伊朗北部学童的甲状腺体积：与其他研究的比较。

Thyroid gland volume of schoolchildren in the North of Iran: Comparison with other studies.

作者信息

Kalantari Saeed, Moghadam Masrur Vahabi

机构信息

Department of Endocrinology, Guilan University of Medical Sciences, Rasht, Iran.

Department of Radiology, Guilan University of Medical Sciences, Rasht, Iran.

出版信息

J Res Med Sci. 2015 Nov;20(11):1070-6. doi: 10.4103/1735-1995.172824.

DOI:10.4103/1735-1995.172824

PMID:26941811

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4755094/

Abstract

BACKGROUND

Few studies have shown the limitation of the World Health Organization (WHO)/ International Council for the Control of Iodine Deficiency (ICCIDD)-adopted thyroid gland volume references as universal normative values for thyroid gland volume. So we decided to measure thyroid gland volume by sonography in schoolchildren in Rasht, Gilan Province, Iran - Rasht is a metropolitan city on the Caspian Sea coast - and compare them to WHO normative values.

MATERIALS AND METHODS

In a cross-sectional study, 2,522 schoolchildren, aged 6-13 years, in Rasht, Gilan Province, Iran were selected by multistage random sampling. Data were collected on their age, sex, weight, height, body surface area (BSA), and thyroid gland size by palpation and sonography. The terminal phalange of thumb finger volume was calculated with the same formula used in sonography, for the thyroid gland in 1,085 of these cases.

RESULTS

Goiter prevalence was 64% (1613 cases) by palpation, 76.1% (1228 subjects) grade I and 23.9% (385 cases) grade II. The mean thyroid gland volume in girls was more than boys (3.67 ± 1.89 mL vs 3.41 ± 1.58 mL, P < 0.0001). According to the 1997 WHO thyroid gland volume reference, none of the children had goiter based on BSA and age even in those with grade II goiters (23.9%). In contrast, the median thyroid gland volume in our cases was larger than the 2004 WHO reference. The best single predictor of thyroid gland volume was age (R (2) = 0.391, P < 0.0001) followed by BSA (R (2) = 0.151, P < 0.0001). There was also a significant difference between thyroid gland and finger volume in all grades of goiter and grade II goiters (3 ± 1.4 mL vs 9.59 ± 2.4 mL; P < 0.0001. 4.3 ± 1.4 mL vs 9.3 ± 2.5 mL; P < 0.0001).

CONCLUSION

The WHO standards for thyroid gland volume by sonography may underestimate or overestimate the goiter prevalence in many areas and populations. Finger volume was much larger than thyroid gland volume in even visible goiters.

摘要

背景

很少有研究表明世界卫生组织（WHO）/国际碘缺乏病控制理事会（ICCIDD）采用的甲状腺体积参考值作为甲状腺体积的通用标准值存在局限性。因此，我们决定对伊朗吉兰省拉什特市的学童进行甲状腺超声检查，并将结果与WHO的标准值进行比较——拉什特是里海沿岸的一个大城市。

材料与方法

在一项横断面研究中，通过多阶段随机抽样选取了伊朗吉兰省拉什特市2522名6至13岁的学童。通过触诊和超声检查收集他们的年龄、性别、体重、身高、体表面积（BSA）和甲状腺大小的数据。在其中1085例病例中，用与超声检查相同的公式计算拇指末节指骨体积来代表甲状腺体积。

结果

触诊发现甲状腺肿患病率为64%（1613例），其中I级76.1%（1228例），II级23.9%（385例）。女孩的平均甲状腺体积大于男孩（3.67±1.89 mL对3.41±1.58 mL，P<0.0001）。根据1997年WHO甲状腺体积参考标准，即使在II级甲状腺肿患儿（23.9%）中，按BSA和年龄计算，也没有儿童患有甲状腺肿。相比之下，我们病例中的甲状腺体积中位数大于2004年WHO的参考值。甲状腺体积的最佳单一预测因素是年龄（R²=0.391，P<0.0001），其次是BSA（R²=0.151，P<0.0001）。在所有等级的甲状腺肿和II级甲状腺肿中，甲状腺体积与手指体积之间也存在显著差异（3±1.4 mL对9.59±2.4 mL；P<0.0001。4.3±1.4 mL对9.3±2.5 mL；P<0.0001）。