Relations between various measures of iodine intake and thyroid volume, thyroid nodularity, and serum thyroglobulin1–3

Background: Iodine intake can be measured in various ways, and each method may have advantages and disadvantages. Objective: We sought to investigate the potential associations of various measures of iodine intake with thyroid volume, prevalence of thyroid nodules, and serum thyroglobulin. We also sought to identify, if possible, groups at risk of thyroid disease because of their food choices. Design: This cohort study included 4649 randomly selected subjects with mild-to-moderate iodine deficiency; the subjects lived in 2 cities in Denmark. Iodine intake was estimated by using a food-frequency questionnaire and by measuring iodine excretion in spot urine samples. Thyroid volume and nodularity were measured with ultrasonography. Results: In multiple linear regression models, significant inverse relations were found between thyroid volume and estimated 24-h iodine excretion, iodine intake from diet plus supplements, iodine intake from diet/kg body wt, and milk intake (P = 0.001 for all), but not urinary iodine excretion measured as a concentration (P = 0.40). All measures of iodine intake were significantly related to serum thyroglobulin concentration (P ≤ 0.002), but only some measures of iodine intake were significantly related to the prevalence of thyroid nodules. Conclusions: Even in a geographic area where mild iodine deficiency is common, a significant relation between iodine intake and thyroid volume was found. All measures of iodine intake, except iodine excretion measured as a urinary concentration, predicted thyroid volume. Serum thyroglobulin concentration appears to be a good marker of iodine status. Subgroups with low intakes of milk and milk products had an increased risk of thyroid disease. Am J Clin Nutr 2002;76:1069–76.