Goitre epidemiology: thyroid volume, iodine excretion, thyroglobulin and thyrotropin in Germany and Sweden

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Abstract
Thyroid volume of 1397 German and 303 Swedish adults were estimated by sonography. Thyroid size of 6-16 year old Germans (n = 619) was determined and compared with findings on palpation. Thyroid volume was more than twice as great in German (21.4 .+-. 15.6 ml, mean .+-. SD) than in Swedish adults (10.1 .+-. 4.9 ml). The echopattern was abnormal in 16% of the Germans and in 3.6% of the Swedes. German children have a thyroid volume ranging from 1.8 .+-. 0.4 ml at 6 years to 10.8 .+-. 6.0 ml at 16 years of age. Palpation is by comparison an unreliable method for determining thyroid size. In Germany, the iodine excretion was less in children (n = 619, 39.5 .+-. 30.5, 34.1 .mu.g I/g creatinine, mean .+-. SD, median) than in adults (n = 1193, 83.7 .+-. 94.4, 62.6), (P < 0.001) and much lower than that observed in Sweden (adults n = 98, 170.2 .+-. 93.3, 141.4; 13 year olds n = 113, 172.9 .+-. 224.1, 124), (P < 0.0001). Serum thyrotropin concentration was significantly higher (P < 0.001) in Sweden (n = 62, 1.49 .+-. 0.82 mU/ml), than in Germany (n = 91, 0.97 .+-. 0.52 mU/ml), while serum thyroglobulin was increased in Germany (n = 91, 72.6 .+-. 50.6 .mu.g/l) as compared to Sweden (n = 62, 23.5 .+-. 17.4), (P < 0.0001). These results indicate the goitrogenic effect of iodine deficiency and the continuing need for an effective iodine prophylaxis in the FRG.