title: [Endemic goiter and iodine deficiency: are they still a reality in Spain].
abstract: OBJECTIVE
  To estimate the prevalence of goiter and iodine deficiency in a health district in the Autonomous Community of Valencia, given the absence of data in this region of Spain.
  
  
  METHODS
  We conducted a descriptive, epidemiologic, cross-sectional study, stratified by age and sex, in four interior regions of the province of Valencia. We selected students aged from 6 to 14 years old in 20 centers. Thyroid examination was performed by means of palpation and inspection (goiter > or = 0B). Urinary iodine excretion was analyzed in a routine urine sample. Sociodemographic and anthropometric data, as well as nutritional iodine status, were recorded in a standardized survey. In children with goiter, thyroid-stimulating hormone (TSH), free T4, and antithyroid antibodies were determined.
  
  
  RESULTS
  We studied 928 children (478 boys and 450 girls). The prevalence of goiter was 33.7 % (95 % CI: 30.7-36.9 %). There were no significant differences in the prevalence of goiter by age or sex, but an inverse correlation was detected between the prevalence of goiter and parental socioeconomic position. Mean urinary iodine excretion was 155 .g/l, with no significant correlation with the prevalence of goiter. In children with goiter, 13 had positive antithyroid antibodies, 18 had high TSH (subclinical hypothyroidism), and one had suppressed TSH (subclinical hyperthyroidism).
  
  
  CONCLUSIONS
  There is endemic goiter in the region studied. Urinary iodine levels were in the normal range and could be interpreted as indicating a transition phase to an improvement in iodine deficiency. Autoimmune diseases would only explain 4 % of cases of goiter.
authors.affiliation: Servicio de Pediatría. Hospital Lluís Alcanyís. Xàtiva. Valencia. España. bepero@comv.es
authors.forename: B
authors.initials: B
authors.lastname: Peris Roig
authors.forename: N
authors.initials: N
authors.lastname: Atienzar Herráez
authors.forename: A A
authors.initials: AA
authors.lastname: Merchante Alfaro
authors.forename: F
authors.initials: F
authors.lastname: Calvo Rigual
authors.forename: J M
authors.initials: JM
authors.lastname: Tenías Burillo
authors.forename: S
authors.initials: S
authors.lastname: Selfa Moreno
authors.forename: M J
authors.initials: MJ
authors.lastname: López García
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D003677:Deficiency Diseases / Q000453:epidemiology; D005260:Female; D006043:Goiter, Endemic / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D007455:Iodine / Q000172:deficiency*; D008297:Male; D015995:Prevalence; D013030:Spain / Q000453:epidemiology
chemical_list: D007455:Iodine