Xu F, Sullivan K, Houston R, Zhao J, May W, Maberly G
Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
Eur J Endocrinol. 1999 Jun;140(6):498-504. doi: 10.1530/eje.0.1400498.
The World Health Organization (WHO) recently adopted thyroid volume ultrasonography results from European schoolchildren as the international reference for assessing iodine deficiency disorders. Our objective was to describe thyroid volumes measured by ultrasonography in US and Bangladeshi schoolchildren and compare these with European schoolchildren.
Cross-sectional studies were performed in schoolchildren in the US (n=302) and Bangladesh (n=398). Data were collected on the following: thyroid size by palpation and ultrasonography; urinary iodine; age; sex; weight; and height.
Applying the new WHO thyroid volume references to the Bangladeshi children resulted in prevalence estimates of enlarged thyroid of 26% based on body surface area (BSA) and 7% based on age. In contrast, in the US children, the prevalence estimates were less than 1% for each reference. In the US children, the best single predictor of thyroid volume was BSA (R2=0.32), followed by weight (R2=0.31). Using linear regression, upper normal limits (97th percentile) of thyroid volume from US children were calculated for BSA, weight and age, and were found to be lower than the corresponding references based on BSA and age from European schoolchildren.
In areas with malnutrition, such as Bangladesh, the BSA reference should be preferred to the reference based on age. Results from the US children indicated that a thyroid volume reference based on weight alone would perform as well as the one based on BSA. European schoolchildren had larger thyroids than US children, perhaps due to a residual effect of iodine deficiency in the recent past in some areas in Europe.
世界卫生组织（WHO）最近采用了欧洲学童的甲状腺体积超声检查结果作为评估碘缺乏症的国际参考标准。我们的目的是描述美国和孟加拉国学童通过超声测量的甲状腺体积，并将其与欧洲学童的进行比较。
对美国（n = 302）和孟加拉国（n = 398）的学童进行了横断面研究。收集了以下数据：通过触诊和超声检查的甲状腺大小；尿碘；年龄；性别；体重；和身高。
将新的WHO甲状腺体积参考标准应用于孟加拉国儿童，基于体表面积（BSA）的甲状腺肿大患病率估计为26%，基于年龄的为7%。相比之下，在美国儿童中，每个参考标准下的患病率估计均低于1%。在美国儿童中，甲状腺体积的最佳单一预测指标是BSA（R2 = 0.32），其次是体重（R2 = 0.31）。使用线性回归，计算了美国儿童基于BSA、体重和年龄的甲状腺体积正常上限（第97百分位数），发现其低于欧洲学童基于BSA和年龄的相应参考标准。
在营养不良地区，如孟加拉国，基于BSA的参考标准应优于基于年龄的参考标准。美国儿童的结果表明，仅基于体重的甲状腺体积参考标准与基于BSA的标准表现相当。欧洲学童的甲状腺比美国儿童的大，这可能是由于欧洲一些地区近期碘缺乏的残留影响。
