Prevalence of Goitre in Isfahan, Iran, Fifteen Years After Initiation of Universal Salt Iodization.
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Date
2010-08
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Abstract
This cross-sectional study investigated the prevalence of goitre in Isfahan, a centrally-located city in Iran,
15 years after the initiation of universal salt iodization. In total, 2,523 Isfahani adults (1,275 males, 1,248
females) aged >20 years were selected by multi-stage cluster-sampling method. Goitre rate, serum thyroidstimulating
hormone (TSH), thyroxine (T4), thyroid peroxidase antibody (TPOAb), thyroglobulin antibody
(TgAb), and urinary iodine concentration (UIC) were measured and compared between the goitrous
(n=478) and the non-goitrous (n=2,045) participants. The total goitre rate was 19% (n=478) of the 2,523
adults. The rate of Grade I and II goitre was 12.4% (n=312) and 6.6% (n=166) respectively. The total goitre
rate, Grade I and II goitre were more prevalent among women than among men. Hypothyroidism was
observed in 6.4% (130/2,045) and 18.6% (89/478) of the non-goitrous and goitrous participants respectively
[odds ratio (OR)=3.6, 95% confidence interval (CI) 2.7-4.9, p=0.001]. Hyperthyroidism was present
in 0.8% (17/2,045) and 5.2% (29/478) of the non-goitrous and goitrous adults respectively (OR=9.0, 95%
CI 4.9-16.6, p=0.001). Hypothyroidism was more prevalent in Grade II than in Grade I goitre and among
those without goitre (31.3%, 14.1%, and 6.4% respectively) (p=0.001). Positive TPOAb was observed in
24% (n=50) of the non-goitrous and 33.5% (n=84) of the goitrous subjects (p=0.03). Positive TPOAb was
observed in 24.6% (35 of 142) of the Grade I and 45% (49 of 109) of the Grade II goitrous adults (p=0.001).
Positive TgAb was observed in 21.6% (n=45) of the non-goitrous and 35.9% (n=90) of the goitrous adults
(p=0.001). Positive TgAb was observed in 30.3% (43 of 142) of the Grade I and 43.1% (47 of 109) of the
Grade II goitrous adults (p=0.04). The median UIC was 18 μg/dL (range 1-80 μg/dL). It was 17.9 μg/dL and
19 μg/dL in the non-goitrous and goitrous adults respectively. After 15 years of successful universal salt
iodization in Isfahan, goitre is still endemic, which may be due to thyroid autoimmunity. However, other
environmental or genetic factors may have a role.
Description
Keywords
Autoimmunity, Cross-sectional studies, Goitre, Hypothyroidism, Hyperthyroidism, Impact studies, Iodine, Iodine deficiency, Iran
Citation
Ashraf Aminorroaya, Amini Massoud, Hovsepian Silva. Prevalence of Goitre in Isfahan, Iran, Fifteen Years After Initiation of Universal Salt Iodization. Journal of Health, Population and Nutrition. 2010 Aug; 28(4): 351-358.