| 1. |
- Andersson, M, et al.
(författare)
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Adequate iodine nutrition in Sweden: a cross-sectional national study of urinary iodine concentration in school-age children.
- 2009
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Ingår i: European journal of clinical nutrition. - : Springer Science and Business Media LLC. - 0954-3007 .- 1476-5640. ; 63:7, s. 828-34
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Tidskriftsartikel (refereegranskat)abstract
- Background/Objectives:Sweden has a long-standing salt iodization program; however, its effects on iodine intake have never been monitored on a national level. The objective of this study was to evaluate iodine nutrition in the Swedish population by measuring the urinary iodine concentration (UIC) in a national sample of Swedish school-age (6-12 years of age) children.Subjects/Methods:A stratified probability proportionate to size cluster sampling method was used to obtain a representative national sample of school-age children from 30 clusters. Spot urine samples were collected for UIC analysis using a modified Sandell-Kolthoff method.Results:The median UIC of the children (n=857) was 125 mug/l (range 11-757 mug/l). The proportion of children with a UIC <100 mug/l was 30.0% and the proportion of children with a UIC <50 and >300 mug/l was 5.5 and 3.0%, respectively.Conclusions:The iodine nutritional status of the Swedish population is adequate. Iodized table salt remains the main dietary source of iodine in Swedish diet. Recommendations to reduce total salt intake in the population urge increased use of iodized salt in the production of processed foods. Pregnant and lactating women with high iodine requirements may still be at risk for low iodine intake. This study will serve as the basis for future monitoring of iodine nutritional status in Sweden.European Journal of Clinical Nutrition advance online publication, 10 September 2008; doi:10.1038/ejcn.2008.46.
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| 4. |
- Milakovic, Mille, 1967, et al.
(författare)
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Determination of intrathyroidal iodine by X-ray fluorescence analysis in 60- to 65-year olds living in an iodine-sufficient area.
- 2006
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Ingår i: Journal of internal medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 260:1, s. 69-75
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: X-ray fluorescence (XRF) is a non-invasive method for determining the iodine content of the thyroid gland in vivo. In spite of the obvious clinical value of such a method in situations of iodine deficiency or iodine overload, the method has not so far been widely used. The objective was to investigate the applicability of the XRF method in a larger number of subjects. DESIGN AND SUBJECTS: The study comprised 37 individuals, aged 60-65 years, who had spent their entire life with iodine supplementation through iodinated table salt. Individuals with (previous) thyroid disease were excluded. The individual thyroid function had previously been evaluated by measurements of thyroid-related hormones, thyroid volume and 131-Iodine (131I) uptake which indicated a sufficient iodine intake of the population in the area. Iodine in the right thyroid lobe in each subject was examined using XRF. RESULTS: The mean thyroid iodine concentration was 0.4 mg mL(-1), corresponding to a mean total iodine content of 5.2 mg (range 0.9-20.2). There was a pronounced difference between individuals. No correlation was found between iodine concentration and 131I uptake or thyroid volume. Neither was iodine content and 131I uptake correlated. CONCLUSIONS: In a population living under iodine-sufficient conditions, a large variation of iodine stored in the thyroid is compatible with euthyroidism. Determination of the iodine pool by XRF investigation is feasible in a clinical setting and the method offers a unique possibility to study the intrathyroidal iodine pool in subjects with thyroid disease. The low radiation dose enables the use of the method in pregnant women and also in young individuals.
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| 5. |
- Milakovic, Mille, 1967, et al.
(författare)
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Effect of lifelong iodine supplementation on thyroid 131-I uptake: a decrease in uptake in euthyroid but not hyperthyroid individuals compared to observations 50 years ago.
- 2006
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Ingår i: European journal of clinical nutrition. - : Springer Science and Business Media LLC. - 0954-3007 .- 1476-5640. ; 60:2, s. 210-3
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In Sweden, iodine has been added to table salt (10 mg/kg) since 1936; this amount was increased in 1966 to 50 mg/kg. OBJECTIVE: To investigate a euthyroid Swedish population (n = 44, 60-65 years) with its entire lifespan with iodine supplementation as for 24-h 131-I uptake (24 h IU) and thyroid nodularity (thyroid scintigraphy). To compare the euthyroid 24 h IU with uptake of thyrotoxic individuals, and with observations from 1955. METHODS: The 24 h IU was used in euthyroid individuals after oral administration of 0.1 MBq/2.7 microCi radioiodine and imaging of the thyroid gland was carried out using 99mTc-pertechnetate. RESULTS: In 1999-2000, the mean 24 h IU in the euthyroid individuals was 21% (range 11-33%) and the normal (central 95%) reference interval was 14-30%. Scintigraphy suggested multinodular goitre in three euthyroid individuals. In Graves' patients (n = 53, 50-65 years), the mean 24 h IU was 61% (range 29-89%). In 1955, the 24 h IU in euthyroid individuals was higher (38%, range 10-70%), while hyperthyroid patients had uptake values similar to those recorded in the present investigation (mean 62%, range 40-90%). CONCLUSIONS: The population sample studied had to be small for ethical reasons. We conclude that the reference interval for 24 h IU is 14-30% in this population that had spent its entire lifespan with iodine supplementation. This is lower than that recorded in a Swedish euthyroid population half a century ago having had low-grade table-salt iodine supplementation for 20 years. Values for hyperthyroid patients, however, do not appear to have been affected likewise.
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| 6. |
- Milakovic, Mille, 1967
(författare)
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Iodine status and iodine pool an a small community in western Sweden
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Iodine is essential in the synthesis of the vital hormones of the thyroid gland. On a worldwide basis, iodine deficiency is the global most important cause of thyroid disease. The most common disorder is development of goitre, but most important is the brain damage in children caused by low thyroid hormone levels during preg-nancy in women with pronounced iodine deficiency, where cretinism is the most severe form. Iodine defi-ciency used to occur in Sweden, but following the introduction of a national programme of iodine supplemen-tation in 1936 with 10 mg/kg of table salt and an increase in the level to 50 mg/kg in 1966, Sweden is regarded as iodine replete. However, no monitoring programme is currently in progress and the actual iodine status of the population is therefore unknown. The aim of this thesis was to evaluate the effect of iodine supplementa-tion in a small community in western Sweden. Methods: Three age groups, each comprising 60 individuals were chosen, Group 1: 7-9 years, Group 2: 15-17 years and Group 3: 60-65 years old. Thyroid volume by ultrasonography and urinary iodine were measured in all groups. In the young people and adults, blood samples were collected for analyses of TSH, total and free T4, total and free T3 and TPOAb. In the elderly group, a radionuclear investigation was also performed com-prising scintigraphy and 24h 131-I uptake. The iodine contnet of the thyroid gland was determined by X-ray fluorescence (XRF). The 24h 131-I uptake was compared with that of a consecutively measured group of patients with Graves¡¦ disease patients referred for treatment and with data retrieved from 1955. Results: The median for urinary iodine concentration in the three age groups was 194 ƒÝg/L (Group 1), 246 ƒÝg/L (Group 2) and 190 ƒÝg/L (Group 3), indicating an adequate iodine intake well above the WHO definition of iodine deficiency, < 100 ƒÝg/L. The median thyroid volumes were 4.7 mL (Group 1), 11.5 mL (Group 2) and 14.3 mL (Group 3), which are within established reference volumes. The mean 24h 131-I uptake for the euthy-roid individuals was 21%, while it was 61% for the Graves¡¦ patients. In 1955, the uptake was higher, 38% and with a wider range, in the euthyroid subjects, whereas, in the hyperthyroid patients, it was similar, 62%, to recent recorded values. The X-ray fluorescence (XRF) analyses revealed a mean thyroid iodine concentration of 0.6 mg/mL and a mean total iodine content of 8.6 mg, which is in accordance with other internationally, published data. There was a pronounced variation in the thyroid iodine content between individuals. Four teenagers (7%) had an elevated TPOAb concentration, three of the subjects being girls (8%). 29% of the adult women had elevated TPOAb. Conclusion: Urinary iodine concentration and thyroid volumes were within the recommended reference values in WHO guidelines. The 24h 131-I uptake values confirm that the iodine intake in this community is sufficient. No correlation was found between intrathyroidal iodine, iodine uptake and urinary iodine, also indicating iodine sufficiency. We conclude, that the inhabitants of the community studied, has a sufficient iodine intake. There is a need of a more extensive nation-wide evaluation of iodine status.
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| 7. |
- Milakovic, Mille, 1967, et al.
(författare)
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Screening for thyroid disease of 15-17-year-old schoolchildren in an area with normal iodine intake.
- 2001
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Ingår i: Journal of internal medicine. - 0954-6820. ; 250:3, s. 208-12
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The prevalence of thyroid disease in Swedish schoolchildren is today insufficiently known. The aim of the study was therefore to determine the prevalence of abnormal thyroid function and thyroid autoimmunity in teen-age schoolchildren and to compare the findings with a healthy control group of 60-65-year-old inhabitants from the same community. SETTING: A semirural community of approximately 15,000 inhabitants. DESIGN: Cross-sectional study. MAIN OUTCOME MEASURES: Thyroid volume and serum concentrations of serum thyrotropin (TSH), total and free thyroxine (T4), total and free 3,5,3'-triiodothyronine (T3), and antithyroperoxidase antibodies (TPOAb). RESULTS: Four schoolchildren (7%, 59 screened) had elevated TPOAb concentration, three of the subjects being girls (8%). One girl with a goitre was overtly hypothyroid and one girl showed borderline-high serum TSH concentration suggesting subclinical autoimmune thyroid disease. One euthyroid boy had a goitre and high concentration of TPOAb. The serum free T3 concentration was significantly higher in 15-17-year-old than 60-65-year-old (7.4 vs. 6.4 pmol L(-1), P < 0.001). The concentrations of other thyroid hormones and of TSH in 15-17-year-old did not differ from those of the 60-65-year-old. CONCLUSIONS: We found three cases of thyroid disease in need of immediate attention or later follow-up. The prevalence of autoimmune thyroid disease was high as indicated from TPOAb measurements. Thyroid tests including TPOAb measurement should be performed on wide indications when teenagers seek medical advice. The reference intervals for teen-age children for commonly used first line tests (TSH and free T4) do not differ from those for adults.
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| 8. |
- Milakovic, Mille, 1967, et al.
(författare)
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[Ultrasonic measurement of residual urine is considerate and reliable]. : Skonsamt och säkert att mäta residualurin med ultraljud.
- 1999
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Ingår i: Lakartidningen. - 0023-7205. ; 96:1-2, s. 47-8
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Tidskriftsartikel (refereegranskat)abstract
- The measurement of residual urine is often an invaluable aid in the examination of patients with prostate enlargement. As a result of the increasing scope of pharmacological treatment options in cases of such urinary problems, more such investigations are now being performed in primary care. Traditionally, residual urine has been measured by catheterisation of the urethra, which is associated with a risk of infection and other complications. As experience of ultrasound measurement of residual urine in 30 patients at a primary health centre suggests it to be a rapid, easily tolerated method unaccompanied by complications, it would seem to be an appropriate procedure even for use in the elderly with any of a variety of chronic diseases. It was also found easy for various categories of staff to learn.
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| 9. |
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| 10. |
- Nyström, Helena Filipsson, 1966, et al.
(författare)
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Thyroid volume in Swedish school children: a national, stratified, population-based survey.
- 2010
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Ingår i: European journal of clinical nutrition. - : Springer Science and Business Media LLC. - 1476-5640 .- 0954-3007. ; 64:11, s. 1289-95
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Tidskriftsartikel (refereegranskat)abstract
- Sweden has had a salt iodination program since 1936. This first national surveillance study on iodine nutrition infers an adequate level of urinary iodine concentration (UIC 125μg/l) and the aim is now to evaluate thyroid volume (Tvol) in the same national sample.
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