Abstract
The occurrence of goitre is dependent on genetic and environmental factors, but the associations with socio-economic and life-style factors have only been examined briefly. A cohort of 4649 participants from the general population was examined with questionnaires, thyroid ultrasonography, clinical examination and blood tests. Data were analysed in linear models and logistic regression analysis. Thyroid volume and serum thyroglobulin were closely associated with educational level with higher values in the group with the lowest levels of education (p < 0.001). The same pattern applied to thyroid multinodularity at ultrasonography (p = 0.002) and palpable goitre (p = 0.01). Physical activity in leisure time was negatively associated with thyroid enlargement (p = 0.02) and serum thyroglobulin (p < 0.001). These associations diminished markedly if adjustment was made for smoking habits, alcohol consumption and iodine intake. Familial occurrence of goitre was associated with goitre prevalence (Odds Ratio 2.5, 95% CI: 1.6–3.9), but did not confound the socio-economic associations. In conclusion, social imbalances in the occurrence of goitre were identified. These imbalances could in part be explained by differences in smoking habits and iodine intake.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Delange F. The disorders induced by iodine deficiency. Thyroid 1994; 4(1): 107–128.
Bertelsen JB, Hegedus L. Cigarette smoking and the thyroid. Thyroid 1994; 4(3): 327–331.
Knudsen N, Bulow I, Laurberg P, Ovesen L, Perrild H, Jørgensen T. Association of Tobacco Smoking with Goiter in a Low-Iodine-Intake Area. Arch Intern Med 2002; 162: 439–443.
Knudsen N, Bulow I, Laurberg P, Perrild H, Ovesen L, Jørgensen T. Alcohol consumption is associated with reduced prevalence of goitre and solitary thyroid nodules. Clin Endocrinol (Oxf.) 2001; 55(1): 41–46.
Brix TH, Kyvik KO, Hegedus L. Major role of genes in the etiology of simple goiter in females: A populationbased twin study. J Clin Endocrinol Metab 1999; 84(9): 3071–3075.
Knudsen N, Bulow I, Jørgensen T, Laurberg P, Ovesen L, Perrild H. Goitre prevalence and thyroid abnormalities at ultrasonography. A comparative epidemiological study in two regions with slightly different iodine status. Clin Endocrinol (Oxf.) 2000; 53(4): 479–485.
Knudsen N, Bols B, Bulow I, Jørgensen T, Perrild H, Ovesen L, et al. Validation of ultrasonography of the thyroid gland for epidemiological purposes. Thyroid 1999; 9(11): 1069–1074.
Gutekunst R, Becker W, Hehrmann R, Olbricht T, Pfannenstiel P. Ultraschalldiagnostik der Schilddruse. Dtsch Med Wochenschr 1988; 113(27): 1109–1112.
Schlumberger M, Fragu P, Gardet P, Lumbroso J, Violot D, Parmentier C. A new immunoradiometric assay (IRMA) system for thyroglobulin measurement in the follow-up of thyroid cancer patients. Eur J Nucl Med 1991; 18(3): 153–157.
Wilson B, Van Zyl A. The estimation of iodine in thyroidal amino acids by alkaline ashing. S Afr J med Sci 1967; 32(3): 70–82.
Laurberg P. Thyroxine and 3,5,3'-triiodothyronine content of thyroglobulin in thyroid needle aspirates in hyperthyroidism and hypothyroidism. J Clin Endocrinol Metab 1987; 64(5): 969–974.
Bartels H, Bohmer M. Eine Mikromethode zur Kreatininbestimmung. Clin Chim Acta 1971; 32(1): 81–85.
Knudsen N, Christiansen E, Brandt-Christensen M, Nygaard B, Perrild H. Age-and sex-adjusted iodine/ creatinine ratio. A new standard in epidemiological surveys? Evaluation of three different estimates of iodine excretion based on casual urine samples and comparison to 24 h values. Eur J Clin Nutr 2000; 54(4): 361–363.
Knudsen N, Bulow I, Jørgensen T, Perrild H, Ovesen L, Laurberg P. Serum tg-a sensitive marker of thyroid abnormalities and iodine deficiency in epidemiological studies. J Clin Endocrinol Metab 2001; 86(8): 3599–3603.
Osler M, Gerdes LU, Davidsen M, Bronnum-Hansen H, Madsen M, Jørgensen T, et al. Socioeconomic status and trends in risk factors for cardiovascular diseases in the Danish MONICA population, 1982-1992. J Epidemiol Community Health 2000; 54(2): 108–113.
Muzzo S, Burgueno M, Carvajal F, Moreno R, Leiva L. Endemic goiter in three census areas of Chile Arch Latinoam Nutr 1994; 44(2): 82–86.
Freire-Maia DV, Freire-Maia A. Endemic goitre in whites and negroes: Racial or social effect? Trop Geogr Med 1981; 33(4): 387–392.
Mertz DP, Tomaras K. The importance of sociomedical factors for the regression of endemic goiter in South Baden. MMW Munch Med Wochenschr 1976; 118(44): 1419–1422.
Stone T. Endemic goitre, nutrition, and landholding in Bangladesh. Int J Epidemiol 1984; 13(1): 58–64.
Joshi DC, Mishra VN, Bhatnagar M, Singh RB, Garg SK, Chopra H. Socioeconomic factors and prevalence of endemic goitre. Ind J Public Health 1993; 37(2): 48–53.
Freire-Maia DV, Freire-Maia A, Schull WJ, Morton NE, Quelce-Salgado A, Lobo LC. Epidemiology and genetics of endemic goiter. I. Epidemiological aspects. Isr J Med Sci 1983; 19(1): 11–16.
Gibson HB, Howeler JF, Clements FW. Seasonal epidemics of endemic goitre in Tasmania. Med J Aust 1960; June 4: 875–880.
Koutras DA, Katsouyanni EK, Livadas DP, Piperingos GD, Tzonou A, Trichopoulos D. An epidemiologic survey of thyroid enlargement among schoolchildren in a non-endemic area. Endokrinologie 1982; 79(3): 349–354.
Wong FL, Ron E, Gierlowski T, Schneider AB. Benign thyroid tumors: General risk factors and their effects on radiation risk estimation. Am J Epidemiol 1996; 144(8): 728–733.
Knudsen N, Perrild H, Christiansen E, Rasmussen S, Dige-Petersen H, Jørgensen T. Thyroid structure and size and two-year follow-up of solitary cold thyroid nodules in an unselected population with borderline iodine deficiency. Eur J Endocrinol 2000; 142(3): 224–230.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Knudsen, N., Bülow, I., Laurberg, P. et al. Low socio-economic status and familial occurrence of goitre are associated with a high prevalence of goitre. Eur J Epidemiol 18, 175–181 (2003). https://doi.org/10.1023/A:1023001400945
Issue Date:
DOI: https://doi.org/10.1023/A:1023001400945