Zimmermann Michael B, Hess Sonja Y, Molinari Luciano, De Benoist Bruno, Delange François, Braverman Lewis E, Fujieda Kenji, Ito Yoshiya, Jooste Pieter L, Moosa Khairya, Pearce Elizabeth N, Pretell Eduardo A, Shishiba Yoshimasa
Laboratory for Human Nutrition, Swiss Federal Institute of Technology Zürich, Rüschlikon, Switzerland.
Am J Clin Nutr. 2004 Feb;79(2):231-7. doi: 10.1093/ajcn/79.2.231.
Goiter prevalence in school-age children is an indicator of the severity of iodine deficiency disorders (IDDs) in a population. In areas of mild-to-moderate IDDs, measurement of thyroid volume (Tvol) by ultrasound is preferable to palpation for grading goiter, but interpretation requires reference criteria from iodine-sufficient children.
The study aim was to establish international reference values for Tvol by ultrasound in 6-12-y-old children that could be used to define goiter in the context of IDD monitoring.
Tvol was measured by ultrasound in 6-12-y-old children living in areas of long-term iodine sufficiency in North and South America, central Europe, the eastern Mediterranean, Africa, and the western Pacific. Measurements were made by 2 experienced examiners using validated techniques. Data were log transformed, used to calculate percentiles on the basis of the Gaussian distribution, and then transformed back to the linear scale. Age- and body surface area (BSA)-specific 97th percentiles for Tvol were calculated for boys and girls.
The sample included 3529 children evenly divided between boys and girls at each year ( +/- SD age: 9.3 +/- 1.9 y). The range of median urinary iodine concentrations for the 6 study sites was 118-288 micro g/L. There were significant differences in age- and BSA-adjusted mean Tvols between sites, which suggests that population-specific references in countries with long-standing iodine sufficiency may be more accurate than is a single international reference. However, overall differences in age- and BSA-adjusted Tvols between sites were modest relative to the population and measurement variability, which supports the use of a single, site-independent set of references.
These new international reference values for Tvol by ultrasound can be used for goiter screening in the context of IDD monitoring.
学龄儿童甲状腺肿患病率是人群中碘缺乏病（IDD）严重程度的一个指标。在轻度至中度碘缺乏病地区，通过超声测量甲状腺体积（Tvol）来对甲状腺肿进行分级比触诊更可取，但解读需要来自碘充足儿童的参考标准。
本研究旨在建立6至12岁儿童超声测量Tvol的国际参考值，可用于在碘缺乏病监测中定义甲状腺肿。
对生活在北美洲、南美洲、中欧、东地中海、非洲和西太平洋长期碘充足地区的6至12岁儿童进行超声测量Tvol。由2名经验丰富的检查人员使用经过验证的技术进行测量。数据进行对数转换，基于高斯分布计算百分位数，然后再转换回线性尺度。计算了男孩和女孩Tvol的年龄和体表面积（BSA）特异性第97百分位数。
样本包括3529名儿童，每年男孩和女孩人数均等（年龄±标准差：9.3±1.9岁）。6个研究地点的尿碘中位数范围为118 - 288μg/L。各地点年龄和BSA调整后的平均Tvol存在显著差异，这表明在长期碘充足的国家，特定人群参考值可能比单一国际参考值更准确。然而，相对于人群和测量变异性，各地点年龄和BSA调整后的Tvol总体差异较小，这支持使用一组独立于地点的单一参考值。
这些新的超声测量Tvol国际参考值可用于碘缺乏病监测中的甲状腺肿筛查。
