Not that simple goiter
https://doi.org/10.14341/ket12696
Abstract
The year 2020 marks the centenary of the publication of a classic study by American physicians D. Marine and O. Kimball on the effectiveness of endemic goiter prevention in children in Akron, Ohio. Although goiter has been known from immemorial times, there is still a problem with determining the normal size of the thyroid gland, without which the diagnosis of goiter remains extremely subjective. For example, in Sweden over the past 20 years, not a single case of endemic goiter has been registered, which is not surprising: the country eliminated this pathology decades ago, and the median urinary iodine concentration indicates the optimal iodine intake. Cases of sporadic goiter in children in Sweden are also rare — no more than 6–8 per year. But in Belarus, with the same population (about 10 million), about 2900 cases of goiter in children, both endemic and sporadic, are recorded annually despite the fact that, due to the extensive use of iodized salt since the beginning of the 2000s, there is no iodine deficiency. The incidence of goiter in children, however, having decreased many times over the past 20 years, remains 3 times higher than in Russia, where iodine prophylaxis, if carried out on a limited scale. From the experience of Belarus, Sweden and Russia, we see that the main thing when assessing data on the incidence of goiter and other thyroid diseases associated with iodine deficiency should be not absolute numbers, but the trend of these indicators over the past years. This information should be more actively used by endocrinologists in Russia to assess the effectiveness of preventive measures both at the regional and federal levels.
Keywords
iodine,
endemic goiter,
sporadic goiter,
incidence,
prevalence,
medical statistics,
Russia,
Belarus,
Sweden
About the Author
Gregory A. Gerasimov
https://www.researchgate.net/profile/Gregory_Gerasimov2
Iodine Global Network (IGN)
United States
Competing Interests: not
Iodine Global Network (IGN)
United States
MD, PhD, Professor, eLibrary Author ID: 296623.
Myrtle Beach
Competing Interests: not
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Supplementary files
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1. Fig. 1. A photograph of an African woman with a visible goiter; one of the winners of the 2012 World Press Photo competition | |
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2. Fig. 2. Dynamics of the incidence of endemic and other forms of non-toxic goiter in children (left graph) and adolescents (right graph) in the Russian Federation from 2009 to 2015. [9]. | |
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3. Fig. 3. Dynamics of the incidence (left graph) and prevalence (right graph) of endemic and other forms of non-toxic goiter in adults in the Russian Federation from 2009 to 2015. [9]. | |
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4. Fig. 4. Dynamics of the incidence of diffuse goiter (E01.0 and E04.0) in children and adolescents in the Republic of from 1998 to 2017 [10]. | |
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5. Fig. 5. Dynamics of the incidence of diffuse goiter (E01.0 and E04.0) in adults from 2000 to 2016 in the Republic of Belarus [11]. | |
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6. Fig. 6. The incidence (cases per 100 thousand population) of other forms of non-toxic goiter (E04) in children and adolescents (0-19 years) in Sweden from 1998 to 2018 [13]. | |
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7. Fig. 7. Morbidity (per 100 thousand population) with other forms of non-toxic goiter (E04) in adults (from 20 to 85 years old) in Sweden in 2016. | |
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Review
For citations:
Gerasimov G.A. Not that simple goiter. Clinical and experimental thyroidology. 2020;16(3):4-11. (In Russ.) https://doi.org/10.14341/ket12696
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