Thyroid volume, selenium levels and nutritional habits in a rural region in Albania.
OBJECTIVE
Environmental factors are involved in goiter development. An increased number of goitrous patients were identified among outpatients in Gyrocaster, a mountainous region in Southwestern Albania. We examined possible associations of thyroid enlargement with nutritional factors.


METHODS
112 consecutive patients, 104 females, aged 52.8 +/-12.1 (mean+/-SD), who either were taking thyroxine (n=27) or were suspected to have thyroid disease were examined. Thyroid parameters and nutritional habits were recorded and serum selenium and urine iodine levels were determined; thyroid ultrasound was performed.


RESULTS
The median thyroid volume (TV) was 20.4 ml (range 4.4-97.6). All consumed food was home-produced. TV correlated negatively with the frequency of lamb-goat meat and vegetables consumption (p=0.05 and p=0.03, respectively). Mean TV was significantly lower in those eating lamb-goat >1 times/week (21.4+/-13.3 vs 31.9+/-23 ml, p<0.01). The association of TV with lamb meat consumption was independent of sex, education or occupation (p < 0.009). Selenium levels ranged from 30.6-138 microg/L (reference range 43-190). There was no association between selenium levels and TV. 43% of the subjects had TSH < 0.3 mU/L (those on thyroxine were excluded). Log TSH correlated negatively with TV and fT4 levels (p < 0.007), indicating the presence of autonomy (TSHRab positive in two subjects). Mean urinary iodine excretion was 99.8+/-35.3 microg/gr creatinine (normal >100).


CONCLUSIONS
Nutritional factors may be involved in the development of goiter in Southwestern Albania. No role of selenium was found. The higher consumption of lamb-goat meat and vegetables, all non-industrialized, appeared to be protective. This finding may reflect better socioeconomic status, although this was not identified. Unrecognized subclinical hyperthyroidism, probably due to thyroid autonomy, was quite common.
Doupis
John
J
Department of Endocrinology, Metabolism and Diabetes, Evgenideion Hospital, Athens University School of Medicine, Athens, Greece.
Stavrianos
Charalambos
C
Saltiki
Katerina
K
Mantzou
Emily
E
Mastrokostopoulos
Antonios
A
Philippou
George
G
Alevizaki
Maria
M
D000328:Adult; D000415:Albania / Q000453:epidemiology; D005260:Female; D006042:Goiter / Q000453:epidemiology* / Q000208:ethnology / Q000473:pathology*; D006801:Humans; D015994:Incidence; D007455:Iodine / Q000652:urine; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D009929:Organ Size; D012189:Retrospective Studies; D012424:Rural Population; D012643:Selenium / Q000097:blood*; D012923:Social Class; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography
D007455:Iodine; D012643:Selenium