Prevalence of goiter among schoolchildren from Gorgan, Iran, a decade after national iodine supplementation: Association with age, gender, and thyroperoxidase antibodies

Background: One decade after universal salt iodization in Iran, goiter prevalence, urinary iodine concentration (UIC) and thyroperoxidase antibody (TPOAb) values were assessed among schoolchildren in Gorgan, Iran. Methods: From 2003-2004, 500 girls and 900 boys aged 7-11 yr were evaluated for goiter by palpation. UIC was measured in 183 randomly-selected goitrous children. Serum TSH, T 4, and TPOAb were measured in 53 goitrous and 30 non-goitrous children with adequate UIC. Results: Goiter was detected in 370 (26.4%) children. Goiter was present in 31 % of girls and 17% of boys age 9 (p<0.012); 37% of girls and 20% of boys age 10 (p<0.003); and 52% of girls and 19% of boys age 11 (p<0.0001). Median (range) UIC for all goitrous children sampled was 190 (20-600) μg/l; 220 (30-590) in boys and 170 (20-600) in girls (p=0.001). Eight point seven percent of goitrous children and 22% of goitrous girls aged 10-11 had UIC<100 μg/l, while 47% of the goitrous children had UIC≥200 μg/l. TPOAb was present in 52.8% of goitrous children and 10% of non-goitrous children (p=0.0001 ). TPOAb was present in 53.9% of 10-11 and 22.7% of 7-9 yr old goitrous and non-goitrous children (p=0.003) with adequate UIC. Median (range) TSH was 2.9 (0.3-10.9) mlU/l in TPO-positive and 1.8 (0.5-4.1) in TPO-negative children (p=0.001 ). Conclusions: Gorgan, Iran, is an iodine-sufficient area and almost half of schoolchildren have more than adequate UIC. TPOAb is associated with endemic goiter. Despite sufficient UIC overall, some school-aged girls remain at risk of iodine deficiency. ©2005, Editrice Kurtis

An assessment of urinary and breast milk iodine concentrations in lactating mothers from Gorgan, Iran, 2003

Dietary iodine is essential for the production of thyroid hormones. Breast-fed infants are reliant on maternal iodine intake. The aim of this study was to evaluate iodine sufficiency in lactating women in Iran. The sample consisted of 100 lactating mothers referred to the Taleghani Hospital of Gorgan, Iran. Goiter was graded according to World Health Organization (WHO) classification. Spot urine and breast-milk samples were collected for the measurement of iodine concentrations. Urine iodine concentrations (UIC) less than 100 and breast-milk iodine concentrations (MIC) less than 50 μg/L were considered consistent with iodine deficiency. Forty-three percent of women had grade 1 and 2 goiters, respectively. The median UIC was 259 μg/L. UIC was less than 100 in 16. Grade 1 and 2 goiters were each present in 8 of mothers with UIC less than 100 μg/L. The median MIC was 93.5 μg/L. MIC was less than 50 μg/L in 19. Grade 1 and 2 goiters were present in 11 and 8, respectively, of women with MIC <50 mg/L. MIC and UIC levels were significantly correlated (r = 0.44, p < 0.0001). Iodine deficiency and goiter were associated (p < 0.0001). UIC and MIC concentrations are sufficient in Gorgan, Iran. However, individual infants remain at risk for low iodine intake via breast milk. © Mary Ann Liebert, Inc