Study of Biochemical Risk Factors Involved in the Pathogenesis of Goiter in Adults in Sindh


Background: Deficiencies of iodine, Selenium, are the 2 most common micronutrient deficiencies in some areas of Pakistan, although control programs, when properly implemented, can be effective.
Objective: We investigate these deficiencies and their possible interaction in adult age in both genders of Hyderabad & plane areas of Sindh.
Design: Goiter, signs of Iodine deficiency, and biochemical markers of thyroid (Thyroid Hormones), Serum Selenium status were assessed in 100 younger aged 15–30 y.
Results: The goiter rate was 30.5%.TSH levels in adult goiter cases were significantly higher 11.40 ± 3.80 μIU/ml (p <0.002) than the control subjects 1.27 ± 0.42 μIU/ml (matched for age and gender and with no personal history of goiter). As compared to control subjects T3 levels were significantly higher 1.80 ± 1.02 ng/dl (p <0.001) in goiter cases. The T4 levels were comparable between goiter patients and control subjects. There were significantly lower 42.68± 11.07 μg/L (p <0.001) serum selenium levels in goiter cases as compared to control subjects 88.88 ± 10.39 μg/L. There were significantly lower 60.32 ± 20.47 μg/L (p <0.001) urine iodine levels in goiter cases as against the controls.
Conclusion: The finding of present study that T3 and T4 levels in goiter patients were within normal ranges indicates that the cause of enlarged thyroid gland in these patients is deficiency of iodine in the diet. The finding that iodine was excreted in significantly lower amounts in goiter patients than in the control subjects, also suggests mild
iodine deficiency to be the cause of goiter in these patients.


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