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DOI: 10.1055/s-2007-990298
© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York
Goiter Persistence After Iodine Replenishment, the Potential Role of Selenium Deficiency in Goitrous Schoolchildren of Semirom, Iran
Publication History
received 28.03.2007
first decision 14.06.2007
accepted 23.08.2007
Publication Date:
10 December 2007 (online)
Abstract
Background: Despite long-standing iodine supplementation in Iran, the prevalence of goiter remains high in some areas. This suggests other nutritional deficiencies may be considered as responsible factors of goiter persistence. Therefore, we assessed the prevalence of selenium deficiency in children living in a mountainous area in Iran to evaluate its correlation with goiter.
Methods: In this cross-sectional study, 1828 students from the 108 primary schools of urban and rural areas of Semirom in central Iran were selected by multistage random cluster sampling. After obtaining written consent from their parents, the children were examined for goiter grading. Grade 2 goitrous children (108 cases) were compared with non-goitrous children (111 children) as control group for serum selenium concentration.
Results: Overall, 36.7% of 1828 students had goiter. The mean and median urinary iodine excretion level was 19.3 and 18.5 μg/dl respectively. This was within normal limits. Of 219 evaluated cases, 109 children had selenium deficiency. Mean serum levels of selenium in the goitrous and control groups were 62.7 μg/l and 60.8 μg/l, respectively (p=0.42). There was a borderline significant difference of the goiter prevalence in selenium deficient and selenium sufficient subjects (40.8% vs. 54.3%, p=0.037).Twelve children had clinical or subclinical hypothyroidism. The mean (SD) serum selenium concentration of euthyroid and hypothyroid students were 61.9 (17.2) μg/l and 66.4 (11.9) μg/l respectively (p=0.35).
Conclusion: In the area studied, selenium deficiency cannot explain high prevalence of goiter and other responsible factors should be investigated. Selenium deficiency may also have mild borderline significant protective effects on thyroid function and goiter.
Key words
selenium - goiter - selenoproteins - thyroid - cretinism
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Correspondence
Dr. M. Siavash
Department of Internal Medicine/Endocrinology
Isfahan University of Medical Sciences
Medicine College/Daneshgah street
81745-313 Isfahan
Islamic Republic of Iran
Email: siavash@med.mui.ac.ir