Screening of 1520 children living in the Khvalynsk district of the Saratov region, including assessment of urinary excretion of iodine and ultrasonic examinations of the thyroid in children and adults, revealed endemic goiter in the region. Special attention was paid to echographic examination of the thyroid; this method was used in examinations of 161 children aged 2 to 14 with thyroid enlargement of the I-III degree. 103 (64.0%) of there children had enlarged thyroid, in some children with diffusely enlarged thyroid of the I-II degree ultrasonic examination showed no enlargement, and in some children the gland was found even reduced in size. The greatest discrepancy between the data of palpation and ultrasonography was observed in first-degree thyroid enlargement, the least so in second-degree enlargement; in third-degree enlargement there was no such a discrepancy. Assessment of thyroid structure revealed various disorders of the organ in 29 of the 161 examined children, these disorders present both in enlarged glands and in those of normal or reduced size. Nodes that could not be palpated were detected in 2 children. Ultrasonic examinations of 56 adults aged 20 to 60 revealed changed structure of the thyroid in 35, with nodes of various sizes and localization detected in 15 of these.
After the first examinations made in 1960-1972 the endemic area of the Saratov region was re-examined in order to study over time the children's health status, to estimate the tension of goiter endemic and the biogeochemical characteristics of the area. Relative iodine deficiency and unbalance of trace elements in the environment were ascertained. Considerable prevalence of thyroid hyperplasia, stages I-II, II (50.7%) was established among the child population with practically equal distributions among girls (5376%) and boys (46.4%). During the 20-year period, the number of children with the enlarged thyroid was found to be 1.5-fold as increased. According to the data on the hormonal profile, 23.3% of the children manifested the dissociation of the content of T3 and T4 in the blood serum, whereas 88% of the children had a high level of TSH. In addition to the thyroid pathology, carious disease, chronic diseases of the nasopharynx, anemias and posture impairment occurred most often. Only 10.7% of the children can be regarded as practically healthy. The significance of the familial and hereditary preparedness for the onset of endemic goiter has been confirmed.
A total of 1649 children aged 0 to 16 years were examined in the Khvalynsk district of the Saratov region endemic for goiter. Age-specific features of prevalence of goiter and chronic somatic diseases were studied. Goiter was found to form starting from the first years of life, with its morbidity peaks observed at the age of 3, 5, 7, and 12. Disease incidence in children with endemic goiter was found to be higher than in those without thyroid abnormalities.