Association of Salt Iodization and Urine Iodine Concentration in Schoolchildren from Public Schools in Northeast of Brazil

Abstract Background High goiter prevalence caused by iodine deficiency (medium content 5.6 mg potassium iodide [KI]/kg of salt, median urine iodine concentration [UIC] 68 μg/L) in Croatia was observed in 1991 and 1995 when salt was iodized with 10 mg KI/kg. A new regulation introduced in 1996, specified 25 mg KI/kg of salt resulting in an increase of median UIC to 248 μg/L. Afterwards, goiter prevalence was only assessed in two small studies. Methods In this study, we investigated the prevalence and etiology of goiter in 3594 schoolchildren 17 years after an increase in salt iodization in Croatia. Thyroid size was determined by palpation in 1777 girls and 1817 boys aged 10–18 years. In goitrous children, a thyroid ultrasound and thyroid-stimulating hormone, free thyroxine (fT4), free triiodothyronine (fT3), thyroid peroxidase (TPO) and thyroglobulin (TG) antibody measurements were performed. Results Goiter was found in 32 children (0.89% vs. 2.8% in 1991, p<0.00001 and 27% in 1995, p<0.00001), simple goiter (SG) in 18/32 (56%) goitrous children vs. 126/152 (82.8%) in 1991 p<0.00001, autoimmune thyroiditis (AT) in 13/32 (40.6%) vs. 19/152 (12.5%) in 1991 p<0.0009, nodules in four: two cysts, toxic adenoma and carcinoma (in 1991 two adenomas and one cyst), Graves’ disease was not found (four in 1991). Subclinical hypothyroidism was found in three children. Thyroid disease was diagnosed in four of 32 children before the investigation. Increased iodine supply decreased goiter prevalence and SG/AT ratio in goitrous patients. Conclusions As thyroid abnormalities were found in 0.89% of children and some required treatment, thyroid examination is important in apparently healthy children regardless of sufficient iodization.

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Iodine Status of Brazilian School-Age Children: A National Cross-Sectional Survey

Nutrients ◽

10.3390/nu12041077 ◽

2020 ◽

Vol 12 (4) ◽

pp. 1077 ◽

Cited By ~ 1

Author(s):

Juraci A. Cesar ◽

Iná S. Santos ◽

Robert E. Black ◽

Maria A. D. Chrestani ◽

Fabio A. Duarte ◽

...

Keyword(s):

Public Schools ◽

Rural Areas ◽

Skin Color ◽

Significant Proportion ◽

Urinary Iodine ◽

Iodine Concentration ◽

World Health ◽

School Age Children ◽

Urinary Iodine Concentration ◽

Salt Iodization

Salt iodization is the main public health policy to prevent and control iodine deficiency disorders. The National Salt Iodization Impact Assessment Survey (PNAISAL) was conducted to measure iodine concentration among Brazilian schoolchildren. A survey including 6–14-year-old schoolchildren from public and private schools from all 26 Brazilian states and the Federal District was carried out in the biennia 2008–2009 and 2013–2014. Municipalities, schools, and students were randomly selected. Students were interviewed at school using a standard questionnaire, which included the collection of demographic, educational, weight, height, and 10 mL non-fasting urine collection information. The analyses were weighted according to the population of students per federative unit. The median urinary iodine concentration (MUIC) for the entire sample by region, federative unit per school, and student characteristics, was described from the cutoff points defined by the World Health Organization (severe disability: <20 µg/L, moderate: 20–49 µg/L, mild: 50–99 µg/L, adequate: 100–199 µg/L, more than adequate: 200–299 µg/L, and excessive: >300 µg/L). In total, 18,864 students (95.9% of the total) from 818 schools in 477 municipalities from all federative units were included in this study. Almost 70% were brown skin color, nine-years-old or older, studied in urban schools, and were enrolled in elementary school. The prevalence of overweight/obesity, as measured by body mass index (BMI) for age, was about twice as high compared to nutritional deficits (17.3% versus 9.6%). The MUIC arrived at 276.7 µg/L (25th percentile = 175.5 µg/L and 75th percentile = 399.71 µg/L). In Brazil as a whole, the prevalence of mild, moderate, and severe deficit was 6.9%, 2.6%, and 0.6%, respectively. About one-fifth of the students (20.7%) had adequate iodine concentration, while 24.9% and 44.2% had more than adequate or excessive concentration, respectively. The prevalence of iodine deficits was significantly higher among younger female students from municipal public schools living in rural areas with the lowest BMI. The median urine iodine concentration showed that Brazilian students have an adequate nutritional intake, with a significant proportion of them evidencing overconsumption of this micronutrient.

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Effect of iodine-containing antiseptics on urine iodine levels of surgical staff after iodization

Turkish Journal of Biochemistry ◽

10.1515/tjb-2019-0090 ◽

2019 ◽

Vol 45 (3) ◽

pp. 277-281

Author(s):

Cemile Idiz ◽

Aysu Altun ◽

Canan Basaran-Kucukgergin ◽

Zuhal Kofoglu ◽

Ismail Cem Sormaz ◽

...

Keyword(s):

Urinary Iodine ◽

Iodine Concentration ◽

Urinary Iodine Concentration ◽

Operation Room ◽

Antiseptic Solution ◽

Salt Iodization ◽

Iodine Contamination ◽

L 62 ◽

Possible Cause ◽

Urine Iodine

AbstractBackgroundThe routine use of topical iodinated antiseptic could be a possible cause of iodine contamination. This study was aimed to determine urinary iodine status of operation-room staff who routinely use iodine-containing antiseptics for cleansing of the hands after salt iodization.Materials and methodsThe study included 40 operation-room staff who use surgical hand-scrub solutions. Participants applied an iodized brush for a minimum of three times a day on weekdays and were iodine-free on the weekends. Morning urine samples from all volunteers to analyze the urinary iodine concentration (UIC) twice a week. Modified microplate method of Sandell-Kolthoff reaction used to measure UIC.ResultsThe UICs were significantly higher on Friday (median 194 μg/L (70–396 μg/L)) compared to the Monday concentrations (median 125 μg/L (62–264 μg/L), p < 0.001). Mild iodine deficiency occurred in 32.5% of the subjects on Monday, in 5% on Friday. On Monday, there were no subjects with UIC > 300 μg/L, but on Friday, 7.5% of the subjects had UIC > 300 μg/L.ConclusionDespite both the use of iodized antiseptic solution and mandatory iodization, operation-room staff had only median iodine levels with low risk of iodine intoxication.

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Iodine Status of Taiwanese Population in 2013: 10 Years After Changing From Mandatory to Voluntary Salt Iodization

Food and Nutrition Bulletin ◽

10.1177/0379572117738883 ◽

2017 ◽

Vol 39 (1) ◽

pp. 75-85 ◽

Cited By ~ 2

Author(s):

Fan-Fen Wang ◽

Kam-Tsun Tang ◽

Wen-Harn Pan ◽

Justin Ging-Shing Won ◽

Yao-Te Hsieh ◽

...

Keyword(s):

Age Groups ◽

Urinary Iodine ◽

Iodine Concentration ◽

World Health ◽

Urinary Iodine Concentration ◽

Taiwanese Population ◽

Iodine Nutrition ◽

Iodine Status ◽

Salt Iodization ◽

Health Organization

Background: In 2003, Taiwan’s iodine policy changed from mandatory to voluntary. The Nutrition and Health Survey in Taiwan (NAHSIT) 2001-2002 for schoolchildren showed adequate iodine nutrition, while NAHSIT 2005-2008 for adults showed the iodine status was at borderline adequacy. Objective: To investigate the iodine status of the Taiwanese population from schoolchildren to adulthood 10 years after the change of the salt iodization policy. Method: Urinary iodine was measured in samples from subjects in NAHSIT 2013. Results: The median urinary iodine concentration (UIC) of the Taiwanese population aged 6 years and above in 2013 was 96 μg/L, indicating mild iodine deficiency. The median UIC of 6- to 12-year-old schoolchildren was 124 μg/L (interquartile range [IQR]: 92-213 μg/L), and 115 μg/L (IQR: 80-166 μg/L), 125 μg/L (IQR: 74-161 μg/L), 73 μg/L (IQR: 52-131 μg/L), and 78 μg/L (IQR: 52-132 μg/L) in populations aged 13 to 18 years, 19 to 44 years, 45 to 64 years, and ≥65 years, respectively. Declining iodine nutrition in age groups ≥45 years old was noted that the median UIC of populations aged 45 to 64 years and ≥65 years was 99 and 88 μg/L, respectively, in NAHSIT 2005-2008. The median UIC of schoolchildren was not lower than that during the mandatory salt fortification period, but the distribution of urinary iodine levels signified a dietary pattern change. Conclusion: Wide-ranging variation in iodine nutrition levels was observed in different age groups. Universal salt iodization, as suggested by the World Health Organization, should be the best strategy to achieve adequate iodine nutrition.

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People's Knowledge and Practice of Salt Iodization, as Well as the Assessment of Iodine Content in Salt in the Cumilla Region of Bangladesh

Journal of Advances in Medical and Pharmaceutical Sciences ◽

10.9734/jamps/2021/v23i830251 ◽

2021 ◽

pp. 12-24

Author(s):

Sadia Jahan ◽

Md. Saddam Hossain ◽

Md. Anisur Rahman Bhuiyan ◽

Susmita Roy Lisa ◽

Somaia Haque Chadni

Keyword(s):

Iodine Deficiency ◽

Rural Areas ◽

Iodine Content ◽

Iodine Concentration ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Salt Iodization ◽

Knowledge And Practice ◽

Urban And Rural Areas ◽

And Behavior

Aim: To evaluate the household iodine content and knowledge, attitude, and behavior regarding salt iodization among the residents of Cumilla, Bangladesh. Subjects and Methods: We conducted a cross-sectional survey of 700 inhabitants in Cumilla's urban and rural areas to determine the iodine concentration of salt they consume. The participants were asked about what they know about iodine deficiency and salt iodization as well as how their salt was packaged and stored. Among them, 338 people provided a sample of salt to be tested of its iodine content by the titrimetric method. Results: 46.57% of people knew that iodization was the best way to prevent iodine deficiency while 35.14% considered salt iodization during purchasing. Most people stored salt in plastic boxes (89.7%) and closed containers (84.14%).Among all participants, only 37.14% of people were aware of the iodine requirement during pregnancy. In urban regions, the median iodine content was 36.76 ppm (OR=0.658, 95% CI, 0.469-0.925), while in rural areas, the median iodine content was 40.92 ppm (OR=1.188, 95% CI, 1.022-1.380). Iodine levels were less than 15 ppm (minimum limit) in 6.8% of samples and greater than 40 ppm (maximum limit) in 56.5%. Only 36.7% of the salt samples contained adequate iodine. Conclusion: An effective and consistent approach for controlling iodine concentration in distributed salt is required at Cumilla, Bangladesh.

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Urinary Iodine Concentration in a Cohort of Adult Outpatients with Thyroid Diseases in Liguria 14 Years after the Law on Salt Iodization

Nutrients ◽

10.3390/nu12010011 ◽

2019 ◽

Vol 12 (1) ◽

pp. 11

Author(s):

Conte ◽

Comina ◽

Monti ◽

Sidoti ◽

Vannozzi ◽

...

Keyword(s):

Medical Records ◽

Urinary Iodine ◽

Thyroid Volume ◽

Iodine Concentration ◽

Thyroid Diseases ◽

Outpatient Clinics ◽

Urinary Iodine Concentration ◽

Salt Iodization ◽

Clinical Records ◽

Iodine Sufficiency

Italy is considered a mildly iodine-deficient country. The aim of this study was to evaluate the iodine status of a cohort of adults living in Liguria after the 2005 salt iodization program. We searched all medical records of patients examined in two endocrine outpatient clinics in Genoa and Savona for data on urinary iodine. Subjects were under evaluation for thyroid diseases. Information on the type of salt used was found in few clinical records. Iodized salt use was reported in 29%, 20%, and 13% of records of people living in Genoa districts, the Savona district and nearby districts, respectively. The average urinary iodine concentration was 112.9 ± 62.3 µg/L (n = 415, median 101.0 µg/L). Non-significant differences (P > 0.05) were found between subjects with (median 103.5 µg/L) and without (median 97.5 µg/L) a thyroid gland, between the periods 2009–2013 (median 105.0 µg/L) and 2014–2018 (median 97.5 µg/L), and between Genoa (median 94.0 µg/L), Savona (median 105.0 µg/L) and the other districts (median 114.5 µg/L). No correlation with age, body mass index, creatinine, free thyroxine, thyroglobulin, levo-thyroxine dosage, or thyroid volume was observed. These data suggest a borderline status of iodine sufficiency in this cohort.

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Prevalence of iodine deficiency among pregnant women in Gwembe and Sinazongwe districts of Southern Province, Zambia: a cross-sectional study

BMC Nutrition ◽

10.1186/s40795-020-00397-w ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Trevor Kaile ◽

Bornwell Sikateyo ◽

Masauso M. Phiri ◽

Charles Michelo

Keyword(s):

Pregnant Women ◽

Iodine Deficiency ◽

Iodine Concentration ◽

Cross Sectional Study ◽

Iodine Intake ◽

Health Concern ◽

Cross Sectional ◽

Southern Province ◽

Food And Nutrition ◽

Urine Iodine

Abstract Background Maternal iodine deficiency is one of the common causes of morbidity and mortality during pregnancy. Maternal iodine deficiency during pregnancy is associated with a number of adverse outcomes such as abortion, stillbirth, congenital anomalies, perinatal mortality and irreversible mental retardation. A study conducted in Zambia among pregnant women in 2013 on the prevalence of iodine deficiency showed that iodine deficiency was not a public health concern. The previous study used Urine Iodine concentration (UIC) as a marker of iodine deficiency among the pregnant women. Our study was conducted to assess the prevalence of iodine deficiency among pregnant women in Gwembe and Sinazongwe districts of Southern Province, Zambia, using urine iodine concentration and goitre presence by manual palpation. Methods We carried out a community based, cross sectional study in rural areas of Gwembe and Sinazongwe districts between April 2016 to March 2018. Data were collected from 412 pregnant women by a multistage cluster sampling technique. The presence of a goitre was examined by manual palpation and urinary iodine concentration was determined by the Ultra Violet Method using PerkinElmer Labda UV Spectrometer equipment made in Jena Germany (Model 107,745). As part of the existing baseline data, we used results of a 2013 countrywide study (n = 489) for household salt iodine content which showed a greater than 40 ppm at 76.2%, between 15 and 40 ppm at 19.21% and less than 15 ppm at 4.59%. Statistical analysis was done using Stata version 14.0. The outputs of analysis are presented as median and Interquartile range (IQR) as the urine data were not normally distributed. Further, the categorical and independent variables were presented as proportions (percentages) to describe the distribution and trends in the target sample population. Results The median Urine Iodine concentration (UIC) of the pregnant women was 150 μg/L (Interquartile Range (IQR): 100–200 μg/L). Based on the UIC, There were 49% pregnant women who had inadequate iodine intake with urine iodine concentration of less than 150 μg/L, 34.0% had UIC of 150–249 μg/L indicating adequate iodine intake, 13.0% with UIC of 250–499 μg/L indicating more than adequate iodine intake, and 5.0% with UIC of above 500 μg/L indicating excessive iodine intake. To determine whether the women had access to iodized salt, we used baseline data from 2013 Zambia national survey for iodine concentration in household salt samples as being an average of 40 ppm, which also showed that 95.41% households consumed adequately iodized salt (≥15 ppm). The prevalence of goitre in our study was very low at 0.02% among the pregnant women of all ages who participated in the study (18–49 years). Conclusion Iodine deficiency was still not a public health concern among the pregnant women of Gwembe and Sinazongwe districts of Southern Province in Zambia. Goitre prevalence has remained very low in this study area. The UIC and goitre observations were consistent with the Zambia National Food and Nutrition Commission findings in 2013 report. However, our study showed more pregnant women with insufficient than adequate iodine status indicating the risk of developing IDD is still high in this region. It also reinforces the argument that strengthening of the existing salt iodization program is needed in order to make a homogenous iodated salt available to the communities. The National Food and Nutrition Commission of Zambia needs to find innovative ways of sensitizing people about the adverse effects of IDDs and how these could be prevented. It is recommended that iodine supplementation be introduced as part of the package of Antenatal clinic care for all pregnant women.

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Larger Thyroid Volume and Adequate Iodine Nutrition in Chinese Schoolchildren: Local Normative Reference Values Compared with WHO/IGN

International Journal of Endocrinology ◽

10.1155/2016/8079704 ◽

2016 ◽

Vol 2016 ◽

pp. 1-9 ◽

Cited By ~ 4

Author(s):

Zhe Mo ◽

Xiaoming Lou ◽

Guangming Mao ◽

Zhifang Wang ◽

Wenming Zhu ◽

...

Keyword(s):

Reference Values ◽

Urinary Iodine ◽

Thyroid Volume ◽

Reference Interval ◽

Iodine Concentration ◽

Zhejiang Province ◽

Urinary Iodine Concentration ◽

Iodine Nutrition ◽

Local Reference ◽

Urine Iodine

Objective. Thyroid volume measured by ultrasound to define goiter needs reliable local thyroid volume reference from iodine-sufficient populations. The aim of this study is to explore the reference interval for normal thyroid volume in schoolchildren aged 8–10 years from Zhejiang Province, China.Methods. A probability-proportionate-to-size sampling method was applied to select a representative sample of 1213 children aged 8–10 years in Zhejiang Province to detect the thyroid volume, salt iodine, and urine iodine.Results. Median urinary iodine concentration in involved schoolchildren was 178.30 (125.00) μg l−1, with the percentage of samples less than 100 μg l−1as 12.69% and more than 300 μg l−1as 15.25%. Thyroid volume was significantly correlated with age and anthropometric measurements independently of each other. The 97th percentile of thyroid volume in our study was larger generally than the new international reference.Conclusions. The iodine nutritional status in Zhejiang Province was at an adequate level. Despite some limitations in this study, we initially established the reference values for thyroid volume in 8–10-year-old schoolchildren in Zhejiang Province, China, as a local reference to be used for monitoring iodine deficiency disorders.

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Thyroid stimulating hormone isn’t a sensitive indicator of iodine nutritional status in schoolchildren

Revista de Ciências Médicas e Biológicas ◽

10.9771/cmbio.v14i3.14990 ◽

2016 ◽

Vol 14 (3) ◽

pp. 350

Author(s):

Renata De Oliveira Campos ◽

Joaquim Custódio Silva Júnior ◽

Elton Estrela Ramos

Keyword(s):

Public Schools ◽

Nutritional Status ◽

Filter Paper ◽

Urinary Iodine ◽

Iodine Concentration ◽

Thyroid Stimulating Hormone ◽

Urinary Iodine Concentration ◽

Iodine Nutrition ◽

Cross Sectional ◽

Stimulating Hormone

Introduction: iodine deficiency disorders (IDD) are most common cause of preventable brain damage, mental retardation and stunted growth in children worldwide. Several indicators are complementary to urinary iodine concentration (UIC) for assessing iodine nutritional status, as thyroid size, thyroglobulin (Tg) and thyroid stimulating hormone (TSH) concentrations in the blood. Objective: analyze TSH in filter paper blood values and correlate with UIC in schoolchildren from public school at state of Bahia, Brazil. Methodology: cross-sectional study was conducted in 880 schoolchildren aged 6-14 years, randomly selected, of public schools in five cities of four micro-regions of Bahia between October 2013 and September 2014. TSH was analyzed in filter-paper blood and UIC were measured by adapted Sandell-Kolthoff reaction. Results: 880 blood samples on filter-paper were analyzed for TSH. The reference range previously established is 0.72 to 6.0 μUI/mL. Results of this research TSH dosage ranged from 0.24 μIU/L to 7.71 μIU/L, with a mean of 1.01±0.55 μUI/L and median 0.89 μUI/L. Only one child presented TSH greater than 6.0 (7.71 μIU/L); however, results of urinary iodine were consistent with a more than adequate nutrition iodine (243.70μg/L). There’ no correlation between TSH and UIC (r= 0.115; p= 0.002). Conclusion: in the present study, schoolchildren showed low values of TSH, but the mean UIC was indicative of adequate iodine nutrition.

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Iodine Intoxication in Beef Cattle in Turkey - Clinical, Hematological and Biochemical Evaluation

Journal of the Hellenic Veterinary Medical Society ◽

10.12681/jhvms.19611 ◽

2019 ◽

Vol 69 (4) ◽

pp. 1247

Author(s):

S. Şentürk ◽

E. M. Temizel ◽

A. Ö. Karakuş ◽

S. Kasap ◽

F. Akkaya

Keyword(s):

Drinking Water ◽

Clinical Signs ◽

Iodine Concentration ◽

Serum Glucose ◽

Clinical Findings ◽

Excess Iodine ◽

Cholesterol Levels ◽

Healthy Cattle ◽

Hematological Analysis ◽

Urine Iodine

Iodine is an essential trace element for humans and animals. The incidence of iodine poisoning in cattle is low. In the present study, we evaluated the clinical findings, serum glucose and cholesterol, thyroid hormone and urine iodine levels in cattle exposed to excess iodine. All of the clinical data were determined following the addition of potassium iodide to the drinking water. Inappetence, cough, and hyperthermia were notable clinical findings. We detected a very high iodine level (470 μg /L) in an analysis of the drinking water samples. A biochemical analysis revealed that the serum cholesterol levels in the affected cattle were significantly lower (p<0.05) than in healthy cattle. However, the serum glucose in the affected cattle was significantly higher (p<0.05) compared to healthy cattle. The iodine concentration in the urine of the affected animals was also significantly higher (p<0.05) than in the healthy animals. Importantly, a hematological analysis indicated leukocytosis with neutrophilia. Several clinical signs, including hyperthermia, tachycardia, alopecia, and a naso-oral discharge, based on suspected history can suggest iodine intoxication. In addition, biochemical parameters, such as urine iodine, serum glucose and cholesterol levels, were observed to be different between healthy and affected cattle. The thyroid function in affected cattle should also be studied.

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