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Study on influential factors and reference values for thyroid volume in Chinese children aged 6–12 years

Published online by Cambridge University Press:  11 July 2022

Shuli An
Affiliation:
National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology (23618504), Harbin Medical University, Harbin 150081, People’s Republic of China Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin 150081, People’s Republic of China Heilongjiang Province Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin 150081, People’s Republic of China
Weidong Li
Affiliation:
Anhui Provincial Center for Disease Control and Prevention, Hefei 230601, People’s Republic of China
Xiaofeng Wang
Affiliation:
Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, People’s Republic of China
Yanling Wang
Affiliation:
Gansu Provincial Center for Disease Control and Prevention, Lanzhou 730030, People’s Republic of China
Xian Xu
Affiliation:
Anhui Provincial Center for Disease Control and Prevention, Hefei 230601, People’s Republic of China
Guangming Mao
Affiliation:
Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, People’s Republic of China
Xiaonan Zhu
Affiliation:
Gansu Provincial Center for Disease Control and Prevention, Lanzhou 730030, People’s Republic of China
Ming Li
Affiliation:
Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin 150081, People’s Republic of China
Lanchun Liu
Affiliation:
Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin 150081, People’s Republic of China
Xiaotao Cao
Affiliation:
Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin 150081, People’s Republic of China
Fangang Meng*
Affiliation:
National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology (23618504), Harbin Medical University, Harbin 150081, People’s Republic of China Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin 150081, People’s Republic of China Heilongjiang Province Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin 150081, People’s Republic of China
Peng Liu*
Affiliation:
National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology (23618504), Harbin Medical University, Harbin 150081, People’s Republic of China Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin 150081, People’s Republic of China Heilongjiang Province Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin 150081, People’s Republic of China
*
*Corresponding authors: Fangang Meng, email mfg5181397@163.com; Peng Liu, email liup7878@163.com
*Corresponding authors: Fangang Meng, email mfg5181397@163.com; Peng Liu, email liup7878@163.com

Abstract

The purpose of the current study was to research the factors influencing thyroid volume (TVOL) in 6–12-year-old children and update the reference values. A cross-sectional study was carried out in iodine-sufficient areas of four provinces in China. Urine, edible salt and drinking water samples were collected from children. Children’s height, weight and TVOL were measured. Ridge regression was used to screen variables for solving the multicollinearity problem. Quantile regression was used to analyse the relationship between the quantiles of TVOL and other variables. In total, 5653 children aged 6–12 years were enrolled in this study, including 2838 boys and 2815 girls. There was no significant difference in TVOL between boys and girls (P > 0·05). Spearman correlation analysis showed that total TVOL was positively correlated with age, height, weight, body surface area (BSA) and BMI, and the correlation coefficients were 0·616, 0·663, 0·669, 0·685 and 0·479, respectively. Among them, the correlation between TVOL and BSA was the strongest. According to the ridge regression results, age and BSA influenced TVOL, and the ridge regression coefficients were 0·13 and 0·94, respectively. Quantile regression further showed that age and BSA had significant influences on the whole TVOL distribution (P < 0·001). Therefore, the TVOL of children aged 6–12 years in China was mainly influenced by age and BSA, and reference values for TVOL of different genders based on age and BSA were established.

Type
Research Article
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of The Nutrition Society

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References

Wang, Z, Luo, B, Zang, J, et al. (2020) Appropriate range of median urinary iodine concentration in 8- to 10-year-old children based on generalized additive model. Thyroid 30, 15351540.CrossRefGoogle ScholarPubMed
Triggiani, V, Tafaro, E, Giagulli, VA, et al. (2009) Role of iodine, selenium and other micronutrients in thyroid function and disorders. Endocr Metab Immune Disord Drug Targets 9, 277294.CrossRefGoogle ScholarPubMed
Zimmermann, MB, Jooste, PL & Pandav, CS (2008) Iodine-deficiency disorders. Lancet 372, 12511262.CrossRefGoogle ScholarPubMed
Gyamfi, D, Wiafe, YA, Ofori Awuah, E, et al. (2020) Goitre prevalence and urinary iodine concentration in school-aged children in the Ashanti region of Ghana. Int J Endocrinol 2020, 3759786.CrossRefGoogle ScholarPubMed
Guo, W, Pan, Z, Zhang, Y, et al. (2020) Saliva iodine concentration in children and its association with iodine status and thyroid function. J Clin Endocrinol Metab 105, dgaa471.CrossRefGoogle ScholarPubMed
Katagiri, R, Yuan, X, Kobayashi, S, et al. (2017) Effect of excess iodine intake on thyroid diseases in different populations: a systematic review and meta-analyses including observational studies. PLoS One 12, e0173722.CrossRefGoogle ScholarPubMed
Zimmermann, MB & Andersson, M (2012) Update on iodine status worldwide. Curr Opin Endocrinol Diabetes Obes 19, 382–327.CrossRefGoogle ScholarPubMed
Zou, Y, Ding, G, Lou, X, et al. (2013) Factors influencing thyroid volume in Chinese children. Eur J Clin Nutr 67, 11381141.CrossRefGoogle ScholarPubMed
Liu, LC, Meng, FG & Liu, P (2020) Influence factors and correction methods of ultrasonic testing of thyroid volume in children. Chin J Endemiol 39, 379385.Google Scholar
Chen, W, Zhang, Q, Wu, Y, et al. (2019) Shift of reference values for thyroid volume by ultrasound in 8-to 13-year-olds with sufficient iodine intake in China. Thyroid 29, 405411.CrossRefGoogle ScholarPubMed
Ministry of Health of the People’s Republic of China (2007) Diagnostic Criterion of Endemic Goiter (WS276–2007). Beijing: Ministry of Health.Google Scholar
Semiz, S, Senol, U, Bircan, O, et al. (2001) Correlation between age, body size and thyroid volume in an endemic area. J Endocrinol Invest 24, 559563.CrossRefGoogle Scholar
Wang, Y, Dong, X, Fu, C, et al. (2021) Associations between thyroid volume and physical growth in pubertal girls: thyroid volume indexes need to be applied to thyroid volume assessments. Front Endocrinol 12, 662543.CrossRefGoogle ScholarPubMed
Soydan, L, Eren Ozturk, H, Onal, ZE, et al. (2019) Associations of thyroid volume and function with childhood obesity. Acta Endocrinol 5, 123128.Google ScholarPubMed
Licenziati, MR, Valerio, G, Vetrani, I, et al. (2019) Altered thyroid function and structure in children and adolescents who are overweight and obese: reversal after weight loss. J Clin Endocrinol Metab 104, 27572765.CrossRefGoogle ScholarPubMed
Liu, L, Liu, L, Li, M, et al. (2021) Study on association between height, weight, iodine supplementation and thyroid volume. Br J Nutr 14, 19.Google Scholar
Dong, Y, Jan, C, Ma, Y, et al. (2019) Economic development and the nutritional status of Chinese school-aged children and adolescents from 1995 to 2014: an analysis of five successive national surveys. Lancet Diabetes Endocrinol 7, 288299.CrossRefGoogle ScholarPubMed
Teng, D, Yang, W, Shi, X, et al. (2020) An inverse relationship between iodine intake and thyroid antibodies: a national cross-sectional survey in mainland China. Thyroid 30, 16561665.CrossRefGoogle ScholarPubMed
Yang, W, Lu, J, Weng, J, et al. (2010) Prevalence of diabetes among men and women in China. N Engl J Med 362, 10901101.CrossRefGoogle ScholarPubMed
World Medical Association (2013) World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 310, 21912194.CrossRefGoogle Scholar
Cui, SL, Liu, P, Su, XH, et al. (2017) Surveys in areas of high risk of iodine deficiency and iodine excess in China, 2012–2014: current status and examination of the relationship between urinary iodine concentration and goiter prevalence in children aged 8–10 years. Biomed Environ Sci 30, 8896.Google ScholarPubMed
Ministry of Health of the People’s Republic of China (2016) Method for Determination of Iodine in Urine by As3+-Ce4+ Catalytic Spectrophotometry: WS/T107.1–2016. Beijing: Standards Press of China.Google Scholar
General Administration of Quality Supervision & Inspection and Quarantine of the People’s Republic of China (2012) General Test Method in Salt Industry-Determination of Iodine: GB/T 13025.7–2012. Beijing: Standards Press of China.Google Scholar
Chinese Ministry of Health (2012) National Standard on Food Safety-Iodine Content of Edible Salt:GB26878–2011. Beijing: Standards Press of China.Google Scholar
Wang, Y, Cui, Y, Chen, C, et al. (2020) Stopping the supply of iodized salt alone is not enough to make iodine nutrition suitable for children in higher water iodine areas: a cross-sectional study in northern China. Ecotoxicol Environ Saf 188, 109930.CrossRefGoogle ScholarPubMed
Wang, D, Wan, S, Liu, P, et al. (2021) Associations between water iodine concentration and the prevalence of dyslipidemia in Chinese adults: a cross-sectional study. Ecotoxicol Environ Saf 208, 111682.CrossRefGoogle ScholarPubMed
Hess, SY & Zimmermann, MB (2000) Thyroid volumes in a national sample of iodine-sufficient Swiss school children: comparison with the World Health Organization/International Council for the control of iodine deficiency disorders normative thyroid volume criteria. Eur J Endocrinol 142, 599603.CrossRefGoogle Scholar
Institute of Nutrition and Health & Chinese Center for Disease Control and Prevention (2020) Notification of the Evaluation Results of the External Quality Control Network of Iodine Deficiency Disorders Laboratories in China in (2020) No.160, 16/12/2020.Google Scholar
Zimmermann, MB, Hess, SY, Molinari, L, et al. (2004) New reference values for thyroid volume by ultrasound in iodine-sufficient schoolchildren: a World Health Organization/nutrition for health and development iodine deficiency study group report. Am J Clin Nutr 79, 231237.CrossRefGoogle ScholarPubMed
Wang, Y, Zhang, Z, Ge, P, et al. (2009) Iodine deficiency disorders after a decade of universal salt iodization in a severe iodine deficiency region in China. Indian J Med Res 130, 413417.Google Scholar
Zhao, LL & Chen, JS (2020) Analysis on influencing factors of thyroid volume among children aged 8–10 years in iodine deficiency area, Hebi city. Prev Med Trib 26, 457458+462.Google Scholar
Wu, CG,Li, XS, Luo, XJ, et al. (2013) Survey of thyroid volume of school children of Chongqing in 2011. Chin J Endemiol 05, 541544.Google Scholar
Fuse, Y, Saito, N, Tsuchiya, T, et al. (2007) Smaller thyroid gland volume with high urinary iodine excretion in Japanese schoolchildren: normative reference values in an iodine-sufficient area and comparison with the WHO/ICCIDD reference. Thyroid 17, 145155.CrossRefGoogle Scholar
Ueda, D (1990) Normal volume of the thyroid gland in children. J Clin Ultrasound 18, 455462.CrossRefGoogle ScholarPubMed
WHO (2007) Assessment of Iodine Deficiency Disorders and Monitoring their Elimination: a Guide for Programme Managers. Geneva: WHO.Google Scholar
Azizi, F, Delshad, H & Mehrabi, Y (2001) Thyroid volumes in schoolchildren of Tehran: comparison with European schoolchildren. J Endocrinol Invest 24, 756762.CrossRefGoogle ScholarPubMed
Zimmermann, MB, Aeberli, I, Andersson, M, et al. (2013) Thyroglobulin is a sensitive measure of both deficient and excess iodine intakes in children and indicates no adverse effects on thyroid function in the UIC range of 100–299 μg/l: a UNICEF/ICCIDD study group report. J Clin Endocrinol Metab 98, 12711280.CrossRefGoogle ScholarPubMed
UNICEF (2018) Guidance on the Monitoring of Salt Iodization Programmes and Determination of Population Iodine Status.Google Scholar
Xuan, K (2017) The Application of Quantile Regression Based on the Correction Multicollinearity Method. Dissertation, Xinjiang University of Finance & Economics.Google Scholar
Mo, Z, Lou, X, Mao, G, et al. (2016) Larger thyroid volume and adequate iodine nutrition in Chinese schoolchildren: local normative reference values compared with WHO/IGN. Int J Endocrinol 2016, 8079704.CrossRefGoogle ScholarPubMed
García-Ascaso, MT, Ares Segura, S, Ros Pérez, P, et al. (2019) Thyroid volume assessment in 3–14 year-old Spanish children from an iodine-replete area. Eur Thyroid J 8, 196201.CrossRefGoogle ScholarPubMed
Zava, TT & Zava, DT (2011) Assessment of Japanese iodine intake based on seaweed consumption in Japan: a literature-based analysis. Thyroid Res 4, 14.CrossRefGoogle ScholarPubMed
Foo, LC, Zulfiqar, A, Nafikudin, M, et al. (1999) Local versus WHO/International Council for control of iodine deficiency disorders-recommended thyroid volume reference in the assessment of iodine deficiency disorders. Eur J Endocrinol 140, 491497.CrossRefGoogle ScholarPubMed
Darcan, S, Unak, P, Yalman, O, et al. (2005) Determination of iodine concentration in urine by isotope dilution analysis and thyroid volume of school children in the west coast of Turkey after mandatory salt iodization. Clin Endocrinol 63, 543548.CrossRefGoogle ScholarPubMed
Szybiński, Z, Trofimiuk-Müldner, M, Buziak-Bereza, M, et al. (2012) Reference values for thyroid volume established by ultrasound in Polish schoolchildren. Endokrynol Pol 63, 104109.Google ScholarPubMed
Xu, F, Sullivan, K, Houston, R, et al. (1999) Thyroid volumes in US and Bangladeshi schoolchildren: comparison with European schoolchildren. Eur J Endocrinol 140, 498504.CrossRefGoogle ScholarPubMed
Fuse, Y, Ito, Y, Shishiba, Y & Irie, M (2022) Current iodine status in Japan: a cross-sectional nationwide survey of schoolchildren, 2014–2019. J Clin Endocrinol Metab 107, e2065e2079.CrossRefGoogle ScholarPubMed
Gorstein, JL, Bagriansky, J, Pearce, EN, et al. (2020) Estimating the health and economic benefits of universal salt iodization programs to correct iodine deficiency disorders. Thyroid 30, 18021809.CrossRefGoogle ScholarPubMed
Zygmunt, A, Adamczewski, Z, Wojciechowska-Durczynska, K, et al. (2019) Evaluation of the effectiveness of iodine prophylaxis in Poland based on over 20 years of observations of iodine supply in school-aged children in the central region of the country. Arch Med Sci 15, 14681474.CrossRefGoogle ScholarPubMed
Liu, L, Qian, T, Sun, R, et al. (2022) Comparative analysis of five correction methods for thyroid volume by ultrasound and their recommended reference values in Chinese children aged 8–10 years. Br J Nutr 3, 128.Google Scholar
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