Thyroid volume in Swedish school children: a national, stratified, population-based survey

Nyström, Helena Filipsson; Andersson, Maria; Berg, Gertrud E. B.; Eggertsen, Robert; Gramatkowski, E; Hansson, Malin; Hulthén, Lena; Milakovic, Mille; Nyström, Ernst

doi:10.1038/ejcn.2010.162

Cited by 30 publications

(41 citation statements)

References 18 publications

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“…Göteborg is situated close to a salt-water sea and people of Göteborg have had a traditionally high dietary consumption of fish, which may be reflected by the low prevalence of goiter historically and presently (22). Longtime sufficient iodine intake therefore could be one of the many unknown reasons for the lower incidence of TNG we found in Göteborg compared with the average for Sweden.…”

Section: Discussionmentioning

confidence: 37%

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Incidence of hyperthyroidism in Sweden

Abraham-Nordling¹,

Byström²,

Törring³

et al. 2011

European Journal of Endocrinology

199

135

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Introduction: The incidence of hyperthyroidism has been reported in various countries to be 23-93/100 000 inhabitants per year. This extended study has evaluated the incidence for w40% of the Swedish population of 9 million inhabitants. Sweden is considered to be iodine sufficient country. Methods: All patients including children, who were newly diagnosed with overt hyperthyroidism in the years [2003][2004][2005], were prospectively registered in a multicenter study. The inclusion criteria are as follows: clinical symptoms and/or signs of hyperthyroidism with plasma TSH concentration below 0.2 mIE/l and increased plasma levels of free/total triiodothyronine and/or free/total thyroxine. Patients with relapse of hyperthyroidism or thyroiditis were not included. The diagnosis of Graves' disease (GD), toxic multinodular goiter (TMNG) and solitary toxic adenoma (STA), smoking, initial treatment, occurrence of thyroid-associated eye symptoms/signs, and demographic data were registered. Results: A total of 2916 patients were diagnosed with de novo hyperthyroidism showing the total incidence of 27.6/100 000 inhabitants per year. The incidence of GD was 21.0/100 000 and toxic nodular goiter (TNGZSTACTMNG) occurred in 692 patients, corresponding to an annual incidence of 6.5/100 000. The incidence was higher in women compared with men (4.2:1). Seventy-five percent of the patients were diagnosed with GD, in whom thyroid-associated eye symptoms/signs occurred during diagnosis in every fifth patient. Geographical differences were observed. Conclusion: The incidence of hyperthyroidism in Sweden is in a lower range compared with international reports. Seventy-five percent of patients with hyperthyroidism had GD and 20% of them had thyroid-associated eye symptoms/signs during diagnosis. The observed geographical differences require further studies.

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Section: Discussionmentioning

confidence: 37%

“…Sweden is considered to be iodine sufficient with no geographically significant differences in glandular volume in a recent survey. We therefore consider the population in this study to be iodine sufficient (21,22).…”

Section: Study Populationmentioning

confidence: 99%

Incidence of hyperthyroidism in Sweden

Abraham-Nordling¹,

Byström²,

Törring³

et al. 2011

European Journal of Endocrinology

199

135

View full text Add to dashboard Cite

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“…In this study, the MUI in the study's schoolchildren was 178.30 μ g l −1 , which was similar to the data reported in Germany (183.00 μ g l −1 ) [28] and Bahrain (178.00 μ g l −1 ) [13] but higher than that in Turkey (53.00 μ g l −1 ) [29], Bangladesh (73 μ g l −1 ) [10], Switzerland (115 and 118.00 μ g l −1 ) [11, 13], Sweden (125.00 μ g l −1 ) [30], Italy (125.00 μ g l −1 ) [31], Malaysia (132.80 μ g l −1 ) [9], Netherlands (154.40 μ g l −1 ) [32], and Poland (126.60–155.10 μ g l −1 ) [33] and less than that in South Africa (191.00 μ g l −1 ) [13], Iran (212.00 μ g l −1 ) [34], Peru (253.00 μ g l −1 ) [13], Philippines (279.00 μ g l −1 ) [35], the United States (282.00 and 285.00 μ g l −1 ) [10, 13], Japan (281.60 and 288 μ g l −1 ) [13, 36], and Brazil (360.00 μ g l −1 ) [37]. Compliance with the Universal Salt Iodization program has been mandatory since 1994 in Zhejiang Province, China, which was identified as iodine sufficient for decades in several sustained surveys from 1995 to 2011 [38].…”

Section: Discussionmentioning

confidence: 99%

Larger Thyroid Volume and Adequate Iodine Nutrition in Chinese Schoolchildren: Local Normative Reference Values Compared with WHO/IGN

Lou

Mao

et al. 2016

International Journal of Endocrinology

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Objective. Thyroid volume measured by ultrasound to define goiter needs reliable local thyroid volume reference from iodine-sufficient populations. The aim of this study is to explore the reference interval for normal thyroid volume in schoolchildren aged 8–10 years from Zhejiang Province, China. Methods. A probability-proportionate-to-size sampling method was applied to select a representative sample of 1213 children aged 8–10 years in Zhejiang Province to detect the thyroid volume, salt iodine, and urine iodine. Results. Median urinary iodine concentration in involved schoolchildren was 178.30 (125.00) μg l−1, with the percentage of samples less than 100 μg l−1 as 12.69% and more than 300 μg l−1 as 15.25%. Thyroid volume was significantly correlated with age and anthropometric measurements independently of each other. The 97th percentile of thyroid volume in our study was larger generally than the new international reference. Conclusions. The iodine nutritional status in Zhejiang Province was at an adequate level. Despite some limitations in this study, we initially established the reference values for thyroid volume in 8–10-year-old schoolchildren in Zhejiang Province, China, as a local reference to be used for monitoring iodine deficiency disorders.

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“…Sweden is considered iodine sufficient (17,18) with an iodine fortification programme of table salt since 1936. Only a few small observational studies from the 1970s and 1980s have reported on the prognosis after ATD treatment in Sweden, and only a minority of the eligible patients had been treated with ATDs (7,19,20).…”

Section: Introductionmentioning

confidence: 99%

Long-term prognosis after medical treatment of Graves' disease in a northern Swedish population 2000–2010

Mohlin

Nyström

Eliasson

2014

European Journal of Endocrinology

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Objective: To investigate the long-term prognosis of patients with Graves' disease (GD) after antithyroid drug (ATD) treatment and follow-up outside of highly specialised care. Design and methods: Medical records of all patients diagnosed with first-time GD in 2000-2010 with at least 6 months ATD treatment at a central hospital and follow-up in primary health care in the county of Norrbotten in northern Sweden were retrospectively reviewed. Patients were followed for relapse until 31st December 2012. We included 219 patients (mean age 46 years, 82.5% women) with follow-up of maximum 10 years and 829 observed patient years. Data were analysed using Kaplan-Meier estimates and log-rank test. Results: During the observation period, 43.5% of the patients had relapsed into active GD. The cumulative relapse rates were 22.6, 30.2, 36.9 and 41.5% after 6 months, 1, 3 and 5 years respectively. The presence of goitre (PZ0.014) predicted relapse. Previous smoking was protective against relapse (PZ0.003). The levels of free thyroxine or free tri-iodothyronine, age, gender, current smoking and ophthalmopathy did not predict relapse. Agranulocytosis was found in 1.7% (95% CI 0.7-4.0%). Conclusion: A long-term remission of 56.5%, in an iodine-sufficient area where ATD is offered to most patients in the real world of central and district hospitals, is higher than in most studies. Relapse was most common during the first year, and prognosis was excellent after 4 years without relapse. The protective effect of previous smoking merits further research.

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Thyroid volume in Swedish school children: a national, stratified, population-based survey

Cited by 30 publications

References 18 publications

Incidence of hyperthyroidism in Sweden

Incidence of hyperthyroidism in Sweden

Larger Thyroid Volume and Adequate Iodine Nutrition in Chinese Schoolchildren: Local Normative Reference Values Compared with WHO/IGN

Long-term prognosis after medical treatment of Graves' disease in a northern Swedish population 2000–2010

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