The role of thyroid autoantibodies in the etiology of endemic goiter in schoolchildren of Isfahan, Iran.

BACKGROUND

Eleven years after the initiation of universal salt iodization program in Iran, the prevalence of goiter is still high in some areas.

AIM

To investigate the role of thyroid autoimmunity in the etiology of residual goiter in schoolchildren of Isfahan, Iran.

MATERIAL AND METHODS

In a cross-sectional study, 2331 schoolchildren were selected by multi-stage random cluster sampling. Thyroid size was estimated in each child by inspection and palpation. Urinary iodine concentration (UIC), serum anti-thyroperoxidase antibody (anti-TPO Ab), and anti-thyroglobulin antibody (Anti-Tg Ab) were measured.

RESULTS

Overall, 32.9% of children had goiter. The median UIC was 1955.5 microg/dl. There was significant difference in prevalence of positive anti-TPO Ab in goitrous (grade 2) and non-goitrous children (9.7 vs 3.7%, p= 0.02). Goitrous children had higher prevalence of positive anti-Tg Ab than non-goitrous ones (15.1 vs 3.1%, p<0.001).

CONCLUSIONS

According to the present study, goiter is still a public health problem in this region. This study suggests that thyroid autoimmunity is among the contributors of goiter persistence after elimination of iodine deficiency in Isfahan.