F. Aghini-lombardi et al., The spectrum of thyroid disorders in an iodine-deficient community: The Pescopagano survey, J CLIN END, 84(2), 1999, pp. 561-566
We carefully assessed thyroid status and goiter by ultrasound in 1411 subje
cts virtually representing the entire resident population of Pescopagano, a
n iodine-deficient village of Southern Italy. Median urinary iodine excreti
on was 55 mu g/L. The prevalence of goiter was 16.0% in children and 59.8%
in adults. Thyroid nodularity was 0.5% in children and progressively increa
sed with age to 28.5% in the 56-to 65-yr-old group. The prevalence of prese
nt or past hyperthyroidism was 2.9%, including 9 cases with toxic diffuse g
oiter and 20 with toxic nodular goiter. Functional autonomy was rare in chi
ldren, progressively increased with age up to 15.4% in the elderly, and was
related to nodular goiter. The prevalences of overt and subclinical hypoth
yroidism in the adults were 0.2% and 3.8%, respectively. Serum autoantibodi
es to thyroglobulin and thyroperoxidase were detected in 12.6% of the entir
e population. The prevalence of diffuse autoimmune thyroiditis was 3.5%, be
ing very low in children. Thyroid cancer was found in only 1 case. In concl
usion, in the present survey of an iodine-deficient community, a progressiv
e increase with age of goiter prevalence, thyroid nodularity, and functiona
l 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 hypoth
yroidism were not different from those observed in iodine-sufficient areas.