scholarly journals Iodine status five years after the adjustment of universal salt iodization: a cross-sectional study in Fujian Province, China

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Yixuan Lin ◽  
Diqun Chen ◽  
Jiani Wu ◽  
Zhihui Chen
Keyword(s):  
Pregnant Women ◽  
Urinary Iodine ◽  
Interquartile Range ◽  
Iodized Salt ◽  
School Age Children ◽  
Fujian Province ◽  
Cross Sectional ◽  
Lactating Women ◽  
Iodine Status ◽  
Salt Iodization

Abstract Background Universal salt iodization program was introduced to China to eliminate iodine deficiency disorders in 1995. In 2012, Fujian Province decreased the concentration of iodized table salt according to the national unified requirement. This study aimed to assess the effect on iodine status after the adjustment, providing evidence for further adjustment in Fujian Province. Methods Sampling units were selected by multistage cluster sampling method. In each sampling unit, table salt was collected from 30 households. A total of 2,471 people in 2009 and 4,806 people in 2017 provided urine samples and were included in this cross-sectional analysis. Median iodized salt concentration and median urine iodine concentration were present by median and interquartile range. Results Median iodized salt decreased from 29.8 mg/kg in 2009 to 23.9 mg/kg in 2017. The median urinary iodine concentrations for school-age children in 2017 in coastal urban area, non-coastal urban area, coastal rural area and non-coastal rural area were 163.6µg/L (interquartile range = 100.1–252.0µg/L), 198.9µg/L (interquartile range = 128.0-294.0µg/L), 181.8µg/L (interquartile range = 114.1–257.0µg/L) and 218.2µg/L (interquartile range = 148.1-306.5µg/L), respectively. The median urinary iodine concentrations for adults in 2017 in these areas were 151.1µg/L (interquartile range = 98.3-231.7µg/L), 168.7µg/L (interquartile range = 109.6–242.0µg/L), 167.7µg/L (interquartile range = 105.7-245.7µg/L) and 182.7µg/L (interquartile range = 117.1-258.9µg/L). The median urinary iodine concentrations for pregnant women in 2017 in these areas were 157.7µg/L (interquartile range = 106.9-223.8µg/L), 141.5µg/L (interquartile range = 97.7-207.6µg/L), 127.3µg/L (interquartile range = 90.0-184.5µg/L) and 144.8µg/L (interquartile range = 99.9-184.5µg/L). The median urinary iodine concentrations for lactating women in 2017 in these areas were 122.7µg/L (interquartile range = 84.1–172.0µg/L), 123.7µg/L (interquartile range = 70.7-184.7µg/L), 105.8µg/L (interquartile range = 67.1-152.3µg/L) and 110.2µg/L (interquartile range = 74.1-170.3µg/L). Conclusions The overall urinary iodine concentrations among school-age children, adults and lactating women dramatically decreased after implementing the new standard. Almost all of them were iodine adequate, suggesting we reached the expected aim of iodized salt adjustment. However, pregnant women were iodine insufficient after adjustment. Therefore, we should continue the surveillance of iodine status of populations and focus on the additional iodine supplement strategies for pregnant women.

scholarly journals Prevalence of Iodine Insufficiency Is High Among Pregnant and Lactating Women in Northern Bangladesh Three Decades After Initiating Mandatory Salt Iodization

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 1037-1037
Author(s):  
Abu abdullah Mohammad Hanif ◽  
Md Mokbul Hossain ◽  
Mehedi Hasan ◽  
Abu Ahmed Shamim ◽  
Malay Kanti Mridha
Keyword(s):  
Pregnant Women ◽  
Urinary Iodine ◽  
Iodine Content ◽  
Urinary Iodine Concentration ◽  
Second Trimester ◽  
Third Trimester ◽  
Lactating Women ◽  
Iodine Status ◽  
Salt Iodization ◽  
Salt Iodine

Abstract Objectives Optimum Iodine status during pregnancy and lactation is crucial for normal fetal growth and child development. We assessed the urinary iodine concentration of pregnant and lactating women to determine their iodine status and measured salt iodine from their households. Methods We collected spot urine samples and corresponding household salt samples from 80 pregnant women (37 and 43 second and third-trimester women, respectively) and 49 lactating women (with children <6 months). Urinary iodine was determined by manual digestion with ammonium persulfate followed by Sandell-Kolthoff Reaction using 96 multi-well plates and a micro-plate reader at 405 nm. The iodine content in salt was measured by iodometric titration method. Samples were analyzed at the icddr, b Immunology, Nutrition, and Toxicology Laboratory, Dhaka, Bangladesh. Results The median [IQR] UIC in the second-trimester women, third-trimester women, and lactating women was 90.6[41.9–171.5] mcg/L, 67.9[24.2–144.5] mcg/L, and 74.7[48.1–134.8] mcg/L, respectively. More than three-quarters of pregnant women (73% of the second-trimester women and 79% of the third-trimester women) and more than half of the lactating mothers (57%) were below the WHO recommended cut-offs. Only 42% of the household salts were adequately iodized. A moderate positive linear relationship was found between urinary and household salt iodine content (r = 0.51, P < 0.0001). Conclusions Even with mandatory salt iodization policy in Bangladesh for about three decades, the iodine insufficiency among pregnant and lactating women is widespread and needs to be improved through ensuring the availability of adequately iodized salt or supplement. Funding Sources ETH Zurich, Switzerland.

scholarly journals IODINE STATUS OF PREGNANT WOMEN RESIDING IN URBAN SLUMS IN DELHI

2018 ◽  
Vol 11 (7) ◽  
pp. 506
Author(s):  
Spriha Rao ◽  
Gurudayal Singh Toteja ◽  
Neena Bhatia ◽  
Supriya Dwivedi ◽  
Zaozianlungliu Gonmei ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Urinary Iodine ◽  
Urban Slums ◽  
Iodized Salt ◽  
Nutrition Status ◽  
Urinary Iodine Concentration ◽  
Iodine Nutrition ◽  
Cross Sectional ◽  
Iodine Status ◽  
Salt Iodine

Objectives: The present study was carried out to determine the iodine nutrition status among pregnant women in slums of West Delhi.Methods: A community-based cross-sectional study was carried out among the third-trimester pregnant women residing in urban slums of West Delhi. Urinary iodine concentration was estimated using ammonium persulfate method, and salt iodine was estimated using iodometric titration.Results: Of the total 180 pregnant women, 70.6% were consuming adequately iodized salt (iodine levels ≥15 ppm). Median urinary iodine level for the pregnant women was 147.5 μg/L indicating iodine deficiency among this group. A total of 51.1% of women had urinary iodine levels <150 μg/L.Conclusion: Pregnant women belonging to slum community from Delhi have a suboptimal iodine status. Further, the proportion of women consuming iodized salt is less than the national average indicating the need to educate these women about the importance of iodine during pregnancy.

scholarly journals A cross-sectional research of iodine status of pregnant women in Chongqing, south-west China

2020 ◽  
Vol 23 (5) ◽  
pp. 769-775 ◽  
Author(s):  
Ning Yao ◽  
Chunbei Zhou ◽  
Jun Xie ◽  
Shuang Zhou
Keyword(s):  
Nutritional Status ◽  
Pregnant Women ◽  
Iodine Deficiency ◽  
Dietary Habits ◽  
Iodized Salt ◽  
Urinary Iodine Concentration ◽  
Table Salt ◽  
Cross Sectional ◽  
Iodine Status ◽  
Salt Iodization

AbstractObjective:To investigate whether implementation of a universal salt iodization (USI) programme has sufficient effects on pregnant women in Chongqing, the present study evaluated the iodine nutritional status of pregnant women living in Chongqing by spot urinary iodine concentration (UIC), to provide scientific suggestions to better meet the specific iodine needs of this vulnerable group.Design:Cross-sectional design.Setting:A random spot urine sample and household table salt sample were provided by each participant.Participants:A total of 2607 pregnant women from twenty-six of thirty-nine districts/counties in Chongqing participated.Results:The overall median UIC of pregnant women was 171·80 μg/l (interquartile range (IQR) = 113·85–247·00 μg/l) and 40·97 % (n 1057) of participants were iodine insufficient. The median iodine in table salt samples was 25·40 mg/kg (IQR = 23·10–28·30 mg/kg); 93·26 % (n 2406) of samples examined were found to be adequately iodized. Iodine nutritional status was not significantly different according to table salt iodization category. Trimester was identified to be statistically associated with UIC (P < 0·01). Seven districts/counties had median UIC below 150 μg/l and one district had median UIC of 277·40 μg/l.Conclusions:The USI programme in Chongqing prevents iodine deficiency generally, but does not maintain iodine status within adequate and recommended ranges throughout pregnancy. Usage of non-iodized or unqualified iodized salt and the slight change of dietary habits of iodized salt in Chongqing may present a substantial challenge to fight iodine-deficiency disorders; more efforts are needed to ensure adequate iodine intake during pregnancy besides the USI programme.

scholarly journals THE SITUATION OF URINARY IODINE CONCENTRATION (UIC) AMONG SCHOOL AGE CHILDREN, WOMEN AT REPRODUCTIVE AGE AND PREGNANT WOMEN IN INDONESIA: THE ANALYSIS OF RISKESDAS 2013

2017 ◽  
Vol 39 (1) ◽  
pp. 49
Author(s):  
Djoko Kartono ◽  
Atmarita Atmarita ◽  
Abas B Jahari ◽  
Soekirman Soekirman ◽  
Doddy Izwardy
Keyword(s):  
Pregnant Women ◽  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Iodine Concentration ◽  
Iodized Salt ◽  
Reproductive Age ◽  
School Age Children ◽  
Urinary Iodine Concentration ◽  
Iodine Status ◽  
Iodine Level

Iodine Deficiency Disorders (IDD) are the leading cause of goiter, cretinism, developmental delays and other health problems. Iodine deficiency is an important public health issue as it is a preventable cause of intellectual disability. While elimination of iodine deficiency is imperative, it should be noted that excessive intake of iodine can also lead to adverse health effects. This paper analyzed the iodine status using median urinary iodine concentration (MUIC) of school age children (SAC), women of reproductive age (WRA), and pregnant women (PW) who live in the same household from Riskesdas 2013. The total number of households included in the analysis was 13,811 households, from which 6,149 SAC (aged 6 – 12 years), 13,218 WRA (aged 15-49 years), and 578 PW (aged 15-49 years) were enumerated. The national MUIC of SAC, WRA and PWwas  in the normal range indicated that  the iodine status was adequate using WHO epidemiological criteria. Iodine status in some sub-populations indicated deficiency, however, in terms of geographic characteristics people who live in the urban has better iodine status compared to rural areas. Similarly, populations in richer economic quintiles had better iodine status. Only pregnant women in the 1st and 2nd quintile were deficient. Almost all regions in Indonesia showed the MUIC was in the normal adequate range, except NTT-NTB, Maluku-Papua, and East Java for pregnant women who tend to have lower MUIC (<150 µg/L). The status of iodized salt at the household was detected using both Rapid Test Kit/RTK as well as Titration. The result demonstrated a strong association between salt iodine level and iodine status. The MUIC for all three groups were lower when the iodine level in salt was lower, then increased when the levels of iodine content in salt increased. The iodine status of pregnant women consuming non-iodized salt was inadequate. The detrimental effect of iodine deficiency on the mental and physical development of children as well as on the women of reproductive age has been recognized. Indonesia still needs the salt iodization program to keep the iodine status in the normal range. In particular coverage with adequately iodized salt needs to be improved in order to improve the iodine status of pregnant women. For the prevention of Iodine disorders (insufficient), monitoring should be undertaken in regular basis to assess the MUIC, especially for pregnant women.

scholarly journals Amniotic fluid iodine concentrations do not vary in pregnant women with varying iodine intake

2008 ◽  
Vol 99 (6) ◽  
pp. 1178-1181 ◽  
Author(s):  
Eduardo García-Fuentes ◽  
Manuel Gallo ◽  
Laureano García ◽  
Stephanie Prieto ◽  
Javier Alcaide-Torres ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Pregnant Women ◽  
Urinary Iodine ◽  
Public Health Problem ◽  
Iodine Concentration ◽  
Iodine Intake ◽  
Iodized Salt ◽  
Cross Sectional ◽  
International Agencies ◽  
Multivitamin Supplement

Iodine deficiency is an important clinical and public health problem. Its prevention begins with an adequate intake of iodine during pregnancy. International agencies recommend at least 200 μg iodine per d for pregnant women. We assessed whether iodine concentrations in the amniotic fluid of healthy pregnant women are independent of iodine intake. This cross-sectional, non-interventional study included 365 consecutive women who underwent amniocentesis to determine the fetal karyotype. The amniocentesis was performed with abdominal antisepsis using chlorhexidine. The iodine concentration was measured in urine and amniotic fluid. The study variables were the intake of iodized salt and multivitamin supplements or the prescription of a KI supplement. The mean level of urinary iodine was 139·0 (sd94·5) μg/l and of amniotic fluid 15·81 (sd7·09) μg/l. The women who consumed iodized salt and those who took a KI supplement had significantly higher levels of urinary iodine than those who did not (P = 0·01 andP = 0·004, respectively). The urinary iodine levels were not significantly different in the women who took a multivitamin supplement compared with those who did not take this supplement, independently of iodine concentration or multivitamin supplement. The concentrations of iodine in the amniotic fluid were similar, independent of the dietary iodine intake. Urine and amniotic fluid iodine concentrations were weakly correlated, although the amniotic fluid values were no higher in those women taking a KI supplement. KI prescription at recommended doses increases the iodine levels in the mother without influencing the iodine levels in the amniotic fluid.

scholarly journals Iodine deficiency in pregnant women in Sweden: a national cross-sectional study

2019 ◽  
Vol 59 (6) ◽  
pp. 2535-2545 ◽  
Author(s):  
Sofia Manousou ◽  
Maria Andersson ◽  
Robert Eggertsen ◽  
Sandra Hunziker ◽  
Lena Hulthén ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Iodine Deficiency ◽  
Geometric Mean ◽  
Iodized Salt ◽  
National Study ◽  
Urinary Iodine Concentration ◽  
Iodine Nutrition ◽  
Cross Sectional ◽  
Iodine Status ◽  
Supplement Use

Abstract Purpose Voluntary salt iodization at 50 mg/kg salt ensures adequate iodine nutrition in Swedish school-aged children, but iodine status in pregnant women is uncertain. Methods We conducted a cross-sectional national study of 743 pregnant women, at median gestational age of 23 weeks (IQR 9, 38), recruited from maternal health care centers. We measured: urinary iodine concentration (UIC) and urinary creatinine concentration in spot urine samples; thyroglobulin (Tg), thyroid-stimulating hormone (TSH), and total thyroxine (tT4) on dried blood spots (DBS); and thyreoperoxidase antibodies in serum samples. Data on dietary supplement use were obtained, and women were classified as supplement users (consuming multivitamins containing ≥ 150 µg iodine/day) and non-supplement users (no supplements or < 150 µg iodine/day from supplements). Results Overall median UIC [bootstrapped 95% confidence interval (CI)] was 101 µg/L (95, 108; n = 737): 149 µg/L (132, 164) in supplement users (n = 253) and 85 µg/L (79, 92) in non-supplement users (n = 440) (p < 0.001). Overall geometric mean DBS-Tg (95% CI) was 22.1 μg/L (20.8, 23.5; n = 675) and the prevalence of elevated DBS-Tg was 19%. DBS-Tg was lower in supplement users (n = 229) than in non-supplement users (n = 405) (19.1 vs 24.4 μg/L, p < 0.001). DBS-TSH, DBS-tT4, and S-TPOab positivity did not differ between the two groups. Conclusions Pregnant women in Sweden have inadequate iodine nutrition. Women not taking iodine supplements containing ≥ 150 µg iodine/day are affected by mild iodine deficiency and are at higher risk for increased thyroid activity, while maintaining euthyroidism. Iodine intake should be improved in women both before and after conception by promotion of iodized salt instead of non-iodized salt. We urge regular monitoring of iodine status in the general Swedish population, as well as in risk groups.

scholarly journals Assessment of Iodine Status Using Dried Blood Spot Thyroglobulin: Development of Reference Material and Establishment of an International Reference Range in Iodine-Sufficient Children

2006 ◽  
Vol 91 (12) ◽  
pp. 4881-4887 ◽  
Author(s):  
Michael B. Zimmermann ◽  
Bruno de Benoist ◽  
Sandro Corigliano ◽  
Pieter L. Jooste ◽  
Luciano Molinari ◽  
...  
Keyword(s):  
Reference Material ◽  
Reference Range ◽  
Urinary Iodine ◽  
Thyroid Volume ◽  
Iodized Salt ◽  
School Age Children ◽  
Reference Standard ◽  
Iodine Nutrition ◽  
Iodine Status ◽  
International Reference

Abstract Context: Thyroglobulin (Tg) may be a valuable indicator of improving thyroid function in children after salt iodization. A recently developed Tg assay for use on dried whole blood spots (DBS) makes sampling practical, even in remote areas. Objective: The study aim was to develop a reference standard for DBS-Tg, establish an international reference range for DBS-Tg in iodine-sufficient children, and test the standardized DBS-Tg assay in an intervention trial. Design, Participants, and Interventions: Serum Tg reference material of the European Community Bureau of Reference (CRM-457) was adapted for DBS and its stability tested over 1 yr. DBS-Tg was determined in an international sample of 5- to 14-yr-old children (n = 700) who were euthyroid, anti-Tg antibody negative, and residing in areas of long-term iodine sufficiency. In a 10-month trial in iodine-deficient children, DBS-Tg and other indicators of iodine status were measured before and after introduction of iodized salt. Results: Stability of the CRM-457 Tg reference standard on DBS over 1 yr of storage at −20 and −50 C was acceptable. In the international sample of children, the third and 97th percentiles of DBS-Tg were 4 and 40 μg/liter, respectively. In the intervention, before introduction of iodized salt, median DBS-Tg was 49 μg/liter, and more than two thirds of children had DBS-Tg values greater than 40 μg/liter. After 5 and 10 months of iodized salt use, median DBS-Tg decreased to 13 and 8 μg/liter, respectively, and only 7 and 3% of children, respectively, had values greater than 40 μg/liter. DBS-Tg correlated well at baseline and 5 months with urinary iodine and thyroid volume. Conclusions: The availability of reference material and an international reference range facilitates the use of DBS-Tg for monitoring of iodine nutrition in school-age children.

scholarly journals Dried Blood Spot Thyroglobulin as a Biomarker of Iodine Status in Pregnant Women

2016 ◽  
Vol 102 (1) ◽  
pp. 23-32 ◽  
Author(s):  
Sara Stinca ◽  
Maria Andersson ◽  
Sandra Weibel ◽  
Isabelle Herter-Aeberli ◽  
Ralph Fingerhut ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Reference Range ◽  
Urinary Iodine ◽  
Iodine Intake ◽  
Dried Blood Spot ◽  
Urinary Iodine Concentration ◽  
Iodine Nutrition ◽  
Cross Sectional ◽  
Iodine Status ◽  
Blood Spot

Abstract Context: Thyroglobulin (Tg) could be a sensitive biomarker of iodine nutrition in pregnant women (PW). A dried blood spot (DBS) assay would simplify collection and transport in field studies. Objectives: Our aims were to (1) establish and test a reference range for DBS-Tg in PW; (2) determine whether co-measurement of Tg antibodies (Abs) is necessary to define population iodine status. Design, Setting, and Participants: Standardized cross-sectional studies of 3870 PW from 11 countries. For the DBS-Tg reference range, we included TgAb-negative PW (n = 599) from 3 countries with sufficient iodine intake. Main Outcome Measures: We measured the urinary iodine concentration and DBS thyroid-stimulating hormone, total thyroxin, Tg, and TgAb. Results: In the reference population, the median DBS-Tg was 9.2 μg/L (95% confidence interval, 8.7 to 9.8 μg/L) and was not significantly different among trimesters. The reference range was 0.3 to 43.5 μg/L. Over a range of iodine intake, the Tg concentrations were U-shaped. Within countries, the median DBS-Tg and the presence of elevated DBS-Tg did not differ significantly between all PW and PW who were TgAb-negative. Conclusions: A median DBS-Tg of ∼10 μg/L with &lt;3% of values ≥44 μg/L indicated population iodine sufficiency. Concurrent measurement of TgAb did not appear necessary to assess the population iodine status.

scholarly journals Indicators of Iodine Status in Pregnancy and Postpartum in a Group of Pregnant Women from Perimarine Area of Romania

2020 ◽  
Vol 26 (2) ◽  
pp. 63-69
Author(s):  
Scrinic Olesea ◽  
Delia Corina Elena ◽  
Toma Geanina Mirela ◽  
Circo Eduard
Keyword(s):  
Pregnant Women ◽  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Iodine Concentration ◽  
Iodine Intake ◽  
Iodized Salt ◽  
Urinary Iodine Concentration ◽  
Urinary Creatinine ◽  
Iodine Status ◽  
In Pregnancy

Abstract Objective: Assessment of iodine nutritional status in pregnant women in the perimarine area of Romania, a region without iodine deficiency. Adequate iodine intake is the main source for normal thyroid function, ensuring the need for maternal thyroid hormones during pregnancy, but also for the development and growth of children in the fetal and postpartum period. Material and method: Prospective study performed on 74 pregnant women in the first 2 trimesters of pregnancy, originating from the perimarin area. The following indicators of iodine status were analyzed: urinary iodine concentration (UIC), the ratio between urinary iodine concentration and urinary creatinine (UIC/UCr), the prevalence of maternal goiter and the value of neonatal TSH (thyroid stimulating hormone). Results: The mean gestational age was 11 weeks. The ways of iodine intake are: iodized salt - 59.4%, iodized salt and iodine supplements- 23%, only iodine supplements -10.8% and 6.8% consume only non-iodized salt. The median of UIC was 133.03 mcg/l considered insufficient iodine intake (normal in pregnancy UIC >150 mcg/l), but the adjustment of UIC to urinary creatinine reveals a median of 152.83 mcg/g, a value that reflects an adequate iodine intake. The prevalence of goiter was 25.6% characteristic for a moderate iodine deficiency. The prevalence of neonatal TSH >5 mIU/L was registered in 18.8% characteristic of mild iodine deficiency. Conclusions: Monitoring of the iodine nutritional status is recommended for the prevention of disorders due to iodine deficiency under the conditions of universal salt iodization. Perimarine areas considered sufficient in iodine may show variations in iodine status in subpopulations under certain physiological conditions, such as pregnancy. An indicator of iodine status of the population is UIC, but the UIC/UCr ratio may be a more optimal indicator for pregnant women, to avoid possible overestimated results of iodine deficiency in pregnancy.

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