{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T05:22:58Z","timestamp":1788326578773,"version":"build-2803163510"},"reference-count":39,"publisher":"Bioscientifica","issue":"6","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"vor","delay-in-days":1670,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Objectives: The reference values for thyroid volume (Tvol) determined by ultrasound require supportive data of normal Tvol from local iodine-sufficient populations. This study aimed to explore new reference values for Tvol in Chinese adults and comprehensively evaluate the factors associated with enlarged Tvol. Methods: A cross-sectional study was conducted in Tianjin, China. Tvol was measured by ultrasound in adults with long-term iodine sufficiency. Blood and urine samples were collected to evaluate biochemical indexes, thyroid function, and iodine status. Results: A total of 1,991 adults from the urban and suburban areas were analysed. The trend of Tvol increasing with age was observed in men under age 40 years and in women under age 52 years. In the quantile regression analyses, we found that body surface area (BSA) (\u03b2 = 7.22, 95% CI: 5.33, 9.12), thyroid-stimulating hormone (TSH) (\u03b2 = \u22121.48, 95% CI: \u22122.39, \u22120.57), thyroid nodules (TNs) (\u03b2 = 6.70, 95% CI: 2.19, 11.22), and metabolic syndrome (MetS) (\u03b2 = 1.40, 95% CI: 0.63, 2.17) had a strong effect on Tvol at higher percentiles in males. The dominant factors influencing Tvol were BSA (\u03b2 = 9.64, 95% CI: 2.66, 16.61), TSH (\u03b2 = \u22120.78, 95% CI: \u22121.16, \u22120.39), and TNs (\u03b2 = 1.11, 95% CI: 0.43, 1.79) in females. The largest reference values for Tvol based on BSA were 20.18 (17.79, 24.32) mL in males and 15.31 (14.05, 16.70) mL in females. Conclusions: Quantile regression analyses showed that a high BSA index, a decreased TSH level, and the prevalence of TNs were essential factors associated with the enlargement of the thyroid gland. Our findings reported the new reference values for Tvol determined by ultrasound based on gender and BSA in Chinese adults.<\/jats:p>","DOI":"10.1159\/000513494","type":"journal-article","created":{"date-parts":[[2021,7,22]],"date-time":"2021-07-22T17:01:05Z","timestamp":1626973265000},"page":"447-454","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-17","source":"Crossref","is-referenced-by-count":20,"title":["New Reference Values for Thyroid Volume and a Comprehensive Assessment for Influencing Factors in Chinese Adults with Iodine Sufficiency"],"prefix":"10.1530","volume":"10","author":[{"given":"Wenxing","family":"Guo","sequence":"first","affiliation":[{"name":"1The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Long","family":"Tan","sequence":"additional","affiliation":[{"name":"1The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuyao","family":"Dong","sequence":"additional","affiliation":[{"name":"1The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya","family":"Jin","sequence":"additional","affiliation":[{"name":"1The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei","family":"Zhu","sequence":"additional","affiliation":[{"name":"2The Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyan","family":"Wei","sequence":"additional","affiliation":[{"name":"2The Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanting","family":"Chen","sequence":"additional","affiliation":[{"name":"1The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lili","family":"Fan","sequence":"additional","affiliation":[{"name":"1The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cong","family":"Du","sequence":"additional","affiliation":[{"name":"1The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanqi","family":"Zhang","sequence":"additional","affiliation":[{"name":"1The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China"},{"name":"2The Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China"},{"name":"3Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China"},{"name":"4Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","published-online":{"date-parts":[[2021,7,22]]},"reference":[{"key":"2026070711531014200_ref1"},{"issue":"4","key":"2026070711531014200_ref2","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1046\/j.1365-2265.2000.01121.x","article-title":"Goitre prevalence and thyroid abnormalities at ultrasonography: a comparative epidemiological study in two regions with slightly different iodine status","volume":"53","author":"Knudsen","year":"2000","journal-title":"Clin Endocrinol"},{"issue":"10","key":"2026070711531014200_ref3","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1111\/j.1753-4887.2012.00528.x","article-title":"Assessment of iodine nutrition in populations: past, present, and future","volume":"70","author":"Zimmermann","year":"2012","journal-title":"Nutr Rev"},{"key":"2026070711531014200_ref4"},{"key":"2026070711531014200_ref5","volume-title":"Requirements for goiter surveys and the determination of thyroid size, in iodine deficiency in Europe","author":"Gutekunst","year":"1993"},{"issue":"8","key":"2026070711531014200_ref6","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1089\/thy.2015.0613","article-title":"Iodine status and prevalence of thyroid disorders after introduction of mandatory universal salt iodization for 16 years in china: a Cross-Sectional Study in 10 cities","volume":"26","author":"Shan","year":"2016","journal-title":"Thyroid"},{"issue":"4","key":"2026070711531014200_ref7","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1210\/jc.2006-2580","article-title":"Effect of a mandatory iodization program on thyroid gland volume based on individuals' age, gender, and preceding severity of dietary iodine deficiency: a prospective, population-based study","volume":"92","author":"Vejbjerg","year":"2007","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"2026070711531014200_ref8","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1089\/thy.2018.0412","article-title":"Shift of reference values for thyroid volume by ultrasound in 8- to 13-year-olds with sufficient iodine intake in China","volume":"29","author":"Chen","year":"2019","journal-title":"Thyroid"},{"issue":"3\u20134","key":"2026070711531014200_ref9","doi-asserted-by":"crossref","first-page":"141","DOI":"10.2298\/SARH1504141S","article-title":"Regional reference values of thyroid gland volume in Turkish Adults","volume":"143","author":"Sahin","year":"2015","journal-title":"Srp Arh Celok Lek"},{"issue":"2","key":"2026070711531014200_ref10","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1093\/ajcn\/79.2.231","article-title":"New reference values for thyroid volume by ultrasound in iodine-sufficient schoolchildren: a World Health Organization\/Nutrition for Health and Development Iodine Deficiency Study Group Report","volume":"79","author":"Zimmermann","year":"2004","journal-title":"Am J Clin Nutr"},{"key":"2026070711531014200_ref11","first-page":"55","article-title":"Normal values of thyroid gland in Isfahan, an iodine replete area","volume":"13","author":"Adibi","year":"2008","journal-title":"J Res Med Sci"},{"issue":"1","key":"2026070711531014200_ref12","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1530\/eje.0.1460039","article-title":"Parity is associated with increased thyroid volume solely among smokers in an area with moderate to mild iodine deficiency","volume":"146","author":"Knudsen","year":"2002","journal-title":"Eur J Endocrinol"},{"issue":"6","key":"2026070711531014200_ref13","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1007\/s10654-008-9255-1","article-title":"The impact of smoking on thyroid volume and function in relation to a shift towards iodine sufficiency","volume":"23","author":"Vejbjerg","year":"2008","journal-title":"Eur J Epidemiol"},{"key":"2026070711531014200_ref14","doi-asserted-by":"crossref","first-page":"8079704","DOI":"10.1155\/2016\/8079704","article-title":"Larger thyroid volume and adequate iodine nutrition in Chinese School children: local normative reference values compared with WHO\/IGN","volume":"2016","author":"Mo","year":"2016","journal-title":"Int J Endocrinol"},{"issue":"2","key":"2026070711531014200_ref15","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1007\/s11906-018-0812-z","article-title":"The global epidemic of the metabolic syndrome","volume":"20","author":"Saklayen","year":"2018","journal-title":"Curr Hypertens Rep"},{"issue":"4","key":"2026070711531014200_ref16","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1089\/thy.2007.0223","article-title":"Introducing the thyroid gland as another victim of the insulin resistance syndrome","volume":"18","author":"Rezzonico","year":"2008","journal-title":"Thyroid"},{"issue":"9491","key":"2026070711531014200_ref17","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1016\/S0140-6736(05)67402-8","article-title":"The metabolic syndrome: a new worldwide definition","volume":"366","author":"Alberti","year":"2005","journal-title":"Lancet"},{"key":"2026070711531014200_ref18","doi-asserted-by":"crossref","DOI":"10.1017\/CBO9780511754098","volume-title":"Quantile regression","author":"Koenker","year":"2005"},{"issue":"1","key":"2026070711531014200_ref19","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.jmva.2004.05.006","article-title":"Quantile regression for longitudinal data","volume":"91","author":"Koenker","year":"2004","journal-title":"J Multivar Anal"},{"issue":"4","key":"2026070711531014200_ref20","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1111\/1467-9876.00084","article-title":"Quantile regression methods for longitudinal data with drop-outs: application to CD4 Cell counts of patients infected with the human immunodeficiency virus","volume":"46","author":"Lipsitz","year":"1997","journal-title":"J R Stat Soc Ser C"},{"key":"2026070711531014200_ref21","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.nutres.2019.02.009","article-title":"Excessive iodine intake is associated with formation of thyroid nodules in pregnant Chinese women","volume":"66","author":"Gao","year":"2019","journal-title":"Nutr Res"},{"issue":"3","key":"2026070711531014200_ref22","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1046\/j.1365-2265.2000.00939.x","article-title":"Determinants of thyroid volume in healthy French adults participating in the SU.VI.MAX cohort","volume":"52","author":"Barrere","year":"2000","journal-title":"Clin Endocrinol"},{"key":"2026070711531014200_ref23","doi-asserted-by":"crossref","first-page":"36","DOI":"10.59779\/jiomnepal.503","article-title":"Study of thyroid volume by ultrasonography in clinically euthyroid patients","volume":"32","author":"Kayastha","year":"2010","journal-title":"J Inst Med"},{"issue":"2","key":"2026070711531014200_ref24","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1210\/jcem-56-2-260","article-title":"The determination of thyroid volume by ultrasound and its relationship to body weight, age, and sex in normal subjects","volume":"56","author":"Hegedus","year":"1983","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"2026070711531014200_ref25","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1111\/j.1365-2265.1987.tb00784.x","article-title":"Determinants of thyroid volume as measured by ultrasonography in healthy adults in a non-iodine deficient area","volume":"26","author":"Berghout","year":"1987","journal-title":"Clin Endocrinol"},{"issue":"5","key":"2026070711531014200_ref26","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1111\/j.1365-2265.2000.01138.x","article-title":"Determinants of thyroid volume as measured by ultrasonography in healthy adults randomly selected","volume":"53","author":"Gomez","year":"2000","journal-title":"Clin Endocrinol"},{"issue":"11","key":"2026070711531014200_ref27","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1038\/ejcn.2013.173","article-title":"Factors influencing thyroid volume in Chinese children","volume":"67","author":"Zou","year":"2013","journal-title":"Eur J Clin Nutr"},{"issue":"7","key":"2026070711531014200_ref28","first-page":"508","article-title":"Serum thyroglobulin-A sensitive biomarker of iodine nutrition status and affected by thyroid abnormalities and disease in adult populations","volume":"30","author":"Du","year":"2017","journal-title":"Biomed Environ Sci"},{"issue":"6","key":"2026070711531014200_ref29","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1530\/EJE-08-0386","article-title":"Smoking as a risk factor for thyroid volume progression and incident goiter in a region with improved iodine supply","volume":"159","author":"Ittermann","year":"2008","journal-title":"Eur J Endocrinol"},{"issue":"10","key":"2026070711531014200_ref30","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1089\/105072502761016502","article-title":"Risk factors for goiter and thyroid nodules","volume":"12","author":"Knudsen","year":"2002","journal-title":"Thyroid"},{"issue":"2","key":"2026070711531014200_ref31","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1007\/s12020-019-01901-4","article-title":"Relationship between metabolic syndrome and thyroid nodules and thyroid volume in an adult population","volume":"65","author":"Guo","year":"2019","journal-title":"Endocrine"},{"issue":"5","key":"2026070711531014200_ref32","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1089\/met.2014.0158","article-title":"Association between worse metabolic control and increased thyroid volume and nodular disease in elderly adults with metabolic syndrome","volume":"13","author":"Blanc","year":"2015","journal-title":"Metab Syndr Relat Disord"},{"issue":"12","key":"2026070711531014200_ref33","doi-asserted-by":"crossref","first-page":"4534","DOI":"10.1210\/jcem.85.12.7002","article-title":"Parity as a thyroid size-determining factor in areas with moderate iodine deficiency","volume":"85","author":"Rotondi","year":"2000","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"2026070711531014200_ref34","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1385\/BTER:113:3:223","article-title":"Gender-specific determinants of goiter","volume":"113","author":"Farahati","year":"2006","journal-title":"Biol Trace Elem Res"},{"issue":"9","key":"2026070711531014200_ref35","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1055\/s-2004-825901","article-title":"Reference values of thyroid volume in a healthy, non-iodine-deficient Spanish population","volume":"36","author":"Maravall","year":"2004","journal-title":"Horm Metab Res"},{"key":"2026070711531014200_ref36","doi-asserted-by":"crossref","first-page":"31969","DOI":"10.3402\/fnr.v60.31969","article-title":"Iodine status in the Nordic countries: past and present","volume":"60","author":"Nystr\u00f6m","year":"2016","journal-title":"Food Nutr Res"},{"issue":"1","key":"2026070711531014200_ref37","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1017\/S0007114507886387","article-title":"Iodine intake before and after mandatory iodization in Denmark: results from the Danish Investigation of Iodine Intake and Thyroid Diseases (DanThyr) study","volume":"100","author":"Rasmussen","year":"2008","journal-title":"Br J Nutr"},{"key":"2026070711531014200_ref38","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1186\/1471-2458-13-1153","article-title":"Thyroid volume, goiter prevalence, and selenium levels in an iodine-sufficient area: a cross-sectional study","volume":"13","author":"Liu","year":"2013","journal-title":"BMC Public Health"},{"issue":"2","key":"2026070711531014200_ref39","doi-asserted-by":"crossref","first-page":"98","DOI":"10.4274\/jcrpe.1818","article-title":"Normative data of thyroid volume-ultrasonographic evaluation of 422 subjects aged 0-55 years","volume":"7","author":"Ayd\u0131ner","year":"2015","journal-title":"J Clin Res Pediatr Endocrinol"}],"container-title":["European Thyroid Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/513494","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.bioscientifica.com\/etj\/article-pdf\/10\/6\/447\/22021\/etj513494.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/journals.bioscientifica.com\/etj\/article-pdf\/10\/6\/447\/22021\/etj513494.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T16:28:25Z","timestamp":1783441705000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.bioscientifica.com\/etj\/article\/10\/6\/447\/2779\/New-Reference-Values-for-Thyroid-Volume-and-a"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,22]]},"references-count":39,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,11,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000513494","relation":{},"ISSN":["2235-0802","2235-0640"],"issn-type":[{"value":"2235-0802","type":"electronic"},{"value":"2235-0640","type":"print"}],"subject":[],"published":{"date-parts":[[2021,7,22]]}}}