Advertisement

Journal of Endocrinological Investigation

, Volume 36, Issue 5, pp 282–286 | Cite as

The size of the community rather than its geographical location better defines the risk of iodine deficiency: Results of an extensive survey in Southern Italy

  • F. Aghini-LombardiEmail author
  • P. Vitti
  • L. Antonangeli
  • E. Fiore
  • P. Piaggi
  • A. Pallara
  • E. Consiglio
  • A. Pinchera
  • the Southern Italy Study Group for Iodine Deficiency Disorders
Original Article

Abstract

Aim: The objective of this study was to establish the status of iodine nutrition in Southern Italy. Material and methods: The survey was carried out on 11–14 yr old children attending primary school and living in urban and non urban areas of 8 regions of Southern Italy. Urinary iodine excretion (UIE) was measured in 23,103 urinary samples randomly collected. Results: Median UIE in the whole studied population was 74 µg/l [interquartile range (IR) 34–139 µg/l]. UIE was significantly higher in chief towns compared to non chief towns (81 µg/l, IR 39–145 µg/l vs 73 µg/l, IR 33–138 µg/l, p<0.0001) and in areas with >500 inhabitants per km2 (median 87 µg/l, IR 43–154 µg/l) compared to areas with 100–500 per km2 (median 66 µg/l, IR 29–126 µg/l, p<0.0001) and with <100 per km2 (median 61 µg/l, IR 25–121 µg/l, p<0.0001). Median UIE was significantly lower in inland mountainous/hilly areas (68 µg/l, IR 30–129 µg/l) compared to coastal mountainous/hilly areas (79 µg/l, IR 37–144 µg/l, p<0.0001) and lowland (79 µg/l, IR 37–146 µg/l, p<0.0001). According to a binary logistic regression model, population density was the only independent parameter significantly associated with UIE≥100 µg/l. Conclusion: The results of the present survey indicate that: 1) in Southern Italy mild to moderate iodine deficiency is still present; 2) median UIE in non urban areas is lower than in urban areas and is related to the size of the community rather than to its geographical location, being higher in a larger community. This may be due to better diversification of dietary habits and the easier availability of iodized salt and processed food through commercial facilities, more common in larger communities. Future monitoring surveys should take into account these observations.

Key-words

Geographical location iodine deficiency urinary iodine excretion size of the community 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Aghini-Lombardi F, Antonangeli L. IDD status in Italy. In: Aghini-Lombardi F, Antonangeli L, Pinchera A (eds). Iodine deficiency in Europe. National reports on iodine status in west-central European countries. J Endocrinol Invest 2003, 26 (Suppl): 30–1.Google Scholar
  2. 2.
    Vermiglio F, Sidoti M, Finocchiaro MD, et al. Partial beneficial effects of the so called “silent iodine prophylaxis” on iodine deficiency disorders (IDD) in North Eastern Sicily. J Endocrinol Invest 1989, 12: 123–6.PubMedCrossRefGoogle Scholar
  3. 3.
    Aghini-Lombardi F, Antonangeli L, Vitti P, Pinchera A. Status of iodine nutrition in Italy. In: Delange F, Dunn J, Glinoer D eds. Iodine deficiency in Europe. A continuing concern. New York: Plenum Press. 1993, 403–5.CrossRefGoogle Scholar
  4. 4.
    Aghini-Lombardi F, Antonangeli L, Martino E, et al. The spectrum of thyroid disorders in an iodine-deficient community: the Pescopagano survey. J Clin Endocrinol Metab 1999, 84: 561–6.PubMedGoogle Scholar
  5. 5.
    Zimmermann MB. Iodine deficiency. Endocr Rev 2009, 30: 376–408.PubMedCrossRefGoogle Scholar
  6. 6.
    Dunn JT, Pretell EA, Daza CH, Viteri FE. Towards the eradication of endemic goiter, cretinism and iodine deficiency. Pan American Health Organization, World Health Organization, Scientific Publication. J Clin Endocrinol Metab 1986, 502: 215–370.Google Scholar
  7. 7.
    Untoro J, Timmer A, Schultink W. The challenges of iodine supplementation: a public health programme perspective. Best Pract Res Clin Endocrinol Metab 2010, 24: 89–99.PubMedCrossRefGoogle Scholar
  8. 8.
    Fenzi GF, Giusti LF, Aghini-Lombardi F, et al. Neuropsychological assessment in schoolchildren from an area of moderate iodine deficiency. J Endocrinol Invest 1990, 13: 427–31.PubMedCrossRefGoogle Scholar
  9. 9.
    Vermiglio F, Sidoti M, Finocchiaro MD, et al. Defective neuromotor and cognitive ability in iodine deficient schoolchildren of an endemic goiter region in Sicily. J Clin Endocrinol Metab 1990, 70: 379–84.PubMedCrossRefGoogle Scholar
  10. 10.
    Bleichrodt N, Escobar del Rey F, Morreale de Escobar G, Garcia I, Rubio C. Iodine deficiency: implications for mental and psychomotor development in children. In: DeLong G, Robbins J, Condliffe PG (eds). Iodine and the Brain. New York: Plenum. 1989, 269–71.CrossRefGoogle Scholar
  11. 11.
    Cao XY, C. Jiang XM, Dou ZH, et al. Timing of vulnerability of the brain to iodine deficiency in endemic cretinism. N Engl J Med 1994, 331: 1739–44.PubMedCrossRefGoogle Scholar
  12. 12.
    Chiovato L, Aghini-Lombardi F, Vitti P, Pinchera A. The impact of iodine deficiency on neurological and cognitive development. The European experience. In: Stanbury JB (ed). The Damaged Brain of Iodine Deficiency. New York: Cognizant Communication Corporation. 1994, 293–8.Google Scholar
  13. 13.
    Aghini Lombardi F, Pinchera, A, Antonangeli L, et al. Mild iodine deficiency during fetal/neonatal life and neuropsychological impairment in Tuscany. J Endocrinol Invest 1995, 18: 57–62.PubMedCrossRefGoogle Scholar
  14. 14.
    Soriguer F, Millon MC, Munoz R, et al. The auditory threshold in a school-age population is related to iodine intake and thyroid function. Thyroid 2000, 10: 991–9.PubMedCrossRefGoogle Scholar
  15. 15.
    Bleichrodt N, Born MP. A metaanalysis of research on iodine and its relationship to cognitive development. In: Stanbury JB (ed). The Damaged Brain of Iodine Deficiency. New York: Cognizant Communication Corporation. 1994, 195–9.Google Scholar
  16. 16.
    Vermiglio F, Lo Presti VP, Moleti MC, et al. Attention deficit and hyperactivity disorders in the offspring of mothers exposed to mildmoderate iodine deficiency: a possibile novel iodine dficiency disorder in developed countries. J Clin Endocrinol Metab 2004, 89: 6054–60.PubMedCrossRefGoogle Scholar
  17. 17.
    Santiago-Fernandez P, Torres-Barahona R, Muela-Martinez JA, et al. Intelligence quotient and iodine intake: a cross-sectional study in children. J Clin Endocrinol Metab 2004, 89: 3851–7.PubMedCrossRefGoogle Scholar
  18. 18.
    Benton D. Micronutrient status, cognition and behavioural problems in childhood. Eur J Nutr 2008, 47(Suppl 3): 38–50.PubMedCrossRefGoogle Scholar
  19. 19.
    World Health Organization, United Nations Children’s Found & International Council for the Control of Iodine Deficiency Disorders. Assessment of iodine deficiency disorders and monitoring their elimination. Geneva: WHO; WHO/NHD/0.1, Geneva 2001.Google Scholar
  20. 20.
    Sullivan KM. The challenges of implementing and monitoring of salt iodisation programmes. Best Pract Res Clin Endocrinol Metab 2010, 24: 101–6.PubMedCrossRefGoogle Scholar
  21. 21.
    Rasmussen LB, Oversen L, Bulow I, et al. Dietary iodine intake and urinary iodine excretion in a Danish population: effect of geography, supplements and food choice. Br J Nutr 2002, 87: 61–9.PubMedCrossRefGoogle Scholar
  22. 22.
    Vitti P, Martino E, Aghini-Lombardi F, et al. Thyroid volume measurement by ultrasound in children as a tool for the assessment of mild iodine deficiency. J Clin Endocrinol Metab 1994, 79: 600–3.PubMedGoogle Scholar
  23. 23.
    Delange F, Benker G, Caron PH, et al. Thyroid volume and urinary iodine in European schoolchildren: standardization of values for assessment of iodine deficiency. Eur J Endocrinol 1997, 136: 180–7.PubMedCrossRefGoogle Scholar
  24. 24.
    Knudsen N, Bulow I, Jorgensen T, Laurberg P, Oversen L, Perrild H. Goitre prevalence and thyroid abnormalities at ultrasonography: a comparative epidemiological study in two regions with slightly different iodine status. Clin Endocrinol 2000, 53: 479–85.CrossRefGoogle Scholar
  25. 25.
    Laurberg P, Jorgensen T, Perrild H, et al. The Danish investigation on iodine intake and thyroid disease, DanThyr: status and perspectives. Eur J Endocrinol 2006, 155: 219–28.PubMedCrossRefGoogle Scholar
  26. 26.
    Andersson M, Karumbunathan V, Zimmermann MB. Global iodine status in 2011 and trends over the past decade. J Nutr 2012, 142: 744–50.PubMedCrossRefGoogle Scholar
  27. 27.
    Vitti P, Delange F, Pinchera A, et al. Europe is iodine deficient. Lancet 2003, 361: 1226.PubMedCrossRefGoogle Scholar
  28. 28.
    World Health Organisation, United Nations Children’s Fund, International Council for the Control of Iodine Deficiency Disorders. Assessment of iodine deficiency disorders and monitoring their elimination. 3rd ed. Geneva, 2007.Google Scholar
  29. 29.
    Dunn JT, Crutchfield HE, Gutekunst R, Dunn AD. Two simple methods for measuring iodine in urine. Thyroid 1993, 3: 119–23.PubMedCrossRefGoogle Scholar
  30. 30.
    Vanderpump MP, Lazarus JH, Smyth PP, et al. Iodine status of UK schoolgirls: a cross-sectional survey. Lancet 2011, 377: 2007–12.PubMedCrossRefGoogle Scholar

Copyright information

© Italian Society of Endocrinology (SIE) 2013

Authors and Affiliations

  • F. Aghini-Lombardi
    • 1
    Email author
  • P. Vitti
    • 1
  • L. Antonangeli
    • 1
  • E. Fiore
    • 1
  • P. Piaggi
    • 2
  • A. Pallara
    • 3
  • E. Consiglio
    • 4
  • A. Pinchera
    • 1
  • the Southern Italy Study Group for Iodine Deficiency Disorders
  1. 1.Endocrinology Unit, Department of Clinical and Experimental MedicineUniversity of PisaPisaItaly
  2. 2.Department of Electrical System and AutomationUniversity of PisaPisaItaly
  3. 3.National Research CouncilRomeItaly
  4. 4.Department of Biology and Cellular and Molecular PathologyUniversity of NaplesNaplesItaly

Personalised recommendations