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GOITER
| Am J Clin Nutr 2000 Jan;71(1):59-66 |
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Endemic goiter with iodine sufficiency: a possible role
for the consumption of pearl millet in the etiology of endemic goiter.
Elnour A, Hambraeus L, Eltom M, Dramaix M, Bourdoux P
Department of Medical Sciences, Nutrition, Uppsala University, Sweden.
BACKGROUND: Deficiencies of iodine, iron, and vitamin A are the 3 most
common micronutrient deficiencies in developing countries, although control
programs, when properly implemented, can be effective. OBJECTIVE: We
investigated these deficiencies and their possible interaction in preschool
children in the southern Blue Nile area of Sudan. DESIGN: Goiter, signs of
vitamin A deficiency, and biochemical markers of thyroid, vitamin A, and
iron status were assessed in 984 children aged 1-6 y. RESULTS: The goiter
rate was 22. 3%. The median urinary iodine concentration was 0.79 micromol/L
and 19.3% of the children had a concentration >1.57 micromol/L. Although
serum thyroxine and triiodothyronine concentrations were within reference
ranges, the median thyrotropin concentration was 3.78 mIU/L and 44% of the
children had thyrotropin concentrations above normal. The mean urinary
thiocyanate concentration was high (259 +/- 121 micromol/L). The prevalences
of Bitot spots and night blindness were 2.94% and 2.64%, respectively, and
32% of the subjects had serum retinol binding protein concentrations <15
mg/L. A significant positive correlation was observed between thyrotropin
and retinol binding protein. Whereas 88% of the children had hemoglobin
concentrations <1.86 mmol/L, only 13.5% had serum ferritin concentrations
below the cutoff of 12 microg/L and 95% had serum transferrin concentrations
above the cutoff of 2.50 g/L. CONCLUSIONS: Our results indicate that goiter
is endemic in this region of Sudan despite iodine sufficiency and that both
anemia and vitamin A deficiency are health problems in the area. Moreover,
consumption of millet, vitamin A deficiency, and protein-energy malnutrition
are possible etiologic factors in this endemic area.
PMID: 10617947, UI: 20084751
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