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Summary
Goiter prevalence in US children is 6.8%, but high iodine intake, not deficiency, is implicated. Most goiters were mild and asymptomatic, challenging traditional assumptions about iodine deficiency disorders.
Area of Science:
- Pediatric Endocrinology
- Nutritional Science
- Public Health
Background:
- Goiter, or thyroid enlargement, is often associated with iodine deficiency.
- Previous studies have focused on iodine deficiency as the primary cause of goiter.
- Understanding the etiology of goiter in populations with presumed adequate iodine intake is crucial.
Purpose of the Study:
- To investigate the prevalence of goiter in a large cohort of US children.
- To examine the relationship between goiter and iodine status in these children.
- To explore potential causes of goiter in American children, considering high iodine intake.
Main Methods:
- Conducted goiter examinations in 7,785 children aged 9-16 years across four US states.
- Analyzed urinary iodine and creatinine, thyroxine, protein-bound iodine, and plasma inorganic iodide in 377 matched goitrous and nongoitrous children.
- Assessed thyroid size (palpable vs. visible enlargement) and clinical/biochemical thyroid status.
Main Results:
- Overall goiter prevalence was 6.8% among the examined children.
- Most goiters were palpable but not visibly enlarged, with no clinical or biochemical thyroid abnormalities.
- Mean urinary iodine excretion was significantly high (452 µg/gm creatinine), far exceeding deficiency levels; goitrous children and high-prevalence areas showed higher iodine excretion.
Conclusions:
- Goiter in American children is not necessarily linked to iodine deficiency.
- High iodine intake may play a role in the causation of goiter in this population.
- Findings challenge the assumption of iodine deficiency as the sole cause of goiter and highlight the potential impact of excessive iodine.