J. Endocrinol. Invest. 17: 329-333, 1994 Endemic goiter in Calabria: Etiopathogenesis and thyroid function S. And6*, M. Maggiolini*, A. Di Carlo**, A. Diodato**, A. Bloise**, G.P. De Luca*, V. Pezzi*, D. Sisci*, A. Mariano**, and V. Macchia** *Cattedra di Fisiopatologia Endocrina, Dipartimento di Biologia Cellulare, Universita della Calabria, Rende, Cosenza and **Cattedra di Patologia Clinica, Facolta di Medicina e Chirurgia, Universita Federico II, Napoli, Italy ABSTRACT. An endemic gaiter study was carried out in a vast territory of the Calabria region, includ- ing the provinces of Catanzaro and Cosenza. About 50% of 7231 school-children, aged between 6 and 12 years, examined in 34 villages, presented a thy- roid enlargement. The high prevalence of goiter seems to be related to a moderate iodine deficien- cy intake indicated by a mild urinary iodine excre- tion (lower than 100 fl9/9 creatinine). In a few vil- INTRODUCTION The incidence of endemic goiter has been greatly reduced in many areas of the world in which a seri- ous iodine prophylaxis program was practised (1). Iodine prophylaxis has been effective in many coun- tries of Latin America including Argentina, Bolivia, Brazil, Columbia and Honduras (2-4) whereas, dur- ing the last few years, it failed in Guatemala and in Nicaragua (4) due to a non-effective constant surveillance of salt iodization and its use. In Africa and in Asia (5-6), as well as in certain areas of India and China (7), the programs are partly under way. In Europe, iodine deficiency and its consequences are still present in many countries because iodine supplementation has been adequately corrected only in a few countries. In Switzerland (8) as well as in Belgium, Denmark, Finland, Iceland, Ireland, Norway, Sweden and United Kingdom (9) iodine prophylaxis eradicated goiter and cretinism and al- so prevented deaf-mutism, short stature and mental deficiency, all aspects typical of iodine deficiency. In Italy, endemic goiter is still present in many ar- eas (10-15), since iodine prophylaxis has been achieved in a satisfactory way on a relatively high scale only in the Provincia Autonoma of Bolzano Key-words: Endemic goiter, iodine deficiency. iodine excretion, total thy- roid hormones. free thyroid hormones, thyrotropic hormone, thyroglobu- lin. Correspondence: Prof. Vincenzo Macchia. Facolta di Medicina e Chirurgia. Universita Federico II. Via Sergio Pansini 5.80131 Naples. Italy. Received July 10, 1993; accepted February 14,1994. 329 lages, in which a two year voluntary iodine prophy- laxis was carried out, an increase in the urinary io- dine excretion with a decreased goiter prevalence was observed. A slight increase in TT3, FT3 and TSH in one endemic area studied, compared to the control area, was also observed. These data sug- gest that an effective program of iodoprophylaxis is fundamental in this region as well. (Alto Adige) (9) and in few endemic areas of Tuscany (16) and Sicily (17). Regarding Southern Italy we previously described a 50% prevalence of goiter in school-children of four small Calabria vil- lages located between Catanzaro and Piccola Sila (18-19). Ten years later we returned to Calabria and studied goiter prevalence, iodine excretion and thy- roid function in a vast territory of Catanzaro and Cosenza provinces. Furthermore, in few villages of the last province the epidemiological survey was al- so conducted before and after a two year voluntary iodine prophylaxis. The results obtained are report- ed in the present paper. MATERIALS AND METHODS This study concerns two areas: the first (area A) in- cluding nineteen and the second (area B) fifteen small villages respectively located in the Catanzaro and Cosenza provinces. Two epidemiological sur- veys were also carried out: the first (first survey) in 1987-1989 on all villages of both areas and the sec- ond (second survey) in 1991-1992 after two years of voluntary iodine prophylaxis in five small villages (Laino Borgo, Laino Castello, San Basile, Saracena and Mormanno) of area B. These five villages were chosen since their drug-stores carried iodized salt and the population was advised to use it. In the first survey 4468 (2366 males and 2100 females) and 3891 (2101 males and 1790 females) school-chil- dren (aged between 6-12 yr) of area A and area B respectively were examined. In the second survey 855 (453 males and 402 females) school-children