Biological Trace Element Research

, Volume 113, Issue 3, pp 223–230 | Cite as

Gender-specific determinants of goiter

  • Jamshid Farahati
  • Karl Wegscheider
  • Kerstin Christ
  • Elena Gilman
  • Wilhelm Oing


Despite the strong implications of differences between females and males in the risk of goiter, gender-specific issues have not been extensively addressed in investigations of goiter prevalence. The objective of our analysis was to investigate the gender-specific determinants of goiter. Between April 2001 and April 2002. A total of 853 healthy employees from 4 institutions in the western part of Germany between 18 and 68 yr of age were examined by ultrasound of the neck to determine the thyroid volume. Information on sex, age, daily use of iodized salt, the history of goiter in the first-degree relatives, type and amount of smoking, oral contraceptives, and number of pregnancies were assessed by standardized questionnaires. Gender-specific predictors of goiter prevalence were assessed by multivariate logistic regression. The overall prevalence of goiter among study subjects was 204/853 (23.9%). Goiter was present in 80 out of 370 females (21.6%) vs 124/483 (25.7%) in males. In general, smoking (p<0.0001), increasing age (p<0.0001), and lack of daily intake of iodized salt (p=0.004) were associated with goiter prevalence, but not sex (p=0.39) and family history of goiter (p=0.16). In 370 females, parity (p=0.004) and lack of daily intake of iodized salt (p=0.01) were the major determinants for goiter, whereas age (p=0.18), oral contraceptives (p=0.82), family history of goiter (p=0.33), and smoking (p=0.09) did not affect goiter prevalence. In 483 males, smoking (p<0.0001) and age (p<0.001) affected goiter prevalence, but not family history of goiter (p=0.39), and the iodine status failed just to reach the significant level (p=0.08) in this analysis. Gender-specific determinants of goiter are parity and iodine status in females and smoking and increasing age in males.

Index Entries

Iodine goiter smoking parity age 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    R. Hampel, A. Gordalla, H. Zollner, D. Klinke, and M. Demuth, Continuous rise of urinary iodine excretion and drop in thyroid gland size among adolescents in Mecklenburg-West-Pomerania from 1993 to 1997, Exp. Clin. Endocrinol. Diabetes 108, 197–201 (2000).PubMedCrossRefGoogle Scholar
  2. 2.
    R. Hampel, B. Beyersdorf-Radeck, H. Below, M. Demuth, and K. Seelig, Urinary iodine levels within normal range in German school-age children, Med. Klin. 96, 125–128 (2001).CrossRefGoogle Scholar
  3. 3.
    W. Meng, A. Schindler, S. Horack, E. Lux, and A. Muche, Renal iodine excretion by students in East Germany. A prospective study 1989 to 1996, Med. Klin. 93, 347–351 (1998).Google Scholar
  4. 4.
    R. Gartner, F. Manz, and R. Grossklaus, Representative data of iodine intake and urinary excretion in Germany, Exp. Clin. Endocrinol. Diabetes 109, 2–7 (2001).PubMedCrossRefGoogle Scholar
  5. 5.
    J. Rendl, N. Juhran, and C. Reiners, Thyroid volume and urinary iodine in German school children, Exp. Clin. Endocrinol. Diabetes 109, 8–12 (2001).PubMedCrossRefGoogle Scholar
  6. 6.
    H. Volzke, J. Ludemann, D. M. Robinson, et al., The prevalence of undiagnosed thyroid disorders in a previously iodine-deficient area, Thyroid 13, 803–810 (2003).PubMedCrossRefGoogle Scholar
  7. 7.
    R. Gartner, G. Bechtner, M. Rafferzeder, and W. Greil, Comparison of urinary iodine excretion and thyroid volume in students with or without constant iodized salt intake, Exp. Clin. Endocrinol. Diabetes 105, 443–445 (1997).CrossRefGoogle Scholar
  8. 8.
    C. Reiners, K. Wegscheider, H. Schicha, et al., Prevalence of thyroid disorders in the working population of Germany: ultrasonography screening in 96278 unselected employees, Thyroid 14, 926–932 (2004).PubMedCrossRefGoogle Scholar
  9. 9.
    G. J. Kahaly and M. Dietlein, Cost estimation of thyroid disorders in Germany, Thyroid 12, 909–914 (2002).PubMedCrossRefGoogle Scholar
  10. 10.
    J. Farahati, M. Geling, U. Mäder, et al., Changing trends of incidence and prognosis of thyroid carcinoma in “Lower Frankonia”, Germany from 1981–1995, Thyorid 14, 139–145 (2004).Google Scholar
  11. 11.
    D. Glinoer, P. De Nayer, F. Delange, M. Lemone, V. Toppet, and M. Spehl, A randomised trial for the treatment of mild iodine deficiency during pregnancy: maternal and neonatal effects, J. Clin. Endocrinol. Metab. 80, 258–269 (1998).CrossRefGoogle Scholar
  12. 12.
    J. Farahati, P. Bucsky, Th. Parlowsky, U. Mäder, and C. Reiners, Characteristics of differentiated thyroid cancer in children and adolescents with respect to age, gender and histology, Cancer 80, 2156–2162 (1997).PubMedCrossRefGoogle Scholar
  13. 13.
    M. Rotondi, G. Amato, B. Biondi, et al., Parity as a thyroid size-determining factor in areas with moderate iodine deficiency, J. Clin. Endocrinol. Metab. 85, 4534–4537 (2000).PubMedCrossRefGoogle Scholar
  14. 14.
    J. M. Gomez, F. J. Maravall, N. Gomez, A. Guma, and J. Soler, Determinants of thyroid volume as measured by ultrasonography in healthy adults randomly selected, Clin. Endocrinol. 53, 629–634 (2000).Google Scholar
  15. 15.
    N. Knudsen, I. Bulow, P. Laurberg, L. Ovesen, H. Perrild, and T. Jorgensen, Parity is associated with increased thyroid volume solely among smokers in an area with moderate to mild iodine deficiency, Eur. J. Endocrinol. 146, 39–43 (2002).PubMedCrossRefGoogle Scholar
  16. 16.
    J. B. Bertelsen and L. Hegedus, Cigarette smoking and the thyroid, Thyroid 4, 327–331 (1994).PubMedGoogle Scholar
  17. 17.
    S. B. Christensen, U. B. Ericsson, L. Janzon, S. Tibblin, and A. Melander, Influence of cigarette smoking on goiter formation, thyroglobulin, and thyroid hormone levels in women, J. Clin. Endocrinol. Metab. 58, 615–618 (1984).PubMedCrossRefGoogle Scholar
  18. 18.
    U.-B. Ericsson and F. Lindgarde, Effects of cigarette smoking on thyroid function and the prevalence of goiter, thyrotoxicosis and autoimmune thyroiditis, J. Intern. Med. 229, 67–71 (1991).PubMedGoogle Scholar
  19. 19.
    K. Petersen, G. Lindstedt, P. A. Lundberg, C. Bengtsson, L. Lapidus, and E. Nystrom, Thyroid disease in middle-aged and elderly Swedish women: thyroid-related hormones, thyroid dysfunction and goiter in relation to age and smoking, J. Intern. Med. 229, 407–413 (1991).PubMedCrossRefGoogle Scholar
  20. 20.
    R. Gutekunst, H. Smolarek, U. Hasenpusch, et al., Goiter epidemiology: thyroid volume, iodine excretion, thyroglobulin and thyrotropin in Germany and Sweden, Acta Endocrinol. (Copenh.) 112, 494–501 (1986).Google Scholar
  21. 21.
    C. Muller-Leisse, J. Troger, F. Khabirpour, and C. Pockler, Normal values of thyroid gland volume. Ultrasound measurements in schoolchildren 7 to 20 years of age, Dtsch. Med. Wochenschr. 113, 1872–1875 (1988).PubMedCrossRefGoogle Scholar
  22. 22.
    R. Osathanondh, D. Tulchinsky, and I. J. Chopra, Total and free thyroxine and triodothyronine in normal and complicated pregnancy, J. Clin. Endocrinol. Metab. 42, 98–104 (1976).PubMedGoogle Scholar
  23. 23.
    D. Glinoer, Thyroid changes in the pregnant woman, Rev. Med. Brux 17, 210–213 (1996).PubMedGoogle Scholar
  24. 24.
    S. Lindsay, C. W. Nichols, Jr., and I. L. Chaikoff, Induction of benign and malignant thyroid neoplasms in the rat. Induction of thyroid neoplasms by injection of 131-I with or without the feeding of diets containing propylthiouracil and/or desiccated thyroid, Arch. Pathol. 81, 308–316 (1966).PubMedGoogle Scholar
  25. 25.
    Y. Mizukami, T. Michigishi, A. Nonomura, T. Hashimoto, M. Noguchi, and F. Matsubara, Estrogen and estrogen receptors in thyroid carcinomas, J. Surg. Oncol. 47, 165–169 (1994).CrossRefGoogle Scholar
  26. 26.
    Y. Imai, M. Yamakawa, M. Matsuda, and T. Kasajima, Endogenous sex hormone and estrogen binding activity in thyroid cancer, Histol. Histopathol. 4, 39–45 (1989).PubMedGoogle Scholar
  27. 27.
    R. Rossi, P. Franceschetti, I. Maestri, et al., Evidence for androgen receptor gene expression in human thyroid cells and tumours, J. Endocrinol. 148, 77–85 (1996).PubMedCrossRefGoogle Scholar

Copyright information

© Humana Press Inc. 2006

Authors and Affiliations

  • Jamshid Farahati
    • 1
  • Karl Wegscheider
    • 2
  • Kerstin Christ
    • 1
  • Elena Gilman
    • 1
  • Wilhelm Oing
    • 1
  1. 1.Clinic of Nuclear Medicine and RadiologyEssenGermany
  2. 2.Institute for Statistics and EconometryUniversity of HamburgHamburgGermany

Personalised recommendations