Goiter Prevalence and Urinary Iodide Excretion in a Formerly Iodine-Deficient Region After Introduction of Statutory Iodization of Common Salt

Abstract

The objective of this epidemiologic study was to determine the volume of the thyroid gland as well as urinary iodine excretion in dependence on age and gender in a population from an area of low natural iodine supply now receiving iodine prophylaxis. In 430 persons from three communities in the province of Carinthia, Austria, we determined thyroid volume via sonography as well as urinary iodide excretion. As in numerous other European countries, natural iodine supply is insufficient in Austria. Therefore, to reduce goiter incidence, iodization of common salt with 10mg potassium iodide (KI) per kilogram of NaCl was made mandatory in Austria in 1963 by federal law. In 1990, the amount of iodine addition was increased to 20mg KI per kilogram of NaCl. Our results show that mean urinary iodide excretion in the persons investigated was altogether satisfactory (males: 163.7 μg of iodine per gram of creatinine; females: 183.3 μg of iodine per gram of creatinine). Goiter prevalence was 34.3% in women and 21.3% in men. An increase in goiter occurrence with age was noted in both genders. The increase in goiter prevalence was particularly obvious in the age group older than 40, i.e., among those participants who had spent at least a certain span of their lives in an area of iodine deficiency. Thus, the most likely reason for the persistently high goiter prevalence is not current iodine deficit but rather the high number of goiters that had developed previously at the time of iodine deficiency and were unable to undergo regression in spite of today's comparatively good iodine supply situation.