodine status in females and develop optimal cutoff values. MethodsA total of 1991 females were analyzed in this cross-sectional study from the coastal iodine-deficient areas (CIDAs), inland iodine-deficient areas (IIDAs), iodine-adequate areas (IAAs), iodine-excess areas (IEAs), and iodine extra-high areas (IEHAs). SIC, spot urine iodine concentration (SUIC), and daily total iodine intake (TII) were assessed, and ultrasonography was performed in all subjects. ResultsThere was a positive correlation between SIC and SUIC (r = 0.67; 95% CI: 0.64, 0.69; P < 0.001), and TII (r = 0.47; 95% CI: 0.43, 0.50; P < 0.001). The prevalence of thyroid nodules (TN) showed an upward trend with SIC increasing (Z = −2.83; P-trend = 0.005). The area under the receiver-operating characteristic (ROC) curve for SIC to assess iodine deficiency was 0.62 (95% CI: 0.60, 0.65; P < 0.001) and 0.75 (95% CI: 0.73, 0.77; P < 0.001) for iodine excess. The cutoff values were as follows: SIC < 93.32 μg/L, iodine deficiency; 93.32–224.60 μg/L, iodine adequacy; and >224.60 μg/L, iodine excess. When SIC > 224.60 μg/L, the odds ratio (OR) for UIC > 300 μg/L, excessive TII, and the prevalence of TN were 6.44, 3.68, and 1.27 (95% CI: 4.98, 8.31; 2.83, 4.79; and 1.02, 1.56, respectively; P < 0.05); when SIC < 93.32 μg/L, the OR for UIC < 100 μg/L and insufficient TII were 2.34 and 1.94 (95% CI: 1.73, 3.14 and 1.33, 2.83, respectively; P < 0.05). ConclusionsUsing SIC as a biomarker, females in CIDA exhibited mild iodine deficiency, those in IIDA and IAA demonstrated moderate iodine deficiency, and those in IEA and IEHA exhibited an excess of iodine, consistent with SUIC to assess iodine status. SIC can be used as a good biomarker to evaluate the iodine status in population.

Trend analysis of thyroid carcinoma incidence: a retrospective analysis of 2705 cases from an endemic goiter region Runnig title: Trend analysis of thyroid carcinoma an endemic goiter region

Introduction: To provide further data from a population with different genetic background for the contrary views on the ensuing question of “whether iodine status influence the onset and course of thyroid cancer (TC)” by examining trends in TC incidence and prevalence of main sub types of TC in a population from formerly iodine deficient geographic area in Turkey. Methods: Data were retrieved for 2,705 patients (2,161 female, 544 male) who were diagnosed with histopathologically confirmed thyroid cancer at Karadeniz Technical University Farabi Hospital, a university hospital serving a geographic region which remains an endemic goiter area and was formerly iodine-deficient, shortly after mandatory national salt iodization, between 2000 and 2018. Age, gender, subtype, tumor size, stage, and the changes and trends over the years were retrospectively evaluated. Results: Thyroid cancer rates had a trend of increase from 2000 to 2012 and then began to decline. In our region, PTC is more prevalent (93.5%). Among all thyroid cancers, the ratio of micro papillary thyroid cancer (mPTC) is 46.5%, FTC is only 3.5%. mPTC (tumor size ≤10 mm) (49.8%) and macroPTC (tumor size &gt;10 mm) (50.2%) are approximately equal in proportion, and these ratios remained similar over the years covered in this analysis. Stage I PTC is 95.3%. M0 PTC is %98.9. Conclusion: Data from this retrospective epidemiologic study indicates that the rate of PTC is notably high and TC may have a more benign course in our endemic goiter region probably due to iodine supplementation that may affect late-stage thyroid carcinogenesis.

Эндокринная и андрологическая патология у мальчиков-подростков в регионе хронического йододефицита

Objective. To analyze the structure of endocrine and andrological pathology and the impact of iodine deficiency on puberty in adolescent boys living in different ecological and geographical areas of the Republic of Dagestan. Patients and methods. The study included 6513 adolescent boys. The degree of iodine saturation in the Republic of Dagestan was estimated. Renal urinary excretion of iodine was determined in 3457 patients using a flow spectrometer with a System-103 microprocessor (Cibe Corniny, UK). Statistical processing was performed using clinical signs; mean values, standard error of the mean, standard deviations, and coefficient of variation were calculated using MS Visual Fox Pro 9.0, Excel and Biostat 4.03. The significance of differences between the rates of qualitative characteristics was determined by the Dunn index. Results. The analysis of iodine deficiency in different ecological and geographical areas of the Republic of Dagestan revealed that 9.2% of territories in the plain area have severe iodine deficiency. In the mountainous area, 29% of territories have a median severe ioduria. In boys aged 14–17 years, the rate of reproductive disorders increased in territories with different severity of iodine deficiency: moderately severe – 89.6%, mild to moderate – 60.0% (p &lt; 0.05). The clinical and epidemiological analysis of endocrine and andrological pathology showed the severity of iodine deficiency: the rate of endocrine and andrological pathology moderately correlates with the severity of iodine deficiency (R = 0.5), and the leading reproductive pathologies in the Republic of Dagestan are: 1) varicocele, 2) delayed puberty, 3) late diagnosed cryptorchidism. Conclusion. The most frequently detected endocrine and andrological pathology is varicocele, followed by delayed puberty and cryptorchidism. Endocrine and andrological pathology was diagnosed 2.2 times more often in moderately severe iodinedeficient areas of the Republic of Dagestan. Key words: iodine deficiency, ecological and geographical areas, Dagestan, thyroid gland, endocrine and andrological pathology, puberty

Thyroid Ultrasound Elastography: A Promising Undeniably Diagnostic Tool for Predicting the Risk of Malignancy

Thyroid disease is of common occurrence, especially in iodine deficient areas. Thyroid nodules are common findings in the general population. It is important to distinguish the subset of thyroid nodules that are malignant, as morbidity and mortality from thyroid cancer increases with disease stage. B-mode ultrasound features are initially used to select thyroid nodules for FNA. Although FNA is considered the gold standard for diagnosis, it is yet imperfect as up to 1530% of samples are considered non-diagnostic or indeterminate. Thyroid ultrasound elastography(USE) is a noninvasive method of assessing thyroid nodules that provides complementary information to B-mode ultrasound and FNA. The combined use of thyroid USE with B-mode ultrasound may improve the ability to discriminate benign from malignant thyroid nodules and reduce the number of needed FNAs. Thyroid USE may also aid with the difficult problem of distinguishing between malignant and benign follicular neoplasm.The elastic properties of tissue have always been of interest in clinical practice. In the past, the identification of structures that were stiffer on physical palpation would raise the suspicion. With the development and advancement of medicine, there proved to be a true correlation in the prediction of malignancy of lesion: malignant disease tends to stiffen the affected tissue, either by increased cell proliferation or fibrosis. Palpation is the oldest method for the detection of thyroid nodules, which if informed by the knowledge that malignant thyroid lesions tend to be much harder than benign ones. Palpation is dependent on the size, location and skill of the physician. Nodules are very small or located in deep regions; there detection by palpation is difficult or even impossible. Although malignant lesion differs in terms of elasticity, it may not have echogenic properties, preventing its detection by conventional ultrasound. Imaging that indicates the stiffness or deformation related to their structural formation.&#x0D; Bangabandhu Sheikh Mujib Med. Coll. J. 2022;1(2):96-98

Survey of iodized salt coverage in areas with different water iodine concentrations and the iodine status of local women.

There were only two definitions of iodine-deficient (water iodine concentration < 10μg/L) and iodine-excess areas (water iodine concentration > 100μg/L) in China before 2020. Areas with water iodine concentration between 10 and 100μg/L implement the same policy as iodine-deficient areas to provide iodized salt. The definition of iodine-adequate areas was formulated in 2020 for the first time. The paper aims to investigate the coverage rate of iodized salt (CR) in different areas defined according to the latest national standards, evaluate the iodine status of local women, and provide a basis for the revision and improvement of relevant policies. A total of 1948 women aged 18-60 were recruited from the iodine extra-high areas (IEHA), iodine-excess areas (IEA), iodine-adequate areas (IAA), inland iodine-deficient areas (IIDA), and coastal iodine-deficient areas (CIDA). Information on daily diet was collected with the Food Frequency Questionnaire. Drinking water, salt, food, and urine samples were collected and tested in our laboratory. Based on the recommended daily iodine intake, we assessed whether the subjects' daily iodine intake levels were adequate. The CR and the median urinary iodine concentrations (UICs) were 4.02% and 98.03μg/L in CIDA, 89.74% and 144.93μg/L in IIDA, 26.55% and 178.60μg/L in IAA, 8.78% and 446.5μg/L in IEA, 3.95% and 605.4μg/L in IEHA, respectively. The differences among these five areas were statistically significant (P < 0.0001). The daily dietary iodine intakes were mainly from drinking water in IAA (63.92%), IEA (92.29%), and IEHA (92.93%), and were mainly from iodized salt in IIDA (59.22%) and food in CIDA (86.6%). Women in IAA and IIDA were in an adequate iodine state. Women in IEA and IEHA were in an iodine-excess state, and it is necessary to carry out water improvements projects. Women in CIDA were in a slight iodine-deficient state, and health education on scientific iodine fortification should be strengthened to increase iodine intake.

Papillary Thyroid Cancer is also more common in The Iodine Deficiency area: Evaluation of 2748 Patients

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Indeterminate thyroid cytology in an iodine-deficient population: Prevalence, operation rate, risk of malignancy anddiagnostic value of thyroid scintigraphy and 18F-FDG PET imaging parameters.

Patients with indeterminate thyroid cytology often have a diagnostic hemithyroidectomy. The role of molecular imaging, particularly fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET), is controversial, and demographic variations in tumor prevalence and histology influence test performance and clinical utility. We retrospectively assessed the prevalence of indeterminate thyroid cytology and the malignancy rate in patients from an iodine deficient area, and evaluated the diagnostic value of preoperative thyroid scintigraphy and 18F-FDG PET/CT among operated patients. From 2006-2018, all patients with indeterminate thyroid cytology from the North Denmark region were included in the study (population 600,000).Clinical data, including operation rate, preoperative molecular imaging, and histopathological diagnosis, were retrieved. The results from preoperative thyroid scintigraphy and 18F-FDG PET/CT-scanning were compared to the final histopathological diagnosis. Four hundred and thirty-three patients were found with indeterminate thyroid cytology.The main registered reasons for conducting a fine needle aspiration biopsy (FNAB) were "cold nodule", goiter or a palpable nodule (n=312). In 40 patients (9%), FNAB was registered as conducted due to a PET incidentaloma. Four hundred and two patients (93%) underwent diagnostic lobectomy, and this population formed the study population for the following explorative study: One-hundred and two patients (25%) had a malignant diagnosis. In 226 (56%) and 51 (25%) patients, respectively, preoperative thyroid scintigraphy and 18F-FDG PET/computed tomography (CT) was performed. Among patients with a final malignant disease who had a thyroid scintigraphy (40 patients), a cold nodule was seen in 90% of cases; one (atypical) patient presented a warm nodule. Among patients with a final malignant disease 16 patients (16%) had a 18F-FDG PET (incl. 3 missing PET scans). Among the 51 patients with preoperative 18F-FDG PET/CT, no difference in the PET-derived parameters was found between benign (n=33) and malignant tumors (n=13). The prevalence of malignancy (25%) was comparable with that in other studies. In patients with a preoperative thyroid scintigraphy, 90% of malignant cases had a cold nodule on scintigraphy. In patients with a preoperative PET/CT-scanning presenting focal 18F-FDG-uptake, PET-derived parameters had no diagnostic value. However, the diagnostic value of 18F-FDG-avidity vs. non-avidity needs to be addressed prospectively.

Perchlorate, nitrate, and thiocyanate: Environmental relevant NIS-inhibitors pollutants and their impact on thyroid function and human health.

Thyroid disruptors are found in food, atmosphere, soil, and water. These contaminants interfere with the thyroid function through the impairment of thyroid hormone synthesis, plasma transport, peripheral metabolism, transport into the target cells, and thyroid hormone action. It is well known that iodide uptake mediated by the sodium-iodide symporter (NIS) is the first limiting step involved in thyroid hormones production. Therefore, it has been described that several thyroid disruptors interfere with the thyroid function through the regulation of NIS expression and/or activity. Perchlorate, nitrate, and thiocyanate competitively inhibit the NIS-mediated iodide uptake. These contaminants are mainly found in food, water and in the smoke of cigarettes. Although the impact of the human exposure to these anions is highly controversial, some studies indicated their deleterious effects in the thyroid function, especially in individuals living in iodine deficient areas. Considering the critical role of thyroid function and the production of thyroid hormones for growth, metabolism, and development, this review summarizes the impact of the exposure to these NIS-inhibitors on thyroid function and their consequences for human health.

Thyroid volume and nodules in patients with impaired fasting glucose and type 2 diabetes mellitus

Background. The relationship between insulin resistance and thyroid nodules is not clearly understood. Insulin resistance is associated with increased thyroid volume and nodule prevalence in patients with metabolic syndrome. Metformin commonly used in patients with type 2 diabetes mellitus (T2DM) might possibly alter thyroid function and morphology. Data on the association of thyroid morphology and abnormal glucose metabolism are limited. This prospective study was carried out to evaluate impaired fasting glucose (IFG) and T2DM as a risk factor for increased thyroid volume and nodule prevalence in iodine-deficient area. Materials and methods. This was a prospective case-control study in patients with IFG and T2DM. Data were gathered on all patients newly diagnosed with IFG and T2DM between January 2018 and December 2020. Sixty-five patients with IFG and 52people with T2DM were randomly matched for age, gender, and smoking habits with 38 subjects with normal glucose metabolism. Serum thyroid-stimulating hormone (TSH) was evaluated, and thyroid ultrasonography was performed in all participants. Results. Mean TSH level in the T2DM group (2.1±0.9 mIU/l) was significantly higher than in controls (1.4±0.7 mIU/l) and in the IFG group (1.5±0.8 mIU/l) (p&lt;0.001 for both). Thyroid autoantibody levels were within normal limits and did not differ significantly between 3 groups. Mean thyroid volume was significantly higher in the IFG (16.1±4.2 cm3) and T2DM groups (19.4±5.2 cm3) compared to controls (11.9±3.7cm3). In the T2DM group, there was a positive correlation between TSH and body mass index (r=0.43; p&lt;0.01), and between TSH and waist circumference (r=0.37; p&lt;0.01). The number of patients with thyroid nodules was also higher in the IFG (46.2%) and T2DM groups (63.1%) than in controls (18.4%). Conclusions. The results suggest that patients with impaired glucose metabolism and type 2 diabetes mellitus have significantly increased thyroid volume and nodule prevalence.

Iodine deficiency and thyroid dysfunction: Current scenario in Nepal

Iodine deficiency is a major cause of thyroid disorders worldwide. Nepal lies in the endemic area of iodine deficiency which was previously referred to as Himalayan goiter belt, with high prevalence of iodine deficiency disorders including goiter, cretinism and hypothyroidism. With effective implementation of universal salt iodization program, Nepal has a successful public health story to share having drastically reduced the iodine deficiency disorders. Moreover, challenge has appeared with rising number of excess iodine states. Thyroid dysfunction is growing higher and the increasing proportion of hyperthyroidism is particularly concerning. Time has come for us to suitably review the standards of salt iodization and control the increasing number of cases with thyroid dysfunction by the coordinated efforts of all stakeholders, along with sustaining the optimal level of iodine.

The influence of thyroid hormone medication on intra-therapeutic half-life of 131I during radioiodine therapy of solitary toxic thyroid nodules

Despite a significantly improved dietary iodine supply, solitary toxic thyroid nodules (STN) are still a common clinical problem in former iodine deficient areas. Radioiodine treatment (RIT) is a well-established therapeutic option with few side effects and high success rates. As radioiodine biokinetics are individual for every patient, the necessary activity has to be calculated individually by a pre-therapeutic measurement of the intra-therapeutic effective half-life (EHL) in a radioiodine uptake test (RIUT). A suppressive medication with triiodothyronine (T3) or tetraiodothyronine (T4) is often needed to suppress uptake in normal thyroid tissue. Therefore, the aim of this study was to quantify the possible influence of this medication on intra-therapeutic radioiodine biokinetics. A cohort of 928 patients with STN undergoing RIUT and RIT was analysed. Patients were subdivided into 3 groups. Group T3: medication with T3 (n = 274), group T4: medication with T4 (n = 184) and group NM: no additional medication (n = 470). The T3 and T4 subgroups were further subdivided depending on the dose of thyroid hormone medication. In order to analyse the influence of thyroid hormone medication on individual intra-thyroidal biokinetics, the variance of the determined individual EHL between RIUT and RIT within the single groups and within the subgroups was investigated. EHL was significantly decreased between RIUT and RIT in the T3 and T4 subgroups (EHL: T3: 5.9 ± 1.1 d in RIUT and 3.3 ± 1.4 d in RIT (− 43%) (p < 0.05); T4: 5.9 ± 1.2 d in RIUT and 3.4 ± 1.5 d in RIT (− 42%) (p < 0.05). The decrease of EHL did not differ statistically between T3 or T4. However, both showed a highly significant difference compared to the NM group (p < < 0.05). A further subgroup analysis showed a significant dependence of the decrease in EHL related to the dose of thyroid hormone medication of 35–58% (T3) and 15–67% (T4) (p < 0.05). A significantly reduced EHL compared to RIUT in patients receiving thyroid hormone medication was detected. Moreover, a significant correlation between the dose of thyroid hormone medication (T3 or T4) and the decrease of EHL was found. Therefore, an adaption of the calculated activity should be considered in RIUT to obtain the required radiation dose in RIT of patients suffering from STN.

Thyroid Dysfunction, Total Cholesterol Levels and Anthropometric Status in Women of Reproductive Age in Iodine Deficient Area of Prambanan Sub-District, Sleman Regency, Indonesia

Thyroid Dysfunction, Total Cholesterol Levels and Anthropometric Status in Women of Reproductive Age in Iodine Deficient Area of Prambanan Sub-District, Sleman Regency, Indonesia

The Thyroid Condition and Residual Clinical Signs in 31 Existing Endemic Neurological Cretins After 42 Years of Iodine Supplementation in China.

BackgroudEndemic cretinism is the most severe manifestation among the iodine deficiency-related disorders. The clinical status of the cretins may be modified subsequently by the duration and severity of the disease. We aimed to reassess the clinical status and thyroid function of 31 surviving “neurological cretins” after 42 years of iodine supplementation in a historically severely iodine deficiency area of China.MethodsIt was a cross-sectional study in design and we investigated all 31 surviving neurological cretins and 85 controls. A detailed neurological examination was conducted on each patients. All the participants were given a questionnaire and underwent B-mode ultrasonography of the thyroid. The serum levels of thyroid hormones, thyroid antibodies, serum iodine concentration (SIC) and urine iodine concentration (UIC) were measured.ResultsThe neurological cretins had shorter stature than that of the control. Neurological damage is still present in patients with cretinism. The prevalence of subclinical hypothyroidism and thyroid nodule in the cretins was significantly higher (χ2 =4.766, P=0.029 and χ2 =17.077, P<0.0001, respectively) compared with the control. After adjusting for confounding factors, endemic neurocretinism was found to be an independent risk factor for subclinical hypothyroidism (OR=4.412; 95% CI: 1.358–14.334; P=0.014) and thyroid nodule (OR=6.433; 95% CI: 2.323–17.816; P<0.0001).ConclusionsIodine supplementation after birth does not reverse the neurological damage that results from maternal/foetal hypothyroidism in utero and is subsequently manifested as neurological cretinism. There is a cross-sectional association between endemic neurocretinism and subclinical hypothyroidism and thyroid nodule.

Epidemiology of Thyroid Cancer.

Epidemiology of Thyroid Cancer.