[Current state of alimentary iodine deficiency in Germany]. / Aktueller Stand der alimentären lodversorgung in Deutschland.

Germany finds itself among the most iodine deficient countries of Europe. Voluntary use of iodized salt constitutes the only goiter prophylaxis. In the last few years, measures such as the opening up of European internal markets, abolition of lac pertaining to the alimentary iodine consumption. Random samples of urine collected from 5932 persons without thyroid ailment, distributed over 32 regions of Germany, were measured for iodine excretion. The median value of iodine excretion was 72.4 micrograms I/g creatinine. Children under 10 years (76.9) and persons over 70 years (80.7) showed a slightly higher iodine elimination than those between 11-70 years (71.9). No differences between the former East Germany and West Germany as well as North, South and middle regions of unified Germany were observed. 55% of the study population presented with iodine values between 50 and 100 micrograms, 19% with lower than 50 micrograms. Only 9% showed sufficient iodine state. The results expose the inadequacy of the voluntary measures to tackle the problem of alimentary iodine deficiency.

[Goiter incidence in Germany is greater than previously suspected]. / Strumaprävalenz in Deutschland grösser als bisher angenommen.

BACKGROUND: The data regarding goitre prevalence in Germany is based on calculation arising out of dissimilar studies conducted among inhomogeneous study groups. The aim of our study was to collect data towards prevalence of goitre, thyroid size and structure through a prospective nationwide survey conducted using identical examination methods and study protocol. PATIENTS AND METHOD: A total number of 6815 subjects belonging to various age groups and spread over 32 regions in Germany participated in our thyroid ultrasound study conducted with a 7.5 MHz transducer. Information regarding nutrition, use of iodised table salt and iodine containing medicine and/or substances were collected through a questionnaire. The volumetry and age related normal values were followed as per the guidelines set by Deutsche Gesellschaft für Endokrinologie. RESULTS: Enlarged thyroid was seen in 50% of 18 to 70 year age group, 52% of 11 to 17 year age group and in 21% of children up to 10 years. Focal lesions were detected in 2.5% of subjects below 18 years and in 30% of women and 21% of men over 18 years. A positive correlation between age, thyroid volume and number of thyroid nodules was seen. Up to 83% of the examined subjects admitted to using iodised table salt. Children consuming iodised salt were found to have smaller thyroid glands. No correlation was found between the consumption of iodised salt and thyroid size in the adolescent age group and young adults. CONCLUSION: The prevalence of goitre in Germany is higher than it has been reported. The study underlines the insufficiency of the present goitre prophylaxis. Only an iodine prophylaxis (table salt, food products, fodder) backed by legislative measures can bring about a real breakthrough.