, Volume 17, Issue 4, pp 565–571 | Cite as

Iodine intake and chronic autoimmune thyroiditis: a comparative study between coastal and mainland regions in Greece

  • Τ. Giassa
  • I. Mamali
  • Ε. Gaki
  • G. Kaltsas
  • G. Kouraklis
  • Κ. Β. MarkouEmail author
  • T. Karatzas
Original Article



The purpose of this study was to evaluate the relationship between iodine intake and autoimmune thyroiditis in Chios, an island located in the North East Aegean Sea, in comparison to mainland regions in South Western Greece (SWG).

Materials and methods

Urine iodine concentration (UIC), thyroid function (serum TSH, thyroid autoantibodies: anti-TPO and anti-Tg), and thyroid U/S were assessed in 200 subjects (150 females and 50 males) from Chios and 322 subjects (255 females and 67 males) from several mainland regions in SWG. All participants were recruited from outpatient clinics and were diagnosed as euthyroid.


Median UIC in Chios was significantly higher compared to SWG (136.1 vs. 104.5 μg/L, p < 0.001), indicating that both regions are iodine sufficient according to World Health Organization (WHO) criteria. The prevalence of thyroid autoimmunity was 66.5% in Chios and 27% in SWG, significantly higher in females (46.7%) than in males (26.5%). Furthermore, individuals with increased levels of thyroid autoantibodies either anti-TPO or anti-Tg (TAbs) showed increased median UIC levels compared to those / subjects / patients with normal levels (126.7 vs. 108.95 μg/L, p < 0.001). Serum TSH mean values (mIU/L) were greater in females (mean = 2.1 ± 1.41) compared to males (mean = 1.82 ± 1.26) (p = 0.04) and decreased with age.


In conclusion, in the present study, we clearly indicate that increased thyroid autoimmunity is positively associated with increased iodine intake, as well as with the female gender. Moreover, iodine intake and thyroid autoimmunity appear to be significantly higher in a coastal region (Chios) than in mainland Greece (SWG). Additional environmental factors, apart from iodine, should be investigated in future studies. Mean TSH values were increased in females and decreased with age. The latter is probably due to the presence of autonomous goiter in older Greek populations, as a result of long-term status of iodine deficiency in the past.


Iodine Autoimmune thyroid disease Thyroiditis Thyroid Greece 


Compliance with ethical standards

This comparative prospective study was approved by the Ethical committee of University Hospital of Patras in Greece and patient consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Hellenic Endocrine Society 2018

Authors and Affiliations

  • Τ. Giassa
    • 1
  • I. Mamali
    • 1
  • Ε. Gaki
    • 2
  • G. Kaltsas
    • 3
  • G. Kouraklis
    • 3
  • Κ. Β. Markou
    • 1
    Email author
  • T. Karatzas
    • 3
  1. 1.Department of Internal Medicine, Division of EndocrinologyUniversity of Patras Medical School, University HospitalRionGreece
  2. 2.Department of Business AdministrationUniversity of the AegeanLesbosGreece
  3. 3.Laikon General HospitalNational and Kapodistrian University of AthensAthensGreece

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