A national study of iodine status in Albania.

OBJECTIVE: The aim of the study was to determine the iodine status in Albania following 11 yr of iodine prophylaxis and to evaluate factors influencing the outcome. DESIGN: Eight hundred and forty children, aged 6-13 yr, living in 4 different regions and 365 pregnant women living in the same areas, were enrolled for the study. The prevalence of goiter was assessed by palpation and ultrasound imaging and the urinary iodine and the iodine concentration in the salt of different commercial brands were evaluated. Presence of goiter in the family and their eating habits were also investigated as well as the use of iodized salt in the household. MAIN OUTCOME: In children, the prevalence of goiter was 57.6% by palpation and 24.4% by ultrasound imaging. Median urinary iodine was 86.2 microg/l, with pronounced geographical variations (range 3.52-1079 microg/l). In particular, 29.1% of the children had urinary iodine <50 microg/l and 57.1% <100 microg/l. In pregnant women, the median urinary iodine was 85 microg/l. Median iodine concentration in household iodized salt was 21.2 mg/kg, with 60.3% of the brands being adequately and 39.7% non-adequately iodized. Almost all families (99.6%) claimed to use iodized salt. CONCLUSION: Despite the introduction of iodine prophylaxis, there is still a mild iodine deficiency in Albania, particularly in the inner mountainous areas.

[Experience with iodine prophylaxis in the province of Bolzano]. / Esperienze di iodoprofilassi in provincia di Bolzano.

Since 1981 in the province of Bolzano a "free-choice" iodine prophylaxis with iodinated dietary salt has been implemented. An epidemiological survey carried out in 1982 in 3109 schoolchildren living in this region showed an incidence of endemic goiter grade 1B-3 (WHO classification) of 23.6 +/- 14.0% and an urinary iodine excretion of 10.2 +/- 8.0 micrograms/l (colorimetric analysis) compared to the values of 39.6 +/- 17.7 micrograms/l found in a similar population of schoolchildren living in a non goitrous urban area in Northern Italy (Padua). This program of iodine prophylaxis was advertised through the local mass media. A further epidemiological survey, performed in the whole province in the year 1990, involving 1046 schoolchildren, randomly selected, showed an average goiter incidence of 1.6 +/- 1.3% and a urinary iodine excretion of 137.1 +/- 104.4 micrograms/l (ICP-MS analysis) in comparison to the values of 182.6 +/- 131.7 micrograms/l seen in the schoolchildren of the town of Padua. During the period of iodine prophylaxis the content of iodine in the commercially available iodinated dietary salt was also estimated. In 1990 the average content was 31.0 mg/kg and in 1997 was 27.1 mg/kg. These data therefore confirm the usefulness of iodinated salt in the prophylaxis of endemic goiter.

Thyrotropin (TSH) secretion in L-thyroxine treated children: assessment by a ultrasensitive TSH immunoradiometric assay.

The clinical usefulness of the measurement of basal TSH by an ultrasensitive assay (IRMA) versus the TRH test has been challenged in 49 children treated with L-thyroxine. They were given suppressive or replacement therapy depending on the underlying disease. An absent response of TSH to TRH could be predicted from a basal TSH value less than 0.1 mU/l in 88.8% of the cases, while only in 77.7% from a basal TSH value = 0.1 mU/l. A basal TSH value found in the range of the normal children always predicted a normal TRH test. We conclude that a sensitive TSH assay has some clinical application in monitoring L-thyroxine therapy, but can not absolutely replace the TRH test.

Thyroid function in type 1 juvenile diabetes mellitus: tendency to the low T3 syndrome.

We have evaluated the thyroid function in 30 children and adolescents (average age 13 2/12 +/- 3 10/12 years) suffering from type 1 insulin-dependent diabetes (average duration of illness 5 +/- 3 3/12 years). We divided them into group A (good control) and group B (poor control), according to whether they had presented an HbA1C value lower or higher than 10%. The results obtained have been compared with a group of 30 normal patients of the same age. Both groups of diabetics presented T4 values which were notably lower than the control group (P less than 0.05). T3 was appreciably diminished both in group A (P less than 0.05) and in group B (P less than 0.01) and presented a negative correlation with HbA1C, only in group A however. The rT3/T3 ratio, on the other hand, was significantly increased in group B with respect to the controls. No significant differences were found with regard to FT3 and FT4, nor any correlations among thyroid hormones, C peptide, duration of illness, and daily insulin requirement. Our results indicated that the tendency to the low T3 syndrome, already described in adult diabetics, is also identifiable in young diabetics, particularly if poorly controlled.