The role of iodine deficiency and anthropogenic factors in the epidemiology and pathogenesis of goiter in children

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Abstract

The objective of this review is to identify the pathogenetic features and epidemiological patterns of thyroid goiter development in children exposed to iodine deficiency and anthropogenic pollutants in the regions of the Russian Federation.

A systematic analysis of the scientific literature (2015–2024) from the PubMed/MEDLINE, ScienceDirect, eLIBRARY.ru, and CyberLeninka databases was conducted, focusing on original research and clinical guidelines. The coverage time range was 2015–2024. A manual search was also performed in specialized journals, including ("Problemy Endokrinologii" [Problems of Endocrinology], "European Journal of Endocrinology").

Endemic goiter is the leading thyroid pathology among children in the Russian Federation, accounting for 44.5 % of all cases. This is caused by mild to moderate iodine deficiency, which is endemic in approximately 30 regions of the country (Dagestan, Tatarstan, Altai Krai, etc.). The prevalence varies significantly within regions, for example, in Dagestan, it reaches 54.2 % in mountainous areas compared to 19.0 % on the plains, indicating the influence of factors beyond iodine status alone. The incidence peak was observed in adolescents aged 15–17 years (3658.5 per 100,000), with a marked 4:1 female-to-male predominance. In industrial regions such as Chelyabinsk Oblast, one of three thyroid nodules in children shows signs of malignancy. A synergy was identified between iodine deficiency and anthropogenic pollutants (heavy metals, nitrates, uranium and polymetallic ore waste, PM2.5, perchlorates, dietary goitrogens), which block iodine uptake and disrupt hormone synthesis.

Thus, thyroid goiter in children is a multifactorial condition. There is a need to develop regionally adapted prevention programs and improve diagnostic algorithms, considering the combined effects of iodine deficiency and anthropogenic pollutants.

About the authors

B. T. Malikova

Dagestan State Medical University

Author for correspondence.
Email: bela.malikova@mail.ru
ORCID iD: 0009-0001-6007-8948

Assistant of the Department of Endocrinology

Russian Federation, Makhachkala

E. M. Soltakhanov

Dagestan State Medical University

Email: bela.malikova@mail.ru
ORCID iD: 0000-0003-2291-3751

PhD (Medicine), Associate Professor of the Department of Endocrinology

Russian Federation, Makhachkala

A. V. Krivtsov

Ye. A. Vagner Perm State Medical University

Email: a.krivtsov@profklinika.ru

PhD (Medicine), Associate Professor of the Department of Normal Physiology

Russian Federation, Perm

A. T. Tuchalova

Dagestan State Medical University

Email: bela.malikova@mail.ru
ORCID iD: 0000-0002-9803-5687

PhD (Medicine), Associate Professor of the Department of Endocrinology

Russian Federation, Makhachkala

E. M. Nogovitsina

Ye. A. Vagner Perm State Medical University

Email: bela.malikova@mail.ru
ORCID iD: 0000-0002-8029-7662

PhD (Biology), Associate Professor of the Department of Normal Physiology

Russian Federation, Perm

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