title: Ten-year follow-up of thyroid epidemiology in Slovenia after increase in salt iodization.
abstract: OBJECTIVE
  To assess iodine supply and follow thyroid epidemiology for ten years after an iodine increase from 10 to 25 mg of potassium iodide per kilogram of salt in 1999.
  
  
  METHODS
  In 2002 and 2003, we determined the thyroid size by palpation and ultrasound and measured urinary iodine concentration (UIC) in 676 schoolchildren from 34 schools throughout Slovenia. From 1999 to 2009, we followed the incidence of diffuse and nodular goiter, thyroid autonomy, Graves' disease, and Hashimoto's thyroiditis among adults in the stable catchment area of the University Medical Centre Ljubljana with 1000000 inhabitants. RESULTS.:In children, only 1% had a goiter grade 2 (visible and palpable thyroid gland), median thyroid volume was 5.8 mL, and median UIC was 148 μg/L. In adults, the incidence of diffuse goiter and thyroid autonomy decreased significantly (2009 vs 1999, rate ratio [RR], 0.16; 95% confidence interval [CI], 0.12-0.21 and RR, 0.73; 95% CI, 0.62-0.86, respectively), with a lower incidence in younger participants in 2009 (P<0.001). The incidence of multinodular goiter and solitary nodule increased (2009 vs 1999, RR, 1.55; 95% CI, 1.35-1.79 and RR, 1.72; 95% CI, 1.49-1.99, respectively). No long-term changes were observed for Graves' disease (2009 vs 1999, RR, 0.95; 95% CI, 0.81-1.13), while the incidence of Hashimoto's thyroiditis increased strongly (2009 vs 1999, RR, 1.86; 95% CI, 1.64-2.12).
  
  
  CONCLUSIONS
  The change from mildly deficient to sufficient iodine supply was associated with a marked change in the incidence of thyroid epidemiology - a significant decline in the incidence of diffuse goiter and thyroid autonomy and a marked increase in the incidence of Hashimoto's thyroiditis.
authors: University Medical Centre Ljubljana, Department of Nuclear Medicine, Slovenia.
authors: Katja
authors: K
authors: Zaletel
authors: Simona
authors: S
authors: Gaberscek
authors: Edvard
authors: E
authors: Pirnat
mesh_terms: D000293:Adolescent; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007455:Iodine / Q000652:urine; D008297:Male; D017524:Slovenia / Q000453:epidemiology; D017673:Sodium Chloride, Dietary / Q000008:administration & dosage / Q000378:metabolism*; D013959:Thyroid Diseases / Q000453:epidemiology*
chemical_list: D017673:Sodium Chloride, Dietary; D007455:Iodine