title: [Iodine nutrition and prevalence of goiter in adolescents in the Canton of Vaud].
abstract: Iodine deficiency disorders virtually disappeared in Switzerland after iodized salt was introduced in 1922 and the iodine content increased from 3.75 to 7.5 mg/kg in 1962 and to 15 mg/kg in 1980. However, a decreasing iodine intake has recently been reported again. The status of iodine nutrition in the Canton of Vaud was therefore assessed in 348 representative adolescents aged 11 to 17 years from the urban area of Lausanne in 1995. Thyroid size was estimated by inspection and palpation and thyroid volume measured by ultrasonography. Iodine concentration was determined in urine. Thyroid enlargement, as assessed by clinical examination, was found in 15% of the adolescents (stage 1a: 12.9%, 1b: 1.8%, 2: 0.3%), but its positive predictive value was low. The goitre prevalence determined by ultrasonography was only 1.4%. In addition, 4% of the adolescents had nodular or diffuse echo-structure abnormalities. Percentiles of thyroid volume as a function of sex, chronological age and body surface area were lower than WHO reference values. Median iodine concentration in urine was 92 micrograms/l (56.6% < 100 micrograms/l), slightly below WHO recommendations. Iodized cooking salt was consumed by 82% of the adolescents. In conclusion, the adolescents living in the Canton of Vaud had a low normal iodine intake with subclinical thyroid abnormalities. These findings support the recent decision to increase the salt iodine content to 20-30 mg/kg in order to prevent iodine deficiency during puberty and pregnancy. Percentiles of thyroid volume determined in the present study can be used as local reference.
authors.affiliation: Département de Médecine interne, Centre Hospitalier Universitaire Vaudois.
authors.forename: Y
authors.initials: Y
authors.lastname: Fleury
authors.forename: G
authors.initials: G
authors.lastname: van Melle
authors.forename: V
authors.initials: V
authors.lastname: Woringer
authors.forename: E
authors.initials: E
authors.lastname: Temler
authors.forename: R C
authors.initials: RC
authors.lastname: Gaillard
authors.forename: L
authors.initials: L
authors.lastname: Portmann
mesh_terms: D000293:Adolescent; D002648:Child; D004032:Diet; D005260:Female; D006042:Goiter / Q000453:epidemiology*; D006801:Humans; D007455:Iodine / Q000172:deficiency / Q000652:urine; D009751:Nutritional Requirements; D011237:Predictive Value of Tests; D011247:Pregnancy; D011627:Puberty; D013557:Switzerland / Q000453:epidemiology; D013961:Thyroid Gland / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D014463:Ultrasonography
chemical_list: D007455:Iodine