Thyroid volume in Swedish school children; a national, stratified, population-based survey.
Résumé
Background/ Objectives: Sweden has had a salt iodination program since 1936. This first national surveillance study on iodine nutrition infers an adequate level of urinary iodine concentration (UIC 125 ug/L) and the aim is now to evaluate thyroid volume (Tvol) in the same national sample. Subjects/ Methods: A stratified probability proportionate to size cluster sampling was used to obtain a representative national sample of Swedish children aged 6-12 years. Median Tvol obtained ultrasonografically and the prevalence of enlarged thyroid glands were compared with an international reference standard. Regional differences were evaluated through comparisons of Tvol between coastal and inland areas, urban and rural regions, and former goitre and non-goitre regions. Results: Tvol correlated to age, body surface area (BSA), weight, height, and BMI for both sexes, (p<0.0001) but not to UIC. The most important predictors for Tvol were age (girls: p<0.0001, boys: p=0.001) and BSA (girls: p<0.0001, boys p<0.01). Median Tvol was higher in Sweden than in the reference study (p<0.0001). The prevalence of goitre was higher in Sweden (age (22.3%, BSA 15.7%, weight 17.6%, height 12.9%) than in the international reference (age 2.5%, BSA 2.5%, weight 2.5%, height 2.5%)(p<0.0001). Thyroids were larger in boys from urban and former non-goitre areas. Conclusion: Tvols were higher in Swedish school children than in the international reference study although iodine intake is considered optimal in Sweden. These findings underline the importance of regular monitoring of iodine intake, especially concerning the decreased intake of table salt that is likely to follow health campaigns.
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