[Comparative analysis of the effects of iodine prophylaxis in children and adolescents from the region of Szczecin].
The research on iodine metabolism carried out in the '80s and '90s of the twentieth century revealed moderate iodine deficiency in the area of the whole Poland. These results contributed to the introduction of the populational iodine prophylaxis programme consisting in the obligatory iodizing of kitchen salt. In 2002-2003, the research was conducted in the region of Szczecin, the aim of which was to assess the efficiency of this model of iodine prophylaxis. As it was observed, the incidence of goitre among children considerably reduced, however, determination of ioduria (iodine level in the urine) proved that slight iodine deficiency was still present. The aim of our research was the renewed assessment of iodine prophylaxis results in the randomly chosen group of children and adolescents from the region of Szczecin.


METHODS
The study was undertaken in the 2006. In random selected groups of children and adolescents in Szczecin region. The patients administered vitamins or minerals enriched with iodine were excluded from a study. The study included 314 persons aged 13 to 16 years, 151 boys (48%) and 163 girls (52%). Iodine excretion with urine was determined on the basis of catalytic Sandell-Kolthoff reaction. Radioimmunometric and radioimmunological methods were used for the determination of thyrotropin (TSH) and free thyroxine (FT) concentrations. Collected data were then analyzed using sophisticated computer-based statistic program.


RESULTS
In the research conducted in 2002-2003, median urinary iodine concentration was 81.6 microg/l, and the percentage of children with abnormal ioduria excedeed 65%, where slight iodine deficiency (50-100 microg/l) was observed in 43% of children, medium (20-49 microg/l)--in 19%, and serious iodine deficiency (< 20 microg/l) was found in--4.4%. At present, median iodine concentration increased up to 108.1 microg/l, and the proportion of children showing normal ioduria is 58.4% including 5% with urinary iodine concentration exceeding 200 microg/l. The percentage of children with slight and medium iodine deficiency considerably reduced to 21.9% and 10,4% respectively, but the proportion of children with serious deficiency of this element increased (up to 9%). According to the results from 2002-2003, serum concentration of free thyroxine was 14.58 pmol/l, and thyrotropin--2.0 microU/ml. In our results, significantly higher median FT4 concentration (17.54 pmol/l) as well as insignificant increase in median TSH concentration (to 2.1 microU/ml) were observed. Similarly to the previous research, no correlation was found between ioduria and hormone levels. Neither considerable differences in urinary iodine concentrations nor in serum hormone levels were observed between sexes.


CONCLUSIONS
(1) Proper median urinary iodine concentration and satisfactory proportion of people with normal ioduria are an important result of the currently conducted iodine prophylaxis programme in the region of Szczecin. (2) The rising percentage of individuals with high urinary iodine concentrations suggests that there is the necessity for extended research on the assessment of incidence of autoimmune thyroid diseases.
Brodowski
Jacek
J
Pomorska Akademia Medyczna w Szczecinie, Samodzielna Pracownia Pielgniarstwa Rodzinnego. fampiel@sci.pam.szczecin.pl
Karakiewicz
Beata
B
Rotter
Iwona
I
Kamińska
Magdalena
M
Baranowska
Ewa
E
Kochańska-Dziurowicz
Aleksandra
A
Stanjek
Anita
A
Brodowska
Agnieszka
A
Starczewski
Andrzej
A
Laszczyńska
Maria
M
D000293:Adolescent; D018890:Chemoprevention; D003677:Deficiency Diseases / Q000517:prevention & control; D005260:Female; D006801:Humans; D007455:Iodine / Q000172:deficiency* / Q000627:therapeutic use* / Q000652:urine; D008297:Male; D011044:Poland; D013972:Thyrotropin / Q000097:blood*; D013974:Thyroxine / Q000097:blood*
D013972:Thyrotropin; D007455:Iodine; D013974:Thyroxine