RESUMO
Iodine deficiency was endemic in Pars province since several years. Mandatory production of iodinized salt for household use was started from 1994. The aim of this study was to evaluate the prevalence of goiter, urinary iodine excretion in school children ten years after starting the program. A cross sectional study in which 1188 school children, aged of 8 - 13 years, from Marvdasht city were chosen by random cluster sampling for evaluation of goiter prevalence according to WHO classification. Of these this 1188 school children, 500 persons were selected for evaluation of urinary iodine excretion [UIE] by digestion method, difference in UIE was assessed among different age groups, goitrous and non goitrous school children. Following the assessment, goiter was found to be still endemic in school children [39.6%] but majority of them had gradel goiter. Median urinary iodine [95% Cl] excretion levels in boys and girls and total number of school children were 17 micro g/dl [13.1-20.9], 22.4 micro g/dl [20.4-24.1] and 18.8 micro g/dl [16.1-21.5] respectively. Differences in UIE between two sexes were significant [P < 0.001] but differences among age groups were not significant. The UIE levels in goitrous and non goitrous school children were 18 micro g/dl [16.4-19.9] and 20 micro g/dl [17.1-22.9] respectively, with no statistically significant difference. Prevalences of school children with urinary excretion in normal, above normal and below normal ranges were 29.5%, 47.5%, 23% respectively, meanwhile less than 13% had urinary iodine excretion < 5 micro g/dl. We conclude that the iodine intake is sufficient but persistent, albeit, reduced prevalence of goiter in spite of adequate iodine supplementation suggests the existence of additional causes in goiterogenesis. It is necessary to consider the role of other factors in persistence of goiter
RESUMO
Overt hypothyroidism has been found to be associated with cardiovascular diseases. Whether or not subclinical hypothyroidism is also a risk factor for cardiovascular disease is controversial. The aim of this study was to investigate serum thyrotropin levels and subclinical hypothyroidism in relation to presence and extent of coronary artery disease [CAD]. In a sample of 390 persons [239 men and 151 women] with mean age of 55.12 +/- 10.52 years who had referred for coronary angiography, data on general health, thyroid status, medications and previous myocardial infarction were obtained at baseline. They were screened for impaired thyroid function using a sensitive immunoradiometric assay for thyrotropin. Subclinical hypothyroidism was defined as an elevated serum thyrotropin level [>/= 4. 0mU/L] and a normal serum free thyroxine level. A single-, two- or triple vessel disease or normal vessels was documented by coronary angiography. Subclinical hypothyroidism was present in 6.4% of persons and was not associated with a higher frequency [P=0.51] or greater severity [x2=2.172; P=0.70] of CAD. The mean serum thyrotropin level was significantly higher in women [P<0.001]. There was neither correlation between serum thyrotropin level and the presence of CAD [P=0.37] in either sex [men: P=0.67 /women: P=0.97] nor with the extent of CAD [P=0.30] in either of the two groups [men: P=0.70 /women: P=0.34]. Also, serum thyrotropin level was not higher significantly in patients who had has previous myocardial infarction [P=0.95]. There was no correlation between thyrotropin levels or subclinical hypothyroidism and presence or severity of CAD in a cohort of patients who referred for coronary angiography.cohort of patients who referred for coronary angiography