Prospective study on the effect of different iodine intakes on goiter and thyroid nodules
YU Xiao-hui, FAN Chen-ling, SHAN Zhong-yan, TENG Xiao-chun, TENG Di, GUAN Hai-xia, LI Yu-shu, CHONG Wei, YANG Fan, DAI Hong, YU Yang, LI Jia, CHEN Yan-yan, ZHAO Dong, MAO Jin-yuan, GU Xiao-lan, YANG Rong, JIANG Ya-qiu, LI Chen-yang, TENG Wei-ping
Abstract
Objective To investigate the epidemiological characteristics of non-toxic goiter and non-toxic thyroid nodules in the regions with different iodine intakes and the factors influencing the occurrence, development and outcome of goiter and thyroid nodules. Methods 3 385 subjects, who had taken part in the previous survey in 1999 with the ultrasonic examination of thyroid, were composed of individuals in Panshan with chronic mild iodine deficiency,in Zhangwu with more than adequate iodine "after iodine supplementation and in Huanghua with excessive iodine. These 3 groups of subjects were followed up in 2004. Results (1) The cumulative incidences of diffuse goiter in Panshan ,Zhangwu and Huanghua were 7.1% ,4.4% and 6.9% ,respectively ,being the lowest in Zhangwu (P<0.01) and those of nodular goiter were 5.0% ,2. 4% and 0.8%, respectively, being the highest in Panshan (P<0.01). (2) The incidences of single nodule were 4.0% ,5.7% and 5.6%, respectively, and those of multiple nodules 0.4%, 1.2% and 1.0%, respectively. (3)The result of logistic analysis showed that iodine deficiency,iodine excess and positive thyroid autoantibodies (TAA) were the independent risk factors for the occurrence of goiter. (4)In Zhangwu ,the incidence of non-toxic goiter in the group with positive TAA was higher than that in the group with negative TAA(P<0.01) ,while there were no such differences in Panshan and Huanghua. (5)In these three regions, the rates of positive TAA in the individuals with diffuse non-toxic goiter were higher than those in the healthy subjects (P<0.05). And in Huanghua,the rate of positive TAA in subjects with non-toxic nodular goiter was also higher than that in the healthy individuals (P<0.05). Conclusion Iodine deficiency and iodine excess may both induce the raising incidence of goiter. Nodular goiter is prevalent in iodine deficient district and diffuse goiter is the predominant form in places with iodine excess. Thyroid autoimmunity is associated with occurrence and maintenance of goiter, and this phenomenon is more obvious in the community with previous iodine deficiency followed then by treatment with more than adequate iodine.
Key words:
Iodine; Goiter; Thyroid nodules; Epidemiological study ; Prospective study
Contributor Information
YU Xiao-hui
Department of Endocrinology,Institute of Endocrinology, The First Affiliated Hospital of China Medical University,Shenyang 110001, China
FAN Chen-ling
Department of Endocrinology,Institute of Endocrinology, The First Affiliated Hospital of China Medical University,Shenyang 110001, China
SHAN Zhong-yan
Department of Endocrinology,Institute of Endocrinology, The First Affiliated Hospital of China Medical University,Shenyang 110001, China
TENG Xiao-chun
Department of Endocrinology,Institute of Endocrinology, The First Affiliated Hospital of China Medical University,Shenyang 110001, China
TENG Di
Department of Endocrinology,Institute of Endocrinology, The First Affiliated Hospital of China Medical University,Shenyang 110001, China
GUAN Hai-xia
Department of Endocrinology,Institute of Endocrinology, The First Affiliated Hospital of China Medical University,Shenyang 110001, China
LI Yu-shu
Department of Endocrinology,Institute of Endocrinology, The First Affiliated Hospital of China Medical University,Shenyang 110001, China
CHONG Wei
Department of Endocrinology,Institute of Endocrinology, The First Affiliated Hospital of China Medical University,Shenyang 110001, China
YANG Fan
Department of Endocrinology,Institute of Endocrinology, The First Affiliated Hospital of China Medical University,Shenyang 110001, China
DAI Hong
Department of Endocrinology,Institute of Endocrinology, The First Affiliated Hospital of China Medical University,Shenyang 110001, China
YU Yang
Department of Endocrinology,Institute of Endocrinology, The First Affiliated Hospital of China Medical University,Shenyang 110001, China
LI Jia
Department of Endocrinology,Institute of Endocrinology, The First Affiliated Hospital of China Medical University,Shenyang 110001, China
CHEN Yan-yan
Department of Endocrinology,Institute of Endocrinology, The First Affiliated Hospital of China Medical University,Shenyang 110001, China
ZHAO Dong
Department of Endocrinology,Institute of Endocrinology, The First Affiliated Hospital of China Medical University,Shenyang 110001, China
MAO Jin-yuan
Department of Endocrinology,Institute of Endocrinology, The First Affiliated Hospital of China Medical University,Shenyang 110001, China
GU Xiao-lan
Department of Endocrinology,Institute of Endocrinology, The First Affiliated Hospital of China Medical University,Shenyang 110001, China
YANG Rong
Department of Endocrinology,Institute of Endocrinology, The First Affiliated Hospital of China Medical University,Shenyang 110001, China
JIANG Ya-qiu
Department of Endocrinology,Institute of Endocrinology, The First Affiliated Hospital of China Medical University,Shenyang 110001, China
LI Chen-yang
Department of Endocrinology,Institute of Endocrinology, The First Affiliated Hospital of China Medical University,Shenyang 110001, China
TENG Wei-ping
Department of Endocrinology,Institute of Endocrinology, The First Affiliated Hospital of China Medical University,Shenyang 110001, China