Iodine nutrition status of women after 10 years of Lipiodol supplementation: a cross-sectional study in Xinjiang, China

Abstract This study examined the contribution of long-term use of Lipiodol capsules, as a supplement to iodised salt to the control of iodine deficiency disorders among women in Xinjiang of China. A total of 1220 women across Kashgar, Aksu, Turpan and Yili Prefectures were surveyed in 2017. Lipiodol capsules were administered twice yearly in Kashgar and once yearly in Aksu and Turpan, but not in Yili. Urinary iodine concentration (UIC), free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), thyroglobulin antibody, thyroid peroxidase antibody and thyroid volume values were assessed. All the women in the four areas were in a state of non-iodine deficiency by UIC. The UIC were higher than adequate in Kashgar and Aksu (619·4 v. 278·6 μg/l). Thyroid hormone levels differed significantly in Turpan and Yili (FT3: 4·4 v. 4·6 pmol/l, FT4: 13·8 v. 14·2 pmol/l, TSH: 2·0 v. 2·7 mIU/l), but did not differ significantly in Kashgar, Aksu and Yili. The four areas did not differ significantly with regard to thyroid nodules, autoimmune thyroiditis or goitre. However, the detection rates of subclinical hypothyroidism (16·6 %) and total thyroid dysfunction (25·4 %) were higher among women in Yili. The supplementation with Lipiodol capsules had improved the iodine nutrition status of women in iodine-deficient areas of Xinjiang since 2006. To avoid negative effects of excess iodine, we suggest a gradual discontinuation of Lipiodol capsules in women with special needs based on the existing iodine nutrition level of local women.

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Iodine Nutritional Status and Thyroid volume of School-Aged Children in Wuhan, central of China

10.21203/rs.3.rs-61723/v1 ◽

2020 ◽

Author(s):

Fang Chen ◽

Kai Wu ◽

Yan Yang ◽

Mingxing Xu

Keyword(s):

Nutritional Status ◽

Iodine Deficiency ◽

Reference Values ◽

Linear Regression Analysis ◽

Urinary Iodine ◽

Thyroid Volume ◽

Urinary Iodine Concentration ◽

Multivariate Linear Regression Analysis ◽

Iodine Nutrition ◽

School Aged Children

Abstract Background/Aims: Iodine deficiency is a public health problem over the world. China has achieved the iodine deficiency disorders (IDD) elimination goal through a mandatory universal salt iodization (USI) program. The aim of this study is to assess the current iodine nutritional status and thyroid volume of school-aged children in Wuhan, central of China. Methods The cross-sectional study was conducted among 8–10 years old children from 5 districts in Wuhan. A total of 1000 students were investigated. Salt iodine concentrations, urine iodine concentrations were determined using the standardized methods recommended by WHO/ICCIDD. An ultrasonography of thyroid and anthropometric measurements were performed in all subjects. Results The median urinary iodine concentration(MUI) of students was 247.50 µg/L with interquartile range of 147.00 to 384.00 µg/L. Two districts were classified as regions with adequate iodine nutrition, two districts as regions above the requirement, and one district as a region excessive according to the MUI. The prevalence of goiter was 3.0% and 7.8% according to Chinese national and WHO reference values, respectively, and the difference was not observed among different iodine nutrition groups(P༞0.05). The median thyroid volume(Tvol) of all students was 2.56 ml and the P97 of thyroid volume of both male and female in our study was generally higher than that reported by WHO/ICCIDD in 2007 as a function of age and BSA. The Tvol was in significant association with age, height, weight and BSA by Spearman’s correlation analysis(P < 0.001),and the result of multivariate linear regression analysis showed that only BSA were found to have a significant effect on thyroid volume after log conversion (t = 13.437, P < 0.001). Conclusion The present study indicated that the iodine nutrition among school-aged children in Wuhan was generally adequate with a relatively low goiter rate, while some of them have excess iodine nutrition. Thyroid volume in our study was higher than the reference of WHO and showed a significant correlation with BSA. So further researches were needed to evaluate the thyroid function in children with iodine excessive and the applicability of WHO reference in goiter diagnose. It was also highly recommended to establish the local reference values for thyroid volume that might be applicable to precisely define goiter prevalence in Wuhan.

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Thyroglobulin as a marker of iodine nutrition status in the general population

Acta Endocrinologica ◽

10.1530/eje-09-0262 ◽

2009 ◽

Vol 161 (3) ◽

pp. 475-481 ◽

Cited By ~ 58

Author(s):

Pernille Vejbjerg ◽

Nils Knudsen ◽

Hans Perrild ◽

Peter Laurberg ◽

Allan Carlé ◽

...

Keyword(s):

Iodine Deficiency ◽

Age Groups ◽

Urinary Iodine ◽

Thyroid Volume ◽

Nutrition Status ◽

Iodine Nutrition ◽

Serum Thyroglobulin ◽

Cross Sectional ◽

Iodine Status ◽

Reference Limit

ObjectiveThe iodine status of a population is traditionally evaluated by either urinary iodine (UI) excretion or by some measure of thyroid volume and the prevalence of goitre. In this prospective study of a mandatory iodization programme, we aimed to evaluate serum thyroglobulin (Tg) as a marker of iodine status in the population.MethodsTwo identical cross-sectional studies were performed before (1997–1998,n=4649) and after (2004–2005,n=3570) the initiation of the Danish iodization programme in two areas with mild and moderate iodine deficiency. Serum Tg was measured from blood samples. Thyroid volume was measured by ultrasonography.ResultsBefore iodization, the median serum Tg was considerably higher in moderate than in mild iodine deficiency. Iodization led to a lower serum Tg in all examined age groups. The marked pre-iodization difference in Tg level between the regions was eliminated. The prevalence of Tg above the suggested reference limit (40 μg/l) decreased from 11.3 to 3.7% (P<0.0001). Using bootstrapping, we demonstrated a higher efficacy of Tg than of thyroid volume to show a difference between pre- and post-iodization values.ConclusionWe found serum Tg to be a suitable marker of iodine nutrition status in the population. The results may suggest that the Danish iodization programme has led to a sufficient iodine intake, even if the median UI excretion is still marginally low according to WHO criteria.

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Insufficient iodine nutrition status and the risk of pre-eclampsia: a systemic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-043505 ◽

2021 ◽

Vol 11 (2) ◽

pp. e043505

Author(s):

Charles Bitamazire Businge ◽

Anthony Usenbo ◽

Benjamin Longo-Mbenza ◽

AP Kengne

Keyword(s):

Pregnant Women ◽

Iodine Deficiency ◽

Meta Analysis ◽

Random Effect Model ◽

Urinary Iodine ◽

Systemic Review ◽

Nutrition Status ◽

Urinary Iodine Concentration ◽

Iodine Nutrition ◽

Significant Difference

BackgroundAlthough subclinical hypothyroidism in pregnancy is one of the established risk factors for pre-eclampsia, the link between iodine deficiency, the main cause of hypothyroidism, and pre-eclampsia remains uncertain. We conducted a systematic review to determine the iodine nutrition status of pregnant women with and without pre-eclampsia and the risk of pre-eclampsia due to iodine deficiency.MethodsMEDLINE, EMBASE, Google Scholar, Scopus and Africa-Wide Information were searched up to 30th June 2020. Random-effect model meta-analysis was used to pool mean difference in urinary iodine concentration (UIC) between pre-eclamptic and normotensive controls and pool ORs and incidence rates of pre-eclampsia among women with UIC <150 µg/L.ResultsFive eligible studies were included in the meta-analysis. There was a significant difference in the pooled mean UIC of 254 pre-eclamptic women and 210 normotensive controls enrolled in three eligible case–control studies (mean UIC 164.4 µg/L (95% CI 45.1 to 283.6, p<0.01, I2 >50)). The overall proportions of pre-eclampsia among women with UIC <150 µg/L and UIC >150 µg/L in two cross-sectional studies were 203/214 and 67/247, respectively, with a pooled OR of 0.01 (95% CI 0 to 4.23, p=0.14, I2 >50) for pre-eclampsia among women with UIC >150 µg/L. The overall incidence of pre-eclampsia among women with UIC <150 µg/L and UIC >150 µg/L in two cohort studies was 6/1411 and 3/2478, respectively, with a pooled risk ratio of 2.85 (95% CI 0.42 to 20.05, p=0.09, I2 <25).ConclusionAlthough pre-eclamptic women seem to have lower UIC than normotensive pregnant women, the available data are insufficient to provide a conclusive answer on association of iodine deficiency with pre-eclampsia risk.PROSPERO registration numberCRD42018099427.

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Current Iodine Nutrition Status and Awareness of Iodine Deficiency in Tuguegarao, Philippines

International Journal of Endocrinology ◽

10.1155/2014/210528 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Bu Kyung Kim ◽

Jee-Yeong Jeong ◽

Kwang-Hyuk Seok ◽

Andrew S. Lee ◽

Chul Ho Oak ◽

...

Keyword(s):

High School Students ◽

Iodine Deficiency ◽

Urinary Iodine ◽

Thyroid Volume ◽

Public Health Problem ◽

The Philippines ◽

Vulnerable Groups ◽

Nutrition Status ◽

Important Public Health Problem ◽

Iodine Nutrition

The Philippines is one of the countries where adequate iodine status has been achieved. However, iodine deficiency still remains an important public health problem in this country. In this study, we evaluated iodine nutrition status and investigated an awareness status of iodine deficiency targeting high school students of Tuguegarao, Philippines. A total of 260 students provided samples for urinary iodine analysis, among which 146 students completed thyroid volume measurement by ultrasonography and answering the questionnaires. The median urinary iodine level was 355.3 µg/L and only 3.8% of the students were in the range of iodine deficiency status according to the ICCIDD criteria. Although 62.3% of students answered that they can list problems resulting from iodine deficiency, a majority of students (70.5%) were unable to identify problems other than goiter. They did not appreciate that adequate iodine levels are important during pregnancy and for development of children. 33.6% of students answered that they did not use iodized salt and the biggest reason was that they did not find it necessary. Based on these results, we suggest that a future strategy should be focused on vulnerable groups to completely eliminate iodine deficiency, including women at their reproductive ages and during pregnancy.

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Thyroid Function and Thyroglobulin Level in Iodine-Deficient Children of Eastern Nepal

Nepal Journal of Biotechnology ◽

10.3126/njb.v9i1.38670 ◽

2021 ◽

Vol 9 (1) ◽

pp. 75-78

Author(s):

Saroj Kunwar ◽

Saroj Khatiwada ◽

Basanta Gelal ◽

Saroj Thapa ◽

Gaurishankar Shah ◽

...

Keyword(s):

Thyroid Function ◽

Iodine Deficiency ◽

Urinary Iodine ◽

Iodine Concentration ◽

Overt Hypothyroidism ◽

Urinary Iodine Concentration ◽

Free Triiodothyronine ◽

Iodine Nutrition ◽

Serum Thyroglobulin ◽

Cross Sectional

Iodine deficiency during childhood affects physical and mental development. Iodine deficiency or excess both can negatively impact thyroid function. We conducted this study to assess iodine nutrition and thyroid function in children with insufficient urinary iodine concentration. A community-based cross-sectional study was conducted among the selected schools of Udayapur district. Urinary iodine concentration (UIC) was measured in 1012 school children (6-14 years). Based on UIC data, 83 blood samples were collected to measure serum thyroglobulin (Tg), thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), and free thyroxine (fT4). UIC was measured by ammonium persulfate digestion method, and Tg, TSH, fT4, and fT3 were measured using ELISA kits. The median UIE was 236 µg/L, and 11.1% of the children had insufficient UIC. The mean fT3, fT4, and TSH in children with insufficient UIC were 2.55±0.43 pg/mL, 0.96±0.28 ng/dL, and 3.60±1.44 mIU/L respectively. Among children with low UIC levels, the median Tg was 17.5 ng/mL. Overt hypothyroidism was seen in 6%, and subclinical hypothyroidism in 3.6%. The children had sufficient iodine nutrition, and the frequency of thyroid dysfunction was low among the children with insufficient UIC.

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Association between Iodine Nutrition Status and Thyroid Disease-Related Hormone in Korean Adults: Korean National Health and Nutrition Examination Survey VI (2013–2015)

Nutrients ◽

10.3390/nu11112757 ◽

2019 ◽

Vol 11 (11) ◽

pp. 2757 ◽

Cited By ~ 3

Author(s):

Kim ◽

Kwon ◽

Kim ◽

Hong ◽

Park

Keyword(s):

National Health ◽

Thyroid Disease ◽

Urinary Iodine ◽

Iodine Intake ◽

Thyroid Stimulating Hormone ◽

Nutrition Status ◽

Urinary Iodine Concentration ◽

Nutrition Examination Survey ◽

Iodine Nutrition ◽

Health And Nutrition

This study aimed to observe the relationship between iodine nutrition status (dietary iodine intake and estimated iodine intake based on urinary iodine concentration (UIC)) and thyroid disease-related hormones. This study involved 6090 subjects >19 years old with valid UIC, assessed between 2013 and 2015 by the Korean National Health and Nutrition Examination Survey, using a stratified, multistage, clustered probability-sampling design. The estimated iodine intake in participants was measured using UIC and urine creatinine. To examine the effect of iodine intake on thyroid disease, the iodine intake was divided into Korean Dietary Reference Intakes groups, and logistic regression analysis was performed via the surveylogistic procedure to obtain odds ratios (ORs) and 95% confidence intervals (CIs). The estimated iodine intake showed a significant positive correlation with dietary iodine intake (r = 0.021, p < 0.001), UIC (r = 0.918, p < 0.001), and thyroid-stimulating hormone (TSH) (r = 0.043, p < 0.001), but a significant negative correlation with free thyroxine (FT4) (r = −0.037, p < 0.001). Additionally, as the estimated iodine intake increased, age, TSH, and UIC increased, but FT4 decreased (p for trend < 0.0001). The risk of thyroid disease was higher in the “≥tolerable upper intake level (UL ≥ 2400 µg/day)” group than in the “<estimated average requirement (EAR < 150 µg/day)” group in females (OR: 2.418; 95% CI: 1.010–5.787). Also, as iodine intake increased, the risk of thyroid disease increased (p for trend < 0.038).

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Thyroid ultrasound compared with World Health Organization 1960 and 1994 palpation criteria for determination of goiter prevalence in regions of mild and severe iodine deficiency

Acta Endocrinologica ◽

10.1530/eje.0.1430727 ◽

2000 ◽

pp. 727-731 ◽

Cited By ~ 62

Author(s):

M Zimmermann ◽

A Saad ◽

S Hess ◽

T Torresani ◽

N Chaouki

Keyword(s):

Iodine Deficiency ◽

Urinary Iodine ◽

Thyroid Volume ◽

Classification Systems ◽

World Health ◽

Urinary Iodine Concentration ◽

Thyroid Ultrasound ◽

Iodine Deficiency Disorders ◽

Goiter Prevalence

OBJECTIVES: In 1994, WHO/International Council for the Control of Iodine Deficiency Disorders recommended replacing the WHO 1960 four-grade goiter classification with a simplified two-grade system. The effect of this change in criteria on the estimation of goiter prevalence in field studies is unclear. In areas of mild iodine deficiency disorders (IDD) where goiters are small, ultrasound is preferable to palpation to estimate goiter prevalence. However, in areas of moderate to severe IDD, goiter screening by palpation may be an acceptable alternative to thyroid ultrasound. To address these two issues, we compared WHO 1960 and 1994 criteria with thyroid ultrasound for determination of goiter prevalence in areas of mild and severe IDD in Morocco. DESIGN: A cross-sectional study of 400 six- to 13-year-old children from two mountain villages (Ait M'hamed and Brikcha) in rural Morocco was carried out. METHODS: Urinary iodine concentration (UI), whole blood TSH and serum thyroxine were measured. Thyroid size was graded by inspection and palpation by two examiners using both WHO 1960 and 1994 criteria. Thyroid volume was determined by ultrasound. Variation between examiners and examination methods was assessed. Sensitivity and specificity of the two classification systems compared with ultrasound were calculated. RESULTS: Median UIs in Ait M'hamed and Brikcha were 183 and 24 microg/l respectively. In Ait M'hamed, using 1960 and 1994 criteria, goiter prevalence was 21 and 26% respectively, compared with 13% by ultrasound. In Brikcha, with 1960 and 1994 criteria, goiter prevalence was 64 and 67% respectively, compared with 64% by ultrasound. Agreement between observers was better with the 1994 criteria than with the 1960 criteria in Ait M'hamed (kappa=0.53 and 0.47 respectively), while in Brikcha observer agreement was similar with the two systems (kappa=0.67). Using either the 1994 or 1960 criteria, agreement with ultrasound was only moderate in Ait M'hamed (kappa=0.41-0.44), but good in Brikcha (kappa=0.55-0.64). Overall, compared with ultrasound, sensitivity increased 3-4% using 1994 criteria, while specificity decreased 4-5%. CONCLUSIONS: The WHO 1994 criteria are simpler to use than the 1960 criteria and provide increased sensitivity with only a small reduction in specificity. Agreement between observers is better with the 1994 criteria than with the 1960 criteria, particularly in areas of mild IDD. Like the 1960 criteria, the 1994 criteria overestimate goiter prevalence in areas of mild IDD, compared with ultrasound. However, the 1994 palpation criteria provide an accurate estimate of goiter prevalence in areas of severe IDD, and may be an acceptable and affordable alternative to thyroid ultrasound in these areas.

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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 Functions in Bamboo-Shoots Consuming Children of Tripura, North-east India

10.21203/rs.3.rs-615916/v1 ◽

2021 ◽

Author(s):

Indrajit Ray ◽

A. K. Chandra ◽

Saru Kumar Debbarma ◽

Sekhar Kumar Mookerjee ◽

Ajoy Datta ◽

...

Keyword(s):

Urinary Iodine ◽

Thyroid Volume ◽

Thyroid Stimulating Hormone ◽

Consumption Pattern ◽

Thyroid Peroxidase ◽

Free Triiodothyronine ◽

Cross Sectional ◽

North East ◽

Bamboo Shoots ◽

The Village

Abstract PurposeInformation on thyroid functions in populations consuming potent antithyroidal bamboo-shoots (BS) was found scanty. Therefore, to assess thyroid function in BS consuming children was found relevant.MethodsThis cross-sectional study included 127 children from 3 villages. Thyroid volume (TV), free thyroxine (FT4), free triiodothyronine (FT3), thyroid stimulating hormone (TSH), thyroglobulin antibody (Tg-Ab), thyroid peroxidase antibody (TPO-Ab), urinary iodine (UI), urinary thiocyanate (USCN), salt iodine (SI), water iodine (WI), and BS consumption pattern were assessed. ResultsVariable-wise overall mean±SDs/medians/interquartile ranges (IQR) were - age: 8.69±1.69/8.77/7.22-9.74 y, TVol: 0.82±0.27/0.82/0.67-0.96 ml, FT4: 19.5+5.6/20.1/16.9-22.0 pmol/L, FT3: 4.27+1.24/4.22/3.35-4.96 pmol/L, TSH: 2.44+1.39/2.33/1.60-3.15 mIU/L, Tg-Ab: 15.2+10.0/12.5/11.1-14.5 IU/ml, TPO-Ab: 5.58+12.25/3.89/2.90-5.11 IU/ml, UI: 117.4±58.5/108/73-160.5 µg/L, USCN: 0.99+0.67/0.8/0.5-1.2 mg/dl, WI: 4 .69±4.56/3.0/1.35–7µg/L, and BS consumption: 153.8±01.4/119/71.4–214.3 g/person/day respectively. Only 80.3% salt samples had ≥15 ppm iodine. Thyroid dysfunction prevalence was 6.3%. There were positive correlations between TV and FT4 (r=0.2466, p=0.005), UI and TSH (r=0.2633, p=0.003), TSH and FT4 (r=0.2135, p=0.016), TSH and FT3 (r=0.1898, p=0.033), USCN and FT4 (r=0.2477, p=0.005), Tg-Ab and TPO-Ab (r=0.3768, p=<0.001), and negative correlations between Tg-Ab and TSH (r=-0.2024, p=0.023), Tg-Ab and FT4 (r=-0.1869, p=0.035). In boys, USCN had a positive correlation with TPO-Ab (r=0.3069, p=0.018). The village having highest levels of BS consumption (p=0.037) and median UI showed higher TSH levels (p=0.037) and higher FT3 level (p=0.001) compared to the village of lowest BS consumption.ConclusionsThe BS consuming children appear at risk of developing hypothyroidism by Tg-Ab, which may partly be diminished by reducing BS consumption.

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Thyroid dysfunction in region of excess iodine intake of Eastern Nepal

International Journal of Scientific Reports ◽

10.18203/issn.2454-2156.intjscirep20181848 ◽

2018 ◽

Vol 4 (5) ◽

pp. 114

Author(s):

Saroj Thapa ◽

Madhab Lamsal ◽

Rajendra K. Chaudhari ◽

Basanta Gelal ◽

Saroj Kunwar ◽

...

Keyword(s):

Primary School ◽

Subclinical Hypothyroidism ◽

Thyroid Dysfunction ◽

Urinary Iodine ◽

Iodine Concentration ◽

Primary School Children ◽

Nutrition Status ◽

Urinary Iodine Concentration ◽

Iodine Nutrition ◽

Excess Iodine

Background: Iodine deficiency as well as iodine excess can result in an increased prevalence of thyroid disorders. The prevalence of excess iodine nutrition is increasing all over the world. The aim of the present study was to find the occurrence of iodine nutrition status in primary school children of Eastern Nepal and find the prevalence of associated thyroid dysfunction among those with excess urinary iodine concentration.Methods: A community based cross sectional study was conducted in Udayapur district which is located in Eastern part of Nepal. Primary school aged children (6 years to 12 years) were enrolled in this study from three schools. Blood and urine samples were collected and assayed for urinary iodine concentration (UIC), free thyroid hormones (fT3 and fT4), and thyroid stimulating hormone (TSH). Results: The median UIC was 232.27 µg/L. The iodine status showed that 15.5% (n=31) had low UIC, 21% (n=42) had above requirement and 36% (n=72) had excessive iodine nutrition status. The mean concentration of fT3 and fT4 was 2.87 pg/ml and 1.21 ng/dl respectively, while the median TSH concentration was 3.03 mIU/L. The prevalence of thyroid dysfunction was 10% (n=20) with subclinical hypothyroidism being the most common. Majority of participants with subclinical hypothyroidism had excess UIC.Conclusions: Above requirement and excess iodine nutrition is more common in region where there is unregulated consumption and improper monitoring of iodized salt. Subclinical hypothyroidism is common in regions of excess iodine nutrition.

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