Fifteen Years of Iodine Prophylaxis in Italy: Results of a Nationwide Surveillance (Period 2015-2019).
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De Angelis Simona, Medda Emanuela, Rotondi Daniela, Masocco Maria, Minardi Valentina, Contoli Benedetta, Possenti Valentina, Sorbo Angela, D'Amato Marilena, Turco Anna Chiara, Pastorelli Alberto Augusto, Stacchini Paolo, Cas Roberto Da, Bagnasco Marcello, Bonofiglio Daniela, Gasperi Maurizio, Meringolo Domenico, Mian Caterina, Moleti Mariacarla, Vermiglio Francesco, Puxeddu Efisio, Taccaliti Augusto, Tonacchera Massimo, Ulisse Salvatore, Dimida Antonio, Rago Teresa, Nazzari Elena, Schiavo Mara, Bossert Irene, Sturniolo Giacomo, Corbetta Carlo, Cereda Cristina, Cappelletti Laura, Camilot Marta, Teofoli Francesca, Ciatti Renzo, Tarsi Elisabetta, Perrotti Nicola, Marasco Onorina, Scozzafava Giovanna, Righetti Francesca, Andò Sebastiano, Catalano Stefania, Cristofaro Mariarosaria, Sorrenti Giovanni, Censi Simona, Morelli Silvia, Baldini Enke, Plutino Giuseppe, Copparoni Roberto, Alonzo Elena, Giacomozzi Claudia, Silano Marco, Olivieri Antonella
Аннотация
OBJECTIVE: The aim of this study was to evaluate efficiency, effectiveness, and possible adverse effects (increased occurrence of thyroid autoimmunity and hyperthyroidism) of the Italian iodine prophylaxis program.
METHODS: From 2015 to 2019, a nationwide survey was performed. The use of iodized salt was evaluated in a sample of 164 593 adults and in 998 school canteens. A sample of 4233 schoolchildren (aged 11-13 years) was recruited to assess urinary iodine concentration, prevalence of goiter, and thyroid hypoechogenicity on ultrasound, with the latter being an indirect indicator of thyroid autoimmunity. Neonatal TSH values of 197 677 infants screened in regions representative of Northern, Central, and Southern Italy were analyzed to investigate the percentage of TSH values >5.0 mIU/L. Data on methimazole prescriptions were analyzed as indirect indicators of new cases of hyperthyroidism.
RESULTS: The prevalence of the use of iodized salt was 71.5% in adult population and 78% in school canteens. A median urinary iodine concentration of 124 μg/L, a prevalence of goiter of 2.2%, and a prevalence of thyroid hypoechogenicity of 5.7% were observed in schoolchildren. The percentage of neonatal TSH values >5.0 mIU/L resulted still higher (5.1%) than the World Health Organization threshold of 3.0%, whereas the prescriptions of methimazole showed a reduction of 13.5%.
CONCLUSION: Fifteen years of iodine prophylaxis have led to iodine sufficiency in Italy, although there still is concern about iodine nutritional status during pregnancy.