Local versus WHO/International Council for Control of Iodine Deficiency Disorders-recommended thyroid volume reference in the assessment of iodine deficiency disorders

L. C. Foo, A. Zulfiqar, M. Nafikudin, M. T. Fadzil, A. S A Asmah

    Research output: Contribution to journalArticle

    69 Citations (Scopus)

    Abstract

    Objective: Iodine deficiency endemia is defined by the goitre prevalence and the median urinary iodine concentration in a population. Lack of local thyroid volume reference data may bring many health workers to use the European-based WHO/International Council for Control of Iodine Deficiency Disorders (ICCIDD)-recommended reference for the assessment of goitre prevalence in children in different developing countries. The present study was conducted in non-iodine-deficient areas in Malaysia to obtain local children's normative thyroid volume reference data, and to compare their usefulness with those of the WHO/ICCIDD-recommended reference for the assessment of iodine-deficiency disorders (IDD) in Malaysia. Design and methods: Cross-sectional thyroid ultrasonographic data of 7410 school children (4004 boys, 3406 girls), aged 7-10 years, from non-iodine-deficient areas (urban and rural) in Peninsular Malaysia were collected. Age/sex- and body surface area/sex-specific upper limits (97th percentile) of normal thyroid volume were derived. Thyroid ultrasonographic data of similar-age children from schools located in a mildly iodine-deficient area, a severely iodine-deficient area, and a non-iodine-deficient area were also collected; spot urines were obtained from these children for iodine determination. Results: The goitre prevalences obtained using the local reference were consistent with the median urinary iodine concentrations in indicating the severity of IDD in the areas studied. In contrast, the results obtained using the WHO/ICCIDD-recommended reference showed lack of congruency with the median urinary iodine concentrations, and grossly underestimated the problem. The local sex-specific reference values at different ages and body surface areas are not a constant proportion of the WHO/ICCIDD-recommended reference. A further limitation of the WHO/ICCIDD-recommended reference is the lack of normative values for children with small body surface areas (<0.8 m2) commonly found in the developing countries. Conclusion: The observations favour the use of a local reference in the screening of children for thyroid enlargement.

    Original languageEnglish
    Pages (from-to)491-497
    Number of pages7
    JournalEuropean Journal of Endocrinology
    Volume140
    Issue number6
    DOIs
    Publication statusPublished - Jun 1999

    Fingerprint

    Iodine
    Thyroid Gland
    Body Surface Area
    Malaysia
    Goiter
    Developing Countries
    Reference Values
    Urine

    ASJC Scopus subject areas

    • Endocrinology

    Cite this

    Local versus WHO/International Council for Control of Iodine Deficiency Disorders-recommended thyroid volume reference in the assessment of iodine deficiency disorders. / Foo, L. C.; Zulfiqar, A.; Nafikudin, M.; Fadzil, M. T.; Asmah, A. S A.

    In: European Journal of Endocrinology, Vol. 140, No. 6, 06.1999, p. 491-497.

    Research output: Contribution to journalArticle

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