Goitre epidemiology: thyroid volume, iodine excretion, thyroglobulin and thyrotropin in Germany and Sweden

Abstract

Abstract. Thyroid volume of 1397 German and 303 Swedish adults were estimated by sonography. Thyroid size of 6–16 year old Germans (n = 619) was determined and compared with findings on palpation. Thyroid volume was more than twice as great in German (21.4 ± 15.6 ml, mean ± sd) than in Swedish adults (10.1 ± 4.9 ml). The echopattern was abnormal in 16% of the Germans and in 3.6% of the Swedes. German children have a thyroid volume ranging from 1.8 ± 0.4 ml at 6 years to 10.8 ± 6.0 ml at 16 years of age. Palpation is by comparison an unreliable method for determining thyroid size. In Germany, the iodine excretion was less in children (n = 619, 39.5 ± 30.5, 34.1 μg I/g creatinine, mean ± sd, median) than in adults (n = 1193, 83.7 ± 94.4, 62.6), (P <0.001) and much lower than that observed in Sweden (adults n = 98, 170.2 ± 93.3, 141.4; 13 year olds n = 113, 172.9 ± 224.1, 124), (P < 0.0001). Serum thyrotropin concentration was significantly higher (P <0.001) in Sweden (n = 62, 1.49 ± 0.82 mU/ml), than in Germany (n = 91, 0.97 ± 0.52 mU/ml), while serum thyroglobulin was increased in Germany (n = 91, 72.6 ± 50.6 μg/l) as compared to Sweden (n = 62, 23.5 ± 17.4), (P <0.0001). These results indicate the goitrogenic effect of iodine deficiency and the continuing need for an effective iodine prophylaxis in the FRG.