A Pinchera

University of Maryland, Baltimore, Baltimore, Maryland, United States

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Publications (736)3094.55 Total impact

  • M Bigazzi · G Sardano · E Martino · G Vaudagna · R Ronga · A Pinchera · L Baschieri ·
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    ABSTRACT: Measurements of serum thyroxine binding globulin (TBG) by a ligand partitioning sandwich assay were performed in 173 healthy subjects between three months and 92 yr of age. Significant sex-related differences were observed in subjects aged 21 to 50 yr. In males, serum TBG declined progressively reaching a nadir in the fourth decade and then increased with advancing age. In contrast, no significant age-related variation was observed in females.
    Journal of endocrinological investigation 10/2014; 3(4):439-40. DOI:10.1007/BF03349386 · 1.45 Impact Factor
  • Claudio Marcocci · L Bartalena · E Martino · G F Fenzi · A Pinchera ·
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    ABSTRACT: A case of a 17-year-old female with Turner's syndrome and Graves' disease is reported. The karyotype analyzed in peripheral blood lymphocytes showed a 45,X0 pattern without mosaicism. The diagnosis of Graves' disease was based on the presence of diffuse goiter and appropriate laboratory data, including elevated thyroid radioiodine uptake, increased serum thyroxine and free thyroxine index, detectable thyroid-stimulating antibody and elevated thyroid microsomal antibody titer. Hyperthyroidism was first recognized when the patient was 13-year-old and treatment wih carbimazole was instituted for 18 months. Relapse of hyperthyroidism occurred 9 months after withdrawal of therapy, and a second course of antithyroid drug treatment was given for two yr. Ovarian dysgenesis has been described with a relatively high frequency in patients with Hashimoto's thyroiditis, while the association with Graves' disease has been only occasionally encountered. This finding is surprising in view of the etiopathogenetic and genetic relationships between these two thyroid autoimmune disorders. Some possible explanations are offered to clarify this problem.
    Journal of endocrinological investigation 10/2014; 3(4):429-31. DOI:10.1007/BF03349383 · 1.45 Impact Factor

  • Journal of endocrinological investigation 10/2014; 11(9):691-692. DOI:10.1007/BF03350220 · 1.45 Impact Factor

  • Journal of endocrinological investigation 10/2014; 10(5):529-530. DOI:10.1007/BF03348187 · 1.45 Impact Factor
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    ABSTRACT: The prevalence of thyroid diseases in children with Down’s syndrome (DS) is about 3%. The most frequently observed condition is autoimmune subclinical hypothyroidism (SH). Autoimmune SH must be distinguished from defects in the biological activity of the TSH molecule or from the rare inherited condition of thyroid resistance to TSH. To investigate this last aspect we studied 12 patients with DS that had moderately elevated TSH with normal free thyroid hormones without signs of autoimmunity. For the genetic analysis the genomic DNA was extracted from peripheral lymphocytes. All the exons of the TSH receptor (TSHr) and Gsa genes were sequenced. The genetic analysis of the TSHr gene revealed the presence of four polymorphic variants. In two (Pro52Thr — in one patient in the heterozygous state and in the other as a homozygous substitution). In one patient there was an allelic variant in the exon 1 (Asp36His) in the heterozygous state. In 11 patients there was a silent polymorphism in the exon 7 at nucleotide 561. All patients were homozygous for a silent polymorphism in the exon 9 at nucleotide 855. No inactivating mutations of TSHr or Gsa genes were identified in the 12 patients. In conclusion, our results seem to exclude the role of TSHr or Gsa gene mutations in the pathogenesis of the non-autoimmune SH observed in some children with DS.
    Journal of endocrinological investigation 10/2014; 26(10):997-1000. DOI:10.1007/BF03348198 · 1.45 Impact Factor
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    ABSTRACT: The calcium-sensing receptor (CaR) polymorphism A986S has been found to be associated with higher serum calcium levels in normal subjects, suggesting that this amino acid change might decrease the inhibitory activity of the mutated receptor, render the parathyroid cells more prone to proliferate, and eventually increase the risk of developing primary hyperparathyroidism (PHPT). The aim of the present study was to investigate the frequency of this and other 2 known CaR polymorphisms (R990G and Q1011 E) in patients with PHPT and their effect on its phenotype. We studied 103 Italian patients with PHPT and 148 healthy Italian subjects and we compared the results in 50 pairs matched for sex, age and geographic provenience. A fragment of exon 7 of the CaR gene, containing the 3 polymorphic loci of interest (A986S, R990G, and Q1011E), was amplified by PCR and sequenced. Serum calcium and PTH levels, BMD and other biochemical and clinical parameters were evaluated. The frequency distribution of the A9865, R990G, and Q1011 E polymorphisms in the 103 PHPT patients was 39.8%, 5.8%, and 2.0%, respectively. There was no difference in the frequency of the 3 CaR polymorphisms in the 50 matched pairs of patients and controls. We found no significant difference in several clinical and biochemical parameters between PHPT patients carrying or not the 986S allele. Finally, no relationship was observed between the 986S genotype and total and ionized serum calcium in control subjects. The A986S CaR polymorphism is the most common in Italian PHPT patients and the allotype AS does not appear to play a relevant role in the pathogenesis of PHPT and its severity. The A986S polymorphism does not correlate with serum calcium levels in normal Italian subjects.
    Journal of endocrinological investigation 07/2014; 25(7):614-9. DOI:10.1007/BF03345085 · 1.45 Impact Factor
  • Claudio Marcocci · L Bartalena · A Pinchera ·

    Journal of endocrinological investigation 07/2014; 21(7):468-71. DOI:10.1007/BF03347329 · 1.45 Impact Factor
  • F Pacini · A Pinchera · C Giani · L Grasso · F Doveri · L Baschieri ·
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    ABSTRACT: Measurements of serum thyroglobulin (hTg) were performed using a specific radioimmunoassay. Sera with detectable anti-thyroglobulin (anti-Tg) antibody titers (> or = 1:10) as assessed by passive hemagglutination were discarded. Assays were carried out under conditions in which anti-Tg titers less than 1:10 produced no interference. The assay sensitivity was 1.25 ng/ml and the mean +/- SE concentration of serum hTg in 58 control subjects was 9.5 +/- 0.9 ng/ml (range < 1.25-27 ng/ml). A slight but significant (p < 0.025) increase in the mean hTg level was observed in 12 pregnant women at delivery (25.7 +/- 5.2 ng/ml). Moderate to marked elevations of serum hTg were observed in patients with nontoxic goiter (61.4 +/- 15 ng/ml; n = 23), subacute thyroiditis (138 +/- 67 ng/ml; n = 5), toxic adenoma (129 +/- 47 ng/ml; n = 13), untreated (424 +/- 101 ng/ml; n = 35) or treated (328 +/- 222 ng/ml; n = 14) toxic diffuse goiter. 88 patients with thyroid carcinoma and 10 with nonthyroidal malignancies were studied. The mean level of serum hTg was increased in untreated differentiated thyroid carcinoma (89.5 +/- 19 ng/ml; n = 13) but not in undifferentiated (10 +/- 2.9 ng/ml; n = 6) or medullary (0.8 +/- 0.2 ng/ml; = 3) carcinoma. In treated differentiated thyroid carcinoma the mean hTg levels were normal (8.2 +/- 0.2 ng/ml) in patients (n = 24) with no evidence of either a thyroid residue or metastatic disease, moderately increased (56.6 +/- 16 ng/ml) in patients (n = 27) with residual thyroid tissue, markedly elevated in patients with lymph node metastases (199 +/- 50 ng/ml; n = 5) and extremely elevated in those with bone (4004 +/- 982 ng/ml; n = 8) or lung (2520 +/- 620 ng/ml; n = 5) metastases. There was no significant difference in serum hTg between functioning (n = 23) and nonfunctioning (n = 5) metastases as assessed by 131I whole body scan. A slight but significant (p < 0.0005) increase in the mean concentration of hTg was observed in nonthyroidal malignancies (21.7 +/- 4.5 ng/ml; n = 10). Serial measurements showed a transient increase of serum hTg after 131I therapy of differentiated thyroid carcinoma, toxic diffuse goiter or toxic adenoma, with peak values usually occurring within the first three days. A fall of serum hTg after administration of suppressive doses of thyroid hormone to patients with nontoxic goiter and a rise after discontinuation of thyroid suppressive therapy in patients with metastatic differentiated thyroid carcinoma was observed.(ABSTRACT TRUNCATED AT 400 WORDS)
    Journal of endocrinological investigation 07/2014; 3(3):283-92. DOI:10.1007/BF03348277 · 1.45 Impact Factor
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    ABSTRACT: L-asparaginase, an antineoplastic drug used in the treatment of acute lymphoblastic leukemia (ALL), has been previously shown to inhibit the hepatic synthesis of thyroxine-binding globulin (TBG). In two children treated by this drug for ALL, a dramatic decrease in serum sex hormone-binding globulin (SHBG) concentrations was also observed. Serum SHBG levels were still below normal 10 days after L-asparaginase withdrawal. To ascertain whether this reduction was due to the inhibition of SHBG synthesis, SHBG was measured by an immunoradiometric assay (IRMA) in the medium from human hepatoblastoma-derived cells, Hep G2 cells, grown in the absence or presence of graded amounts of the drug from 0.1 nM to 0.1 mM. The results showed a dose-dependent inhibition of SHBG synthesis, with a 50% reduction of SHBG in the medium, assayed by IRMA, using 250 nM L-asparaginase. Furthermore, a time-dependent inhibition was observed using a fixed concentration of the drug (50 nM) added for variable time intervals (1-4 days). These data suggest that the changes observed in vivo are likely due to the inhibitory effect exerted by the drug on SHBG synthesis. This action is not specific, but is part of a general effect at the hepatic level.
    Journal of endocrinological investigation 07/2014; 12(7):489-93. DOI:10.1007/BF03350741 · 1.45 Impact Factor
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    ABSTRACT: A new video-assisted surgical procedure for treatment of primary hyperparathyroidism combined with intraoperative quick PTH measurement was developed. This procedure was successfully used in 6 patients with a single parathyroid adenoma preoperatively localized by neck ultrasound examination.
    Journal of endocrinological investigation 07/2014; 20(7):429-30. DOI:10.1007/BF03347996 · 1.45 Impact Factor
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    ABSTRACT: When thyroid follicles are intact, some colloidal thyroglobulin (Tg) reaches the circulation by megalin-mediated transcytosis and is to various extents complexed with megalin secretory components. In contrast, in papillary thyroid cancer (PTC), serum Tg is not complexed with megalin because it is directly secreted by tumor cells. Here we attempted to use measurement of megalin secretory components to distinguish PTC patients with thyroid remnant plus metastases from those with thyroid remnant only, after thyroidectomy and before 131I ablation. Tg values in anti-Tg antibodies (TgAb)-free sera from 5 PTC patients with thyroid remnant plus metastases and 12 PTC patients with thyroid remnant only were measured following pre-adsorption with uncoupled protein A beads or with protein A beads coupled with antimegalin antibodies. The degree of Tg pre-adsorption with antimegalin antibodies was minimal, with no substantial differences between the two groups. Thus, we concluded that measurement of megalin secretory components is unlikely to be useful to identify the origin of serum Tg in PTC patients after thyroidectomy.
    Journal of endocrinological investigation 07/2014; 27(7):636-42. DOI:10.1007/BF03347495 · 1.45 Impact Factor
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    ABSTRACT: A continuously cultured line of normal rat thyroid (FRTL) cells can be stimulated by immunoglobulin preparations from patients with Graves' disease as measured by increases in intracellular cAMP levels. Responsiveness is concentration-dependent but is delayed in time relative to thyrotropin. Additionally, the cells respond to Graves' immunoglobulins which have no long-acting thyroid stimulator (LATS) activity and are negative when adenylate cyclase stimulation in human thyroid membrane preparations is assayed. No correlation exists between the stimulation activity and the ability of a Graves' immunoglobulin preparation to inhibit thyrotropin binding; cells are responsive even in the presence of such inhibitor activity.
    Journal of endocrinological investigation 05/2014; 5(3):179-82. DOI:10.1007/BF03349476 · 1.45 Impact Factor
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    ABSTRACT: Objective: Sulfate conjugation of thyroid hormones is an alternate metabolic pathway that facilitates the biliary and urinary excretion of iodothyronines and enhances their deiodination rate, leading to the generation of inactive metabolites. A de-sulfating pathway reverses this process and thyromimetic effects have been observed following the parenteral administration of 3,5,3'-triiodothyronine sulfate (T3S) in rats. The present study investigated whether T3S is absorbed after oral administration in humans and if it represents a source of 3,5,3'-triiodothyronine (T3).Methods: Twenty-eight hypothyroid patients (7 men and 21 women, mean age ± SD = 44 ± 11 years) who had a thyroidectomy for thyroid carcinoma were enrolled. Replacement thyroid hormone therapy was withdrawn (42 days for thyroxine, 14 days for T3) prior to radioiodine remnant ablation. A single oral dose of 20, 40, 80 (4 patients/group) or 160 μg (16 patients/group) T3S was administered 3 days before the planned administration of 131I. Blood samples for serum T3S and total T3 (TT3) concentrations were obtained at various times up to 48 hours after T3S administration.Results: At all T3S doses, serum T3S concentrations increased reaching a peak at 2-4 hours and progressively returned to basal levels within 8 to 24 h. The T3S Cmax and area under the curve (AUC0-48h) were directly and significantly related to the administered dose.An increase in serum TT3 concentration levels was observed, significant after 1 hour, further increased at 2 and 4 hours, and then remained steady up to 48 hours after T3S administration. There was a significant direct correlation between the TT3 AUC0-48h and the administered dose of T3S. No changes in serum free thyroxine (FT4) concentrations during the entire study period were observed, while serum TSH levels increased slightly at 48 hours not related to the dose of administered T3S. No adverse events were reported.Conclusions: 1) T3S is absorbed following oral administration in hypothyroid humans; 2) the oral administration of a single dose of T3S is converted to T3 in a dose-dependent manner and results in steady state serum T3 concentrations for 48 hours; 3) T3S may represent a new agent in combination with thyroxine (T4) in the therapy of hypothyroidism, if similar conversion of T3S to T3 can be demonstrated in euthyroid patients who are already taking T4.
    Endocrine Practice 02/2014; 20(7):1-25. DOI:10.4158/EP13331.OR · 2.81 Impact Factor
  • C Marcocci · L Chiovato · S Mariotti · A Pinchera ·
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    ABSTRACT: The changes occurring in the levels of circulating thyroid microsomal antibody (M-Ab) and antithyroglobulin antibody (Tg-Ab) during antithyroid drug therapy were studied in 32 patients receiving methimazole for Graves' disease. M-Ab was determined by competitive binding radioassay and Tg-Ab by a sandwich radiometric method. Before treatment 25 subjects (78.1%) had abnormally elevated (greater than or equal to 75 U/ml) M-Ab levels. A more than 30% reduction of M-Ab concentration with respect to the pretreatment value was found in 16 (64.0%) of these patients within the first 3-5 months of therapy, in 23 (92.0%) within 8-11 months and in 21 (84.0%) at the end of treatment (16-18 months). No change was found in the 7 patients with initial M-Ab levels less than 75 U/ml. The reduction of M-Ab was more pronounced in the patients with good control of thyrotoxicosis than in those who were still hyperthyroid or were rendered hypothyroid during treatment. Twenty-three patients were followed after completion of the course of methimazole therapy, and 13 of them showed relapse of hyperthyroidism. A significant rise of M-Ab with respect to the values observed at the end of treatment occurred in all relapsing patients who had abnormally elevated M-Ab levels before therapy. With one exception, no M-Ab increase was found in the 10 nonrelapsing patients. However, no difference between relapsing and nonrelapsing patients was observed when the M-Ab changes occurring during treatment were considered. A similar trend during and after withdrawal of therapy was noted for Tg-Ab but, because of the relatively small percentage of positive subjects (25%), the results were less conclusive. The present data indicate that methimazole treatment induces a fall of thyroid antibodies in patients with Graves' disease, and that relapse of hyperthyroidism is associated with an increase of these antibodies. However, the antibody changes occurring during treatment showed no prognostic value in predicting the outcome of therapy.
    Journal of endocrinological investigation 01/2014; 5(1):13-9. DOI:10.1007/BF03350476 · 1.45 Impact Factor
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    ABSTRACT: Background: Enhanced reduction of multinodular goiter (MNG) can be achieved by stimulation with recombinant human thyrotropin (rhTSH) before radioiodine ((131)I) therapy. The objective was to compare the long-term efficacy and safety of two low doses of modified release rhTSH (MRrhTSH) in combination with (131)I therapy. Methods: In this phase II, single-blinded, placebo-controlled study, 95 patients (57.2 ± 9.6 years old, 85% women, 83% Caucasians) with MNG (median size 96.0 mL; range 31.9-242.2 mL) were randomized to receive placebo (n=32), 0.01 mg MRrhTSH (n=30), or 0.03 mg MRrhTSH (n=33) 24 hours before a calculated (131)I activity. Thyroid volume (TV) and smallest cross-sectional area of trachea (SCAT) were measured (by computed tomography scan) at baseline, six months, and 36 months. Thyroid function and quality of life (QoL) was evaluated at three-month and yearly intervals respectively. Results: At six months, TV reduction was enhanced in the 0.03 mg MRrhTSH group (32.9% vs. 23.1% in the placebo group; p=0.03) but not in the 0.01 mg MRrhTSH group. At 36 months, the mean percent TV reduction from baseline was 44 ± 12.7% (SD) in the placebo group, 41 ± 21.0% in the 0.01 mg MRrhTSH group, and 53 ± 18.6% in the 0.03 mg MRrhTSH group, with no statistically significant differences among the groups, p=0.105. In the 0.03 mg MRrhTSH group, the subset of patients with basal (131)I uptake <20% had a 24% greater TV reduction at 36 months than the corresponding subset of patients in the placebo group (p=0.01). At 36 months, the largest relative increase in SCAT was observed in the 0.03 mg MRrhTSH group (13.4 ± 23.2%), but this was not statistically different from the increases observed in the placebo or the 0.01 mg MRrhTSH group (p=0.15). Goiter-related symptoms were reduced and QoL improved, without any enhanced benefit from using MRrhTSH. At three years, the prevalence of permanent hypothyroidism was 13%, 33%, and 45% in the placebo, 0.01 mg, and 0.03 mg MRrhTSH groups respectively. The overall safety profile of the study was favorable. Conclusions: When used as adjuvant to (131)I, enhanced MNG reduction could not be demonstrated with MRrhTSH doses ≤ 0.03 mg, indicating that the lower threshold for efficacy is around this level.
    Thyroid: official journal of the American Thyroid Association 12/2013; 24(4). DOI:10.1089/thy.2013.0370 · 4.49 Impact Factor
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    ABSTRACT: Aim: The objective of this study was to establish the status of iodine nutrition in Southern Italy. Material and methods: The survey was carried out on 11-14 yr old children attending primary school and living in urban and non urban areas of 8 regions of Southern Italy. Urinary iodine excretion (UIE) was measured in 23,103 urinary samples randomly collected. Results: Median UIE in the whole studied population was 74 μg/l [interquartile range (IR) 34-139 μg/l]. UIE was significantly higher in chief towns compared to non chief towns (81 μg/l, IR 39-145 μg/l vs 73 μg/l, IR 33-138 μg/l, p<0.0001) and in areas with >500 inhabitants per km² (median 87 μg/l, IR 43-154 μg/l) compared to areas with 100-500 per km² (median 66 μg/l, IR 29-126 μg/l, p<0.0001) and with <100 per km² (median 61 μg/l, IR 25-121 μg/l, p<0.0001). Median UIE was significantly lower in inland mountainous/hilly areas (68 μg/l, IR 30-129 μg/l) compared to coastal mountainous/hilly areas (79 μg/l, IR 37-144 μg/l, p<0.0001) and lowland (79 μg/l, IR 37-146 μg/l, p<0.0001). According to a binary logistic regression model, population density was the only independent parameter significantly associated with UIE ≥ 100 μg/l. Conclusion: The results of the present survey indicate that: 1) in Southern Italy mild to moderate iodine deficiency is still present; 2) median UIE in non urban areas is lower than in urban areas and is related to the size of the community rather than to its geographical location, being higher in a larger community. This may be due to better diversification of dietary habits and the easier availability of iodized salt and processed food through commercial facilities, more common in larger communities. Future monitoring surveys should take into account these observations.
    Journal of endocrinological investigation 05/2013; 36(5-5):282-6. DOI:10.1007/BF03347103 · 1.45 Impact Factor
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    ABSTRACT: Background: GPR7, the endogenous coupled receptor for neuropeptide B and neuropeptide W, is expressed in several regions of the Central Nervous System (CNS), which are involved in the regulation of feeding behaviour. GPR7 affects the regulation of energy balance through a mechanism independent of leptin and melanocortin pathways. Aim: Aim of this study was to investigate whether GPR7 gene mutations can be detected in human subjects and, in that event, if they are differently distributed among lean and obese subjects. Subjects and Methods: The coding region of GPR7 were sequenced in 150 obese patients and 100 normal-weight unrelated controls. Functional studies of the allelic variants were performed. Results: One genetic GPR7 variant was found (Tyr135Phe - rs33977775) in obese subjects (13,3%) and lean control (25%). Functional studies did not reveal significant differences between the wild type and the Tyr135Phe allelic variants in their NPW mediated capacity to inhibit forskolin-induced cAMP production. Conclusions: Screening of GPR7 gene mutations among lean and obese subjects revealed a Tyr135Phe allelic variant that was fairly common in the study population. As indicated by in vitro and in silico studies, this variant is unlikely to cause a functional derangement of the receptor.
    Journal of endocrinological investigation 04/2013; 36(9). DOI:10.3275/8929 · 1.45 Impact Factor
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    ABSTRACT: Background: Iodine deficiency is the result of insufficient intake of dietary iodine and as a consequence causes multiple adverse effects. About 2 billion individuals in the world are affected by iodine deficiency. It has been found that the most effective way to control iodine deficiency is through the universal salt iodization. However, salt iodization alone may not be sufficient to assure adequate iodine nutrition. In most industrialized countries, excess consumption of salt has become recognized as a health risk. Therefore, biofortification of vegetables with iodine offers an excellent opportunity to increase iodine intake. Aim and methods: The aim of this study was to test the efficiency of a new model of iodine prophylaxis in a group of 50 healthy volunteers through the intake of vegetables (potatoes, cherry tomatoes, carrots, and green salad) fortified with iodine. Each serving of vegetables consisted of 100 g of potatoes, carrots, tomatoes, or salad containing 45 mg of iodine (30% of the Recommended Daily Allowance), and the volunteers consumed a single serving of vegetables, as preferred, each day for 2 weeks. Urinary iodine (UI) excretion was measured before and after intake of vegetables. Results: The UI concentration measured in volunteers before the intake of vegetables was 98.3 mg/L (basal value), increasing to 117.5 mg/L during the intake of vegetables. Seven days after the discontinuation of vegetable intake, UI was 85 mg/L. UI concentration increment was 19.6% compared with the basal value; therefore, the difference was statistically significant (P = .035). Conclusions: Biofortification of vegetables with iodine provides a mild but significative increase in UI concentration and, together with the habitual use of iodized salt, may contribute to improve the iodine nutritional status of the population without risks of iodine excess.
    The Journal of Clinical Endocrinology and Metabolism 03/2013; 98(4). DOI:10.1210/jc.2012-3509 · 6.21 Impact Factor
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    ABSTRACT: Context: Iodine deficiency disorders are a major public health problem, and programs have been implemented to improve iodine nutrition. Objective: The objective of the study was to verify the effects of voluntary iodine prophylaxis in a small rural community (Pescopagano, Italy). Design: The design of the study was the evaluation of the prevalence of thyroid disorders 15 years after a previous survey conducted before iodine prophylaxis. Setting: The setting for this study was a general community survey. Participants: One thousand one hundred forty-eight residents were examined in 2010 and 1411 in 1995. Results: In 2010, 757 of 1148 subjects (65.9%) routinely used iodized salt, urinary iodine excretion being significantly higher than in 1955 (median 98.0 μg/L, vs 55.0 μg/L, P < .0001). The prevalence of goiter was lower in 2010 than in 1995 (25.8% vs 46.1%, P < .0001), mainly due to the reduction of diffuse goiter (10.3% vs 34.0%, P < .0001). In 2010 vs 1995, thyroid autonomy in subjects younger than 45 years old (3 of 579, 0.5% vs 25 of 1010, 2.5% P = .004) and nonautoimmune hyperthyroidism in subjects older than 45 years old (8 of 569, 1.4% vs 18 of 401, 4.5%, P = .03) were less frequent. The prevalence of hypothyroidism was higher in 2010 vs 1995 (5.0% vs 2.8%, P = .005), mainly because of an increased frequency of subclinical hypothyroidism in subjects younger than 15 years old (7 of 83, 8.4% vs 0 of 419, 0.0%, P < .0001). Accordingly, serum thyroid autoantibodies (19.5% vs 12.6%; P < .0001) and Hashimoto's thyroiditis (14.5% vs 3.5%; P < .0001) were more frequent in 2010 than in 1995. Conclusions: In the present work, the role of voluntary iodine prophylaxis was assessed in a small rural community relatively segregated, in which genetic and other environmental factors have not substantially changed between the 2 surveys. Iodine intake strongly affected the pattern of thyroid diseases, but the benefits of correcting iodine deficiency (decreased prevalence of goiter and thyroid autonomy in younger subjects and reduced frequency of nonautoimmune hyperthyroidism in older subjects) far outweighs the risk of development of thyroid autoimmunity and mild hypothyroidism in youngsters.
    The Journal of Clinical Endocrinology and Metabolism 03/2013; 98(3):1031-9. DOI:10.1210/jc.2012-2960 · 6.21 Impact Factor

Publication Stats

24k Citations
3,094.55 Total Impact Points


  • 2014
    • University of Maryland, Baltimore
      • Department of Medicine
      Baltimore, Maryland, United States
  • 1977-2014
    • Università di Pisa
      • • Department of Clinical and Experimental Medicine
      • • Department of Chemistry and Industrial Chemistry
      Pisa, Tuscany, Italy
  • 2000-2007
    • Università degli studi di Parma
      Parma, Emilia-Romagna, Italy
  • 2006
    • Azienda Ospedaliero-Universitaria Pisana
      Pisa, Tuscany, Italy
  • 2003
    • Italian National Research Council
      Roma, Latium, Italy
  • 2002
    • Università degli Studi dell'Insubria
      • Department of Clinical and Experimental Medicine
      Varese, Lombardy, Italy
  • 1987-1997
    • Università degli studi di Cagliari
      Cagliari, Sardinia, Italy
  • 1995
    • Johns Hopkins University
      • Department of Molecular Microbiology and Immunology
      Baltimore, Maryland, United States
  • 1994
    • Universidad Peruana Cayetano Heredia
      Λίμα, Lima, Peru
  • 1985-1994
    • University of Florence
      • Dipartimento di Medicina Sperimentale e Clinica
      Florens, Tuscany, Italy
    • University of Catania
      Catania, Sicily, Italy
  • 1989
    • Université Libre de Bruxelles
      Bruxelles, Brussels Capital, Belgium
  • 1988
    • University of Milan
      Milano, Lombardy, Italy
    • Sapienza University of Rome
      Roma, Latium, Italy
    • University of Massachusetts Medical School
      • Department of Medicine
      Worcester, Massachusetts, United States