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Interpretation of normative thyroid volumes in children and adolescents: is there a need for a multivariate model?

Johan Svensson1, Paul E Nilsson, Catherine Olsson

  • 1Department of Pediatrics, Malmö University Hospital, Lund University, Sweden. johan.svensson@pediatrik.mas.lu.se

Thyroid : Official Journal of the American Thyroid Association
|August 17, 2004
PubMed

Insights

Accurate thyroid volume measurement in children requires updated reference criteria. This study developed a multivariate model using body surface area and age to improve thyroid ultrasonography interpretation for pediatric thyroid assessments.

Area of Science:

  • Pediatric endocrinology
  • Medical imaging
  • Biostatistics

Background:

  • Reliable reference criteria are essential for interpreting thyroid volume determined by ultrasonography.
  • Existing World Health Organization/International Council for the Control of Iodine Deficiency Disorders (WHO/ICCIDD) references for thyroid volume have been questioned due to observed discrepancies in iodine-sufficient populations.
  • Systematic bias in the generation of WHO/ICCIDD reference data may contribute to these discrepancies.

Purpose of the Study:

  • To evaluate normative thyroid volumes in a specific pediatric population.
  • To develop a multivariate model for accurate interpretation of thyroid volume.
  • To compare regional thyroid volume references with existing international standards.

Main Methods:

  • Thyroid ultrasonography was performed on 561 children and adolescents.
  • Anthropometrical measurements including body surface area (BSA), age, weight, and height were collected.
  • Multivariate regression analyses were employed to identify predictors of thyroid volume and construct predictive models.

Main Results:

  • Body surface area (BSA) emerged as the strongest predictor of thyroid volume in both genders, followed by age, weight, and height.
  • Age-specific thyroid volume references showed good agreement with international data.
  • BSA-specific references differed from other international references, particularly those based on younger populations.
  • Multivariate analyses confirmed that BSA and age independently and significantly influence thyroid volume.
  • Gender-specific multiple regression models using BSA and age were developed.

Conclusions:

  • A multivariate model incorporating age and body surface area (BSA) provides a more accurate method for interpreting pediatric thyroid volumes.
  • The developed models can help reduce discrepancies observed between different BSA-specific thyroid volume references.
  • This approach enhances the reliability of thyroid ultrasonography for assessing thyroid size in children and adolescents.

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