This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Aghini-Lombardi, F. Articles by Pinchera, A. Search for Related Content PubMed PubMed Citation Articles by Aghini-Lombardi, F. Articles by Pinchera, A.

The Spectrum of Thyroid Disorders in an Iodine-Deficient Community: The Pescopagano Survey¹

Department of Endocrinology (F.A.-L., L.A., E.M., P.V., D.M., F.L., T.R., L.G., R.V., A.P.), University of Pisa, Pisa; and the Department of Internal Medical Sciences, University of Cagliari (A.B.), Cagliari, Italy

Address all correspondence and requests for reprints to: Fabrizio Aghini-Lombardi, M.D., Department of Endocrinology, University of Pisa, via Paradisa 2, I-56124 Pisa, Italy.

We carefully assessed thyroid status and goiter by ultrasound in 1411 subjects virtually representing the entire resident population of Pescopagano, an iodine-deficient village of Southern Italy. Median urinary iodine excretion was 55 µg/L. The prevalence of goiter was 16.0% in children and 59.8% in adults. Thyroid nodularity was 0.5% in children and progressively increased with age to 28.5% in the 56- to 65-yr-old group. The prevalence of present or past hyperthyroidism was 2.9%, including 9 cases with toxic diffuse goiter and 20 with toxic nodular goiter. Functional autonomy was rare in children, progressively increased with age up to 15.4% in the elderly, and was related to nodular goiter. The prevalences of overt and subclinical hypothyroidism in the adults were 0.2% and 3.8%, respectively. Serum autoantibodies to thyroglobulin and thyroperoxidase were detected in 12.6% of the entire population. The prevalence of diffuse autoimmune thyroiditis was 3.5%, being very low in children. Thyroid cancer was found in only 1 case. In conclusion, in the present survey of an iodine-deficient community, a progressive increase with age of goiter prevalence, thyroid nodularity, and functional autonomy was observed. Hyperthyroidism was twice as high as that reported in iodine-sufficient areas, mainly due to an increased frequency of toxic nodular goiter. Although low titer serum thyroid antibodies were relatively frequent, the prevalences of both overt and subclinical autoimmune hypothyroidism were not different from those observed in iodine-sufficient areas.

This article has been cited by other articles:

				A. Corrias, A. Cassio, G. Weber, A. Mussa, M. Wasniewska, A. Rapa, R. Gastaldi, S. Einaudi, F. Baronio, M. C. Vigone, et al. Thyroid Nodules and Cancer in Children and Adolescents Affected by Autoimmune Thyroiditis Arch Pediatr Adolesc Med, June 1, 2008; 162(6): 526 - 531. [Abstract] [Full Text] [PDF]

				B. Biondi and D. S. Cooper The Clinical Significance of Subclinical Thyroid Dysfunction Endocr. Rev., February 1, 2008; 29(1): 76 - 131. [Abstract] [Full Text] [PDF]

				E. A. Nyenwe and S. Dagogo-Jack Recognizing Iodine Deficiency in Iodine-Replete Environments N. Engl. J. Med., September 20, 2007; 357(12): 1263 - 1264. [Full Text] [PDF]

				I. Bulow Pedersen, P. Laurberg, N. Knudsen, T. Jorgensen, H. Perrild, L. Ovesen, and L. B. Rasmussen An Increased Incidence of Overt Hypothyroidism after Iodine Fortification of Salt in Denmark: A Prospective Population Study J. Clin. Endocrinol. Metab., August 1, 2007; 92(8): 3122 - 3127. [Abstract] [Full Text] [PDF]

				T. Rago, F. Santini, M. Scutari, A. Pinchera, and P. Vitti Elastography: New Developments in Ultrasound for Predicting Malignancy in Thyroid Nodules J. Clin. Endocrinol. Metab., August 1, 2007; 92(8): 2917 - 2922. [Abstract] [Full Text] [PDF]

				A. Antonelli, C. Ferri, P. Fallahi, M. Cazzato, S. M. Ferrari, M. Sebastiani, and E. Ferrannini Clinical and subclinical autoimmune thyroid disorders in systemic sclerosis Eur. J. Endocrinol., April 1, 2007; 156(4): 431 - 437. [Abstract] [Full Text] [PDF]

				H. Schoder and M. Gonen Screening for Cancer with PET and PET/CT: Potential and Limitations J. Nucl. Med., January 1, 2007; 48(1_suppl): 4S - 18S. [Abstract] [Full Text] [PDF]

				V F H Brauer, H Below, A Kramer, D Fuhrer, and R Paschke The role of thiocyanate in the etiology of goiter in an industrial metropolitan area Eur. J. Endocrinol., February 1, 2006; 154(2): 229 - 235. [Abstract] [Full Text] [PDF]

				A. Carle, P. Laurberg, I. B. Pedersen, N. Knudsen, H. Perrild, L. Ovesen, L. B. Rasmussen, and T. Jorgensen Epidemiology of subtypes of hypothyroidism in Denmark Eur. J. Endocrinol., January 1, 2006; 154(1): 21 - 28. [Abstract] [Full Text] [PDF]

				S. Mariotti Editorial: Thyroid Function and Aging: Do Serum 3,5,3'-Triiodothyronine and Thyroid-Stimulating Hormone Concentrations Give the Janus Response? J. Clin. Endocrinol. Metab., December 1, 2005; 90(12): 6735 - 6737. [Full Text] [PDF]

				J. J. Diez Goiter in Adult Patients Aged 55 Years and Older: Etiology and Clinical Features in 634 Patients J. Gerontol. A Biol. Sci. Med. Sci., June 1, 2005; 60(7): 920 - 923. [Abstract] [Full Text] [PDF]

				K. Krohn, D. Fuhrer, Y. Bayer, M. Eszlinger, V. Brauer, S. Neumann, and R. Paschke Molecular Pathogenesis of Euthyroid and Toxic Multinodular Goiter Endocr. Rev., June 1, 2005; 26(4): 504 - 524. [Abstract] [Full Text] [PDF]

				B. Biondi, E. A. Palmieri, M. Klain, M. Schlumberger, S. Filetti, and G. Lombardi Subclinical hyperthyroidism: clinical features and treatment options Eur. J. Endocrinol., January 1, 2005; 152(1): 1 - 9. [Abstract] [Full Text] [PDF]

				L. Hegedus, S. J. Bonnema, and F. N. Bennedbaek Management of Simple Nodular Goiter: Current Status and Future Perspectives Endocr. Rev., February 1, 2003; 24(1): 102 - 132. [Abstract] [Full Text] [PDF]

				B. Biondi, E. A. Palmieri, G. Lombardi, and S. Fazio Effects of Subclinical Thyroid Dysfunction on the Heart Ann Intern Med, December 3, 2002; 137(11): 904 - 914. [Abstract] [Full Text] [PDF]

				E. C. Morari, J. L. P. Leite, F. Granja, L. V. M. da Assumpcao, and L. S. Ward The Null Genotype of Glutathione S-Transferase M1 and T1 Locus Increases the Risk for Thyroid Cancer Cancer Epidemiol. Biomarkers Prev., November 1, 2002; 11(11): 1485 - 1488. [Abstract] [Full Text] [PDF]

				J. J. Diez Hypothyroidism in Patients Older Than 55 Years: An Analysis of the Etiology and Assessment of the Effectiveness of Therapy J. Gerontol. A Biol. Sci. Med. Sci., May 1, 2002; 57(5): M315 - 320. [Abstract] [Full Text]

				R. K. Marwaha, N. Tandon, A. K. Karak, N. Gupta, K. Verma, and N. Kochupillai Hashimoto's Thyroiditis: Countrywide Screening of Goitrous Healthy Young Girls in Postiodization Phase in India J. Clin. Endocrinol. Metab., October 1, 2000; 85(10): 3798 - 3802. [Abstract] [Full Text]

				M. Marinò, L. Chiovato, N. Mitsiades, F. Latrofa, D. Andrews, S. Tseleni-Balafouta, A. B. Collins, A. Pinchera, and R. T. McCluskey Circulating Thyroglobulin Transcytosed by Thyroid Cells Is Complexed with Secretory Components of Its Endocytic Receptor Megalin J. Clin. Endocrinol. Metab., September 1, 2000; 85(9): 3458 - 3467. [Abstract] [Full Text]

				M. Marino, G. Zheng, L. Chiovato, A. Pinchera, D. Brown, D. Andrews, and R. T. McCluskey Role of Megalin (gp330) in Transcytosis of Thyroglobulin by Thyroid Cells. A NOVEL FUNCTION IN THE CONTROL OF THYROID HORMONE RELEASE J. Biol. Chem., March 15, 2000; 275(10): 7125 - 7137. [Abstract] [Full Text] [PDF]