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Thyroglobulin as a marker of iodine nutrition status in the general population

P Vejbjerg, Department of Endocrinology and Gastroenterology, Bispebjerg University Hospital, Copenhagen NV, Denmark
N Knudsen, Department of Endocrinology and Gastroenterology, Bispebjerg University Hospital, Copenhagen NV, Denmark
H Perrild, Department of Endocrinology and Gastroenterology, Bispebjerg University Hospital, Copenhagen NV, Denmark
P Laurberg, Department of Endocrinology and Medicine, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark
A Carlé, Dept of Endocrinology and Internal Medicine, Aalborg Regional Hospital, Aalborg, Denmark
I Pedersen, Endocrinology and Medicine, Aalborg Hospital, Aalborg, Denmark
L Rasmussen, Dept. of nutrition, National Food Institute, Søborg, Denmark
L Ovesen, Department of Gastroenterology, Slagelse Hospital, Slagelse, Denmark
T Jørgensen, Research Centre for Prevention and Health, Glostrup, Denmark

Correspondence: Pernille Vejbjerg, Email: pernille.vejbjerg{at}regionh.dk

Objective: The iodine status of a population is traditionally evaluated by either urinary iodine excretion or by some measure of thyroid volume and the prevalence of goitre. In this prospective study of a mandatory iodization programme, we aimed to evaluate serum thyroglobulin as a marker of iodine status in the population.

Methods: Two identical cross-sectional studies were performed before (1997-1998, n=4649) and after (2004-2005, n=3570) the initiation of the Danish iodization programme in two areas with mild and moderate iodine deficiency. Serum thyroglobulin was measured from blood samples. Thyroid volume was measured by ultrasonography.

Results: Before iodization the median serum thyroglobulin was considerably higher in moderate than in mild iodine deficiency. Iodization led to a lower serum thyroglobulin in all examined age groups. The marked pre-iodization difference in thyroglobulin level between the regions was eliminated. The prevalence of thyroglobulin above the suggested reference limit (40 µg/l) decreased from 11.3% to 3.7% (p<0.0001). Using bootstrapping, we demonstrated a higher efficacy of thyroglobulin than of thyroid volume to show a difference between pre- and post iodization values.

Conclusion: We found serum thyroglobulin to be a suitable marker of iodine nutrition status in the population. The results may suggest that the Danish iodization programme has led to a sufficient iodine intake, even if the median urinary iodine excretion is still marginally low according to WHO criteria.