Objective To master the distribution of thyroid volume and goiter of the children aged 8 to 10 years in Shaanxi province, in order to establish local reference range. Methods A total of 39 counties (cities, districts) were randomly selected from Shaanxi province in 2019.From each county, one primary school was randomly sampled from each selected town, which located in five different geographic directions: east, west, south, north and middle in each county.Finally, 42 non-boarding students aged 8-10 years were selected from each primary school, and their thyroids were examined by B-ultrasonography and random urine samples were tested. Results Totally 7 762 children aged 8 to 10 years were investigated.The median urinary iodine concentrations (MUIs) of children were 209.90 μg/L, and the iodine nutrition level of children was more than adequate condition.MUIs in each investigated area were above 100 μg/L, and the iodine nutritional status had been considered sufficient.The data of the thyroid volume (TVol) was abnormal distribution and the median of TVol was 2.68 ml.Children′s TVol was progressively increasing with age.But there was no significant difference on TVol between the male and the female children(Z=0.62, P>0.05).The lowest median of TVol appeared in Hanzhong city (1.90 ml), while the highest was in Ankang city (4.30 ml).The upper limit of normal thyroid volume of children at the age of 8, 9 and 10 years old was 4.4, 4.8 ml and 5.7 ml, respectively. Conclusion There is difference between the results of this study and the Chinese national standard, which can provide reference for monitoring iodine deficiency disorder (IDD) in Shaanxi province and establishing local normative values of TVol for children aged 8 to 10 years.
Key words
thyroid volume /
iodine nutrition /
children /
iodized salt
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References
[1] Patrick H, Katherine L, Andrew J,et al.Thyroid disorders in children and adolescents: a review[J].JAMA Pediatr,2016,170(10):1008-1019.
[2] 中华医学会地方病学分会,中国营养学会,中华医学会内分泌学分会.中国居民补碘指南 [M].北京:人民卫生出版社,2018:19-22.
[3] 国家食品安全风险评估专家委员会.中国食盐加碘和居民碘营养状况的风险评佔评估[R].北京: 国家食品安全风险评估专家委员会, 2010.
[4] 中华人民共和国卫生部.地方性甲状腺肿诊断标准(WS276-2007)[M].北京:人民卫生出版社,2007.
[5] Chen W, Zhang Q, Wu YL,et al.Shift of reference values for thyroid volume by ultrasound in 8- to 13-year-olds with sufficient iodine intake in China[J].Thyroid, 2019, 29(3):405-411.
[6] Ayaka J, Christopher E, Tristan R.A review of sonographic thyroid volume and iodine sufficiency in children: an australian perspective[J].Australas J Ultrasound Med, 2020, 23(1):33-38.
[7] 周爽, 李心术, 谢君,等.2017年重庆市碘缺乏病监测结果分析[J].中华地方病学杂志, 2019, 38(3):207-212.
[8] 陈迪群,陈志辉,王木华,等.福建省家庭户盐碘含量与学龄儿童甲状腺容积关系的横断面研究[J].中国地方病防治杂志, 2017, 32(5):484-487.
[9] 张庆兰, 王培桦, 周永林,等.江苏省1997-2005年目标人群甲状腺容积动态观察[J].上海预防医学杂志, 2006,18(9):435-437.
[10] 刘守军, 张旭丰, 张兆军.儿童少年甲状腺容积的正常值(GB16398-1996)[M].北京: 中国标准出版社, 1996.
[11] WHO, ICCIDD.Recommended normative values for thyroid volume in children aged 6~15 years[J].Bull World Health Organ,1997,75(2):95-97.
[12] WHO/UNICEF/ICCIDD.Assessment of iodine deficiency disorders and monitoring their elimination: a guide for programme managers[R].3rd ed.Geneva:WHO/NUT, 2007: 32-35.