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Title: Iodine status and thyroid nodules in females: a comparison of Cyprus and Romania
Authors: Gängler, Stephanie 
Andrianou, Xanthi 
Piciu, Andra 
Charisiadis, Pantelis 
Zira, Christina 
Aristidou, Kyriacos 
Piciu, Doina 
Makris, Konstantinos C. 
Major Field of Science: Medical and Health Sciences
Field Category: Health Sciences
Keywords: Cancer;Iodine;Nodules;Thyroid;Thyroid hormones
Issue Date: 1-Feb-2017
Source: Public Health, 2017, vol. 143, pp. 37-43
Volume: 143
Start page: 37
End page: 43
Journal: Public Health 
Abstract: The increased comparative prevalence rates of thyroid cancer in Cyprus (>EU average) led us to conduct this study on possible risk factors of thyroid nodules. Romania served as a reference with a comparative thyroid cancer prevalence < EU average. This study aimed to assess the association between urinary iodine (UI) and thyroid nodules in adult females (n = 208) from Cyprus and Romania. Study design A case-control study (n = 208). Methods Cases were females with ultrasound-confirmed thyroid nodules and controls with confirmed absence of nodules. In both countries, subjects underwent ultrasound medical examinations, completed a questionnaire and offered a spot urine sample. Results Median UI level in Cyprus was 94 μg/L, whereas 32% of the Cypriot UI was < 50 μg/L, classifying the population as mildly iodine deficient. In Romania, both cases and controls were iodine sufficient. No significant differences (P > 0.05) in serum free thyroxin (fT4) and thyroid stimulating hormone (TSH) levels were found between cases and controls. Cases had lower median TSH levels compared with controls (1.4 mIU/L and 1.7 mIU/L, P = 0.060), but serum TSH and free thyroxin levels were within normal range. Albeit non-significant, participants with inadequate UI (<100 μg/L) had increased risk for thyroid nodules (odds ratio = 1.40, 95% confidence interval = 0.70, 2.81, P = 0.346), using multiple logistic regression after adjusting for age, body mass index, education, country and serum TSH. Conclusions This was the first study to quantify UI levels in Cyprus. While the Romanian iodine fortification programme reflected onto its UI levels, a representative assessment of iodine status in Cyprus will address the necessity of an iodine fortification programme.
ISSN: 0033-3506
DOI: 10.1016/j.puhe.2016.10.027
Rights: © The Royal Society for Public Health
Type: Article
Affiliation : Cyprus University of Technology 
Archbishop Makarios III Hospital 
Chiricuta Institute of Oncology 
Iuliu Hatieganu University of Medicine and Pharmacy 
Prof. Dr. Ion Chiricuta Institute of Oncology 
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