Endemic Goiter in Greece: An Iodine Balance Study in the Field

Malamos, B.; Koutras, D. A.; Marketos, S.; Rigopoulos, G. A.; Yataganas, Xenophon; Binopoulos, D.; Sfontouris, J.; Pharmakiotis, A. D.; Vought, R. L.; London, William T.

doi:10.1210/jcem-27-10-1372

Cited by 40 publications

(25 citation statements)

References 3 publications

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“…This was also observed in New Guinea [7]. Further more, it was shown in our previous publication that the thyroidal uptake was equally high in all groups of individuals [23], a fact which has also been pointed out by others [7,25,27,32,34,42], This speaks in favour of the view that several factors are involved [26,27] and that, as recently put for ward iodine deficiency may play a permissive role in goitrogenesis [9].…”

Section: Discussionsupporting

confidence: 72%

Regression of Endemic Goitre and of Changes in Iodine Metabolism during 10–15 Years in the East of Finland

Lamberg¹,

Haikonen²,

Hintze³

et al. 1970

Horm Res Paediatr

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In Savonlinna in the east of Finland in 1959 the thyroid uptake was 60–70% in control subjects and in patients with nontoxic goitre (NTG) and with hyperthyroidism and the urinary excretion of stable iodine was 45–60 µg/day. Fourteen patients with NTG, 3 hyperthyroid patients and one healthy control subject were studied in greater detail. The thyroid turnover was normal in NTG with the exception of two patients in whom it was increased. The faecal excretion of iodine was 20 µg/day, the renal iodine clearance 37 ml/min and the calculated iodine concentration in the iodide compartment 0.75–0.90 µg/l. The distribution of ¹³¹I was similar in the control subject and in NTG patients. In a few patients substantial proportions of precipitable iodine were found in the urine and non-butanol-extractable iodine in the blood. In 1969 the uptake was 30–34% in controls and euthyroid goitre patients. The urinary excretion of iodine was 219 µg/day. The goitre incidence in school children in Savonlinna and the surrounding communities was generally 1%, in two communities 6 and 13%, respectively. The figures are markedly lower than those reported in the early 1950s (15–30%). It is concluded that owing to intensified iodine prophylaxis during the last 10 years the endemic goitre is rapidly regressing in this area.

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Section: Discussionsupporting

confidence: 72%

Regression of Endemic Goitre and of Changes in Iodine Metabolism during 10–15 Years in the East of Finland

Lamberg¹,

Haikonen²,

Hintze³

et al. 1970

Horm Res Paediatr

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“…All children at the studied ages from each region were included in the survey, and they and their parents were well informed and aware of the purpose of this study. The regions with (11 regions) and without (6 regions) a past history of endemic goiter from which schoolchildren were examined have been selected based on studies performed 30 years ago in the same geographical areas (1)(2)(3) 65-100 g; Stage III: >100 g). Any thyroid enlargement assessed by palpation to be 40 g or more (Stages Ia-III) was considered to be a goiter.…”

Section: Schoolchildren Studymentioning

confidence: 99%

“…In Greece, 30 years ago the large majority of non-toxic goiter (NTG) was endemic and it was due to iodine deficiency (1,2). At that time, the mean prevalence of NTG among prepubertal boys and girls from endemic goiter areas was about 60% (1), while the prevalence of thyroid autoantibodies (AAB), as estimated by the complement-fixation test, among adult patients with NTG was about 12% (3).…”

Section: Introductionmentioning

confidence: 99%

The predominant form of non-toxic goiter in Greece is now autoimmune thyroiditis

Doufas¹,

Mastorakos²,

Chatziioannou³

et al. 1999

European Journal of Endocrinology

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Endemic non-toxic goiter (NTG) in Greece has been attributed primarily to iodine deficiency. Thirty years ago about 60% of the prepubertal boys and girls examined in endemic goiter regions presented with NTG and among them thyroid autoimmunity was rarely detected. Although iodine supplementation has corrected this deficiency during the past 30 years, new cases of NTG still appear. To evaluate the prevalence and type of NTG and the effect of iodine supplementation on them in Greece at present, we performed two cross-sectional clinical studies and a retrospective pathology one: (i) thyroid gland volume and urinary iodine excretion (UIE) were assessed in a representative sample of 1213 schoolchildren from previously endemic and non-endemic regions; (ii) serum thyroxine, tri-iodothyronine, TSH, thyroid autoantibodies (AAB) (anti-thyroid peroxidase and anti-thyroglobulin antibodies) and UIE (in 60 patients) were measured in 300 consecutive patients with NTG from Athens and Heraklion; and (iii) we compared the prevalence of autoimmunity among fine needle aspiration smears of benign thyroid pathologies performed by the same pathologist between 1985 and 1986 (975 cases) and between 1994 and 1995 (2702 cases). We found that 12.5% of the schoolchildren examined in regions with a previous history of endemic goiter had NTG, whereas this percentage was only 1.7% in areas without such a history. In Athens (61.6%) and Heraklion (58.5%) a substantial number of NTG patients were AAB positive and biochemically hypothyroid. UIE in Athens did not differ between patients with autoimmune goiter (ATG) and simple goiter. The prevalence of autoimmune stigmata in pathology smears has increased from 5.94% (years 1985-1986) to 13.91% (years 1994-1995) (P < 0.05). We conclude that: (i) the persistence of endemic goiter in regional foci despite iodine deficiency correction suggests a possible role for a naturally occurring goitrogen; (ii) ATG is the predominant form of NTG in Greece nowadays; and (iii) the five-fold decrease in the prevalence of NTG during the past 30 years followed by the increase of ATG may support the relative character of the latter.

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“…The following parameters were recorded: sex, age at diagnosis, year of diagnosis, histology, prefecture of birthplace, birthplace categorization (village/city), prefecture of residence, residence categorization (village/city) and categorization of birthplace and residence as an iodine-deficient area or not. The characterization of an area as iodine-deficient or not was based on earlier studies conducted in Greece [6][7][8][9][10] . In this study we did not take into account the patients treatment modalities and disease course due to a paucity of consistently collected data.…”

Section: Methodsmentioning

confidence: 99%

Differentiated thyroid cancer in Greece: 1963-2000. Relation to demographic and environmental factors

Ilias¹,

Alevizaki²,

Lakka-Papadodima³

et al. 2002

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Thyroid cancer (TC) is a relatively rare neoplasia, accounting for 0.35%-0.38% of total deaths due to cancer in Greece. Environmental/nutritional factors are considered to play a role in its pathogenesis. The aim of this retrospective review of patients histories from three of the largest specialized centers in southern Greece, from 1963 to 2000, was to assess associations of differentiated TC (DTC) with demographic and environmental factors. The total number of DTC cases was 610 (119 men or 19.5%, and 491 women or 80.5%), of which 442 cases (72%) were papillary DTCs (pure papillary type: 54.5% and mixed papillary-follicular type: 45.5%), 90 cases (15%) were of the pure follicular type, while 78 cases (13%) were classified as suspicious lesions, requiring follow-up, but not definitively carcinomas. The mean age (±SD) at diagnosis for all groups was 42.3±1.3 years. Fifty percent of the patients were living in Athens at the time of diagnosis. The diagnosis was delayed in patients living in villages compared to those living in cities (mean age ±SD): 43.7±14.1 years and 40.9±13.8 years, respectively; p<0.05, t-test). Patients who were born in iodine-sufficient areas (n=162/193, 84%; X 2 =5.09, P=0.02) had papillary carcinoma more frequently compared to patients who were born in previously iodine-deficient areas (n=159/214, 74%). During the observation period (19632000) there appeared to be three different trends in the incidence of newly diagnosed cases: a random variation during the first nine years and a steady increase during the second two decades (starting before the Chernobyl nuclear accident) followed by a significant decline during the last few years. We suggest that the observed variations in the incidence of DTC could be related to the availability of diagnostic tools as well as to increased awareness.

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Endemic Goiter in Greece: An Iodine Balance Study in the Field

Cited by 40 publications

References 3 publications

Regression of Endemic Goitre and of Changes in Iodine Metabolism during 10–15 Years in the East of Finland

Regression of Endemic Goitre and of Changes in Iodine Metabolism during 10–15 Years in the East of Finland

The predominant form of non-toxic goiter in Greece is now autoimmune thyroiditis

Differentiated thyroid cancer in Greece: 1963-2000. Relation to demographic and environmental factors

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