Institute of Pathophysiology and Nuclear Medicine, Faculty of Medicine, Ss. Cyril and Methodius University Skopje, Majka Tereza 17, 1000, Skopje, North Macedonia.
Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
J Endocrinol Invest. 2020 Aug;43(8):1073-1079. doi: 10.1007/s40618-020-01189-6. Epub 2020 Feb 4.
North Macedonia is historically iodine deficient, but due to the longstanding and effective preventive measures, it has been considered iodine replete since 2003. The aim of the recent national survey was to re-evaluate iodine status and to measure thyroid volume (TVol) by ultrasound in schoolchildren as a representative of the general population.
A stratified probability proportionate to size cluster sampling was used to obtain a representative national sample of school children aged 7-10 years between the 28th of March and 4th of October 2016. Thyroid volume (TVol) was measured using ultrasonography in 1188 children. All TVol measurements were done by a single operator and their medians were compared with an international reference standard.
Significant positive correlation was found between Tvol and age, height, weight, body surface area (BSA), body mass index (BMI) in both girls and boys (p < 0.001), but not between TVol and urinary ioidine concentration (UIC). The most important predictors for Tvol in all children were age, height, weight, BMI, and BSA ( all p < 0.001). In multivariate regression, independent predictors for TVol were only BSA (p < 0.001) and age (p = 0.004) after being adjusted for sex, BMI, and UIC (R = 0.291). The 97th percentile of Tvol in our survey was generally higher than in the reference study and goiter prevalence of 18.3% in boys and 15.6% in girls was found compared to the international standard.
In our survey, Tvol of schoolchildren was larger than in the international reference study, although iodine nutritional status of the country has been considered sufficient for many years. In countries and regions with long and effective, well-documented iodine prophylaxis, the optimal way to have realistic normative TVol would be to create their TVol reference limits. Therefore, the provided data for TVol measured in our survey could be proposed as the national reference TVol for schoolchildren aged 7-10 years.
北马其顿历史上碘缺乏，但由于长期有效的预防措施，自 2003 年以来，北马其顿一直被认为是碘充足的。最近的全国性调查旨在重新评估碘的状况，并通过超声测量学童的甲状腺体积（TVol），以此代表一般人群。
采用分层概率比例整群抽样法，于 2016 年 3 月 28 日至 10 月 4 日，在 7-10 岁的学童中抽取一个具有代表性的全国性样本。对 1188 名儿童的甲状腺体积（TVol）进行超声测量。所有 TVol 测量均由一名操作人员完成，并将其中位数与国际参考标准进行比较。
女孩和男孩的 TVol 与年龄、身高、体重、体表面积（BSA）和体重指数（BMI）均呈显著正相关（p<0.001），但与尿碘浓度（UIC）无关。所有儿童的 TVol 最重要的预测因素是年龄、身高、体重、BMI 和 BSA（均 p<0.001）。多元回归分析表明，BSA 是所有儿童 TVol 的独立预测因素（p<0.001），而年龄是独立预测因素（p=0.004），在调整性别、BMI 和 UIC 后，两者对 TVol 的解释率为 0.291。本研究中，TVol 的第 97 个百分位数普遍高于参考研究，与国际标准相比，男孩和女孩的甲状腺肿患病率分别为 18.3%和 15.6%。
尽管该国的碘营养状况多年来一直被认为是充足的，但在碘预防措施长期且有效的国家和地区，建立现实的 TVol 正常范围的最佳方法是创建其 TVol 参考范围。因此，我们研究中测量的 TVol 数据可以作为 7-10 岁学童的全国性 TVol 参考值。
