Departments of Clinical Medicine and Endocrinology (A.K., I.B.P., P.L.), Aalborg University and Aalborg University Hospital, and Faculty of Medicine (T.J.), Aalborg University, DK-9000 Aalborg, Denmark; Research Centre for Prevention and Health (L.B., T.J.), The Capital Region of Denmark, DK-2600 Glostrup, Denmark; Department of Endocrinology (L.B., N.K., H.P.), Bispebjerg University Hospital, DK-2400 Copenhagen, Denmark; Faculty of Health Sciences (T.J.), DK-2200 Copenhagen, Denmark; Department of Gastroenterology (L.O.), Slagelse Hospital, DK-4200 Slagelse, Denmark; and Department of Nutrition (L.B.R.), National Food Institute, Technical University of Denmark, DK-2860 Søborg, Denmark.
J Clin Endocrinol Metab. 2014 Dec;99(12):4749-57. doi: 10.1210/jc.2014-2438.
Limited longitudinal data are available on changes in the thyroid gland structure in a population and how this is influenced by iodine fortification (IF).
Our objective was to clarify how IF influenced thyroid gland structure in 2 regions with different iodine intake at baseline (Copenhagen, mild iodine deficiency [ID]; Aalborg, moderate ID).
We conducted a longitudinal population-based study (DanThyr) where participants were examined before (1997) and after (2008) the Danish mandatory IF of salt (2000).
We examined 2465 adults, and ultrasonography was performed by the same sonographers using the same equipment, after controlling performances.
Change in thyroid gland structure was evaluated.
The follow-up period saw an increased prevalence of multinodularity (9.8%-13.8 %, P < .001), especially in the previously moderate ID region of Aalborg (9.1%-15.4%, P < .001), whereas no change in prevalence was seen for solitary nodules (5.6%-5.1%, P = .34). In individual participants, changes in thyroid structure and disappearance of thyroid nodules during the 11 years was common with an overall normalization rate of 21.2 (95% confidence interval [CI] = 17.9-24.9) per 1000 person-years. Solitary nodules had a significantly higher normalization rate than multiple nodules (normalization rate ratio 0.47 [95% CI = 0.32-0.67]). A regional difference (Aalborg vs Copenhagen) was seen between normalization rates of multiple nodules (normalization rate ratio 0.29 [95% CI = 0.12-0.64]), but not for solitary nodules (normalization rate ratio 0.81 [95% CI = 0.53-1.21]).
Changes in the thyroid gland structure with both appearance and disappearance of thyroid nodules are common after an iodization program.
关于人群中甲状腺结构的变化以及碘强化（IF）如何影响这些变化的纵向数据有限。
我们的目的是阐明 IF 如何影响基线时碘摄入量不同的 2 个地区（哥本哈根，轻度碘缺乏[ID]；奥尔堡，中度 ID）的甲状腺结构。
我们进行了一项基于人群的纵向研究（DanThyr），其中参与者在丹麦强制性食盐碘强化（2000 年）之前（1997 年）和之后（2008 年）接受了检查。
我们检查了 2465 名成年人，并在控制了表现后，由同一位超声医师使用相同的设备进行了超声检查。
评估甲状腺结构的变化。
在随访期间，多结节的患病率增加（9.8%-13.8%，P<.001），特别是在先前中度 ID 的奥尔堡地区（9.1%-15.4%，P<.001），而单发结节的患病率没有变化（5.6%-5.1%，P=.34）。在个体参与者中，11 年内甲状腺结构的变化和甲状腺结节的消失很常见，总体正常化率为 21.2（95%置信区间[CI] = 17.9-24.9）/1000 人年。单发结节的正常化率明显高于多发结节（正常化率比 0.47 [95% CI = 0.32-0.67]）。多发结节的正常化率存在地区差异（奥尔堡与哥本哈根）（正常化率比 0.29 [95% CI = 0.12-0.64]），但单发结节则不然（正常化率比 0.81 [95% CI = 0.53-1.21]）。
碘强化计划后，甲状腺结节的出现和消失都会导致甲状腺结构的变化。
