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Reference values for thyroid volume established by ultrasound in Polish schoolchildren
Zbigniew Szybiński1, Małgorzata Trofimiuk-Müldner, Monika Buziak-Bereza
1WHO Collaborating Centre for Nutrition at the Department of Endocrinology, Jagiellonian University, Collegium Medicum, Krakow, Poland. szybin@cm-uj.krakow.pl
Insights
This study established new thyroid volume (TV) reference values for Polish children aged 6-12 years. These local values are crucial for accurately assessing iodine deficiency using thyroid ultrasound.
Area of Science:
- Pediatric Endocrinology
- Public Health Nutrition
- Diagnostic Imaging
Background:
- Goitre in children exceeding 5% frequency is a WHO-recognized indicator of iodine deficiency.
- Accurate thyroid volume (TV) assessment via ultrasound is vital for interpreting epidemiological data on iodine status.
- Discrepancies exist regarding the use of local versus international normative values for TV assessment.
Purpose of the Study:
- To establish local Polish normative values for thyroid volume (TV) in children aged 6-12 years.
- To provide updated reference data for accurate iodine deficiency assessment in Polish children.
Main Methods:
- A cohort of 642 children (6-12 years) from a region with optimal iodine supply in Poland were studied.
- Inclusion criteria ensured adequate iodine status (urinary iodine concentration >100 μg/L) and absence of thyroid abnormalities.
- Thyroid volume (TV) was measured using ultrasound (7.5 MHz transducer); urinary iodine concentration (UIC) was determined via Sandell-Kolthoff assay.
Main Results:
- Median urinary iodine concentration (UIC) ranged from 126.6–155.1 μg/L in girls and 132.2–157.6 μg/L in boys.
- The 97th percentile (P97) thyroid volumes (TV) for girls and boys were established, showing variations by age.
- These Polish normative TV values were found to be lower than 1997 WHO values but higher than the 2004 WHO reference.
Conclusions:
- The derived thyroid volume (TV) data serve as appropriate normative values for Polish children.
- These findings support the use of localized reference data for more accurate public health assessments in pediatric populations.
Introduction:
A frequency in excess of 5% of goitre in children is an approved WHO marker of iodine deficiency. As thyroid ultrasound remains the main method of thyroid volume (TV) assessment, the choice of adequate normative values is important for the proper interpretation of epidemiologic data. There is disagreement as to whether local or international normative values should be used. The aim of this study was to establish Polish local TV normative values in children aged 6-12 years.
Material And Methods:
The study was carried out in a group of 642 children aged 6-12 years (312 girls and 330 boys) living in the Polish seaside area with a proven history of best iodine supply. Inclusion criteria were: iodine concentration in casual morning urine samples above 100 μg/L, no goitre on palpation, no pathological findings on thyroid US, no history of thyroid disorders, no treatment affecting thyroid function, and written informed consent from the child's parents. TV was measured ultrasonographically with a 7.5 MHz linear transducer. Urinary iodine concentration (UIC) was measured in urine spot samples using the Sandell-Kolthoff method.
Results:
Median UIC ranged according to age from 126.6 to 155.1 μg/L in girls, and from 132.23 to 157.62 μg/L in boys. TVs at P97 were: 3.96, 4.23, 4.33, 5.44, 6.07, 9.5, and 10.9 for girls and 3.99, 4.2, 4.79, 6.61, 7.38, 7.89, and 9.35 for boys. They were lower than the 1997 WHO normative values but higher than the 2004 reference currently adopted by the WHO.
Conclusions:
The obtained results may be adopted as normative TV values for Polish children.
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