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

¹ Department of Endocrinology and Gastroenterology, Bispebjerg University Hospital, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark² Department of Endocrinology, Aalborg Hospital, University of Aarhus, Aalborg, Denmark³ Department of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark⁴ Department of Gastroenterology, Slagelse Sygehus, Slagelse, Denmark⁵ Research Centre for Prevention and Health, The Capital Region, Glostrup, Denmark⁶ Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark

(Correspondence should be addressed to P Vejbjerg at Department of Endocrinology and Gastroenterology, Bispebjerg University Hospital; Email: pernille.vejbjerg{at}regionh.dk)

Objective: The iodine status of a population is traditionally evaluated by either urinary iodine (UI) 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 (Tg) 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 Tg was measured from blood samples. Thyroid volume was measured by ultrasonography.

Results: Before iodization, the median serum Tg was considerably higher in moderate than in mild iodine deficiency. Iodization led to a lower serum Tg in all examined age groups. The marked pre-iodization difference in Tg level between the regions was eliminated. The prevalence of Tg 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 Tg than of thyroid volume to show a difference between pre- and post-iodization values.

Conclusion: We found serum Tg 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 UI excretion is still marginally low according to WHO criteria.