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 <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 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.

Monitoring Iodine Following Consumption of Iodized Salt in Tehrani Inhabitants

2000 ◽  
Vol 70 (2) ◽  
pp. 65-69 ◽  
Author(s):  
Nahid Salarkia ◽  
Fereidoun Azizi ◽  
Masood Kimiagar ◽  
Hamid Zakeri ◽  
Sedigheh Soheilikhah ◽  
...  
Keyword(s):  
Who Classification ◽  
Age Groups ◽  
Urinary Iodine ◽  
Thyroid Volume ◽  
Iodine Intake ◽  
Iodized Salt ◽  
Digestion Method ◽  
Iodine Status ◽  
Production Distribution ◽  
Serum T4

As the production, distribution and consumption of iodized salt has increased in recent years, this study was carried out to assess iodine status in Tehran in 1996. 1146 families comprising 5140 subjects in the twenty districts of Tehran city from all age groups were randomly selected. Thyroid size was examined by palpation and graded according to the WHO classification. In 163 families selected randomly, thyroid size was determined by ultrasonography and urinary iodine was measured by digestion method. Serum T4, T3 and TSH (IRMA) concentrations were also assayed by kits. Percentage of grades 1 & 2 goiter were 44 & 44% in females and 49 & 33% in males respectively. Median urinary iodine was 17.5 mug/dl. Mean serum T4, T3 and TSH were 8.41 ± 1.4 mug/dl, 170 ± 37 ng/dl and 1.4 ± 0.8 mu/ml, respectively. In 118 children aged 6–10 years median urinary iodine was 17.5 mug/dl. Thyroid volume in children was 4.3 ± 1.9 ml. No correlation was established between the thyroid volume and goiter grade. This study points to the adequacy of iodine intake in the majority of families residing in Tehran.

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

2009 ◽  
Vol 161 (3) ◽  
pp. 475-481 ◽  
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.

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 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 Iodine Status of School Age Children 6-12 Years in Umuahia South LGA of Abia State, Nigeria

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
A.D. Oguizu ◽  
J.O. Nwagwu
Keyword(s):  
Nutrition Education ◽  
Iodine Deficiency ◽  
School Children ◽  
Urinary Iodine ◽  
Food Habit ◽  
Iodized Salt ◽  
School Age Children ◽  
Urinary Iodine Concentration ◽  
School Age ◽  
Iodine Status

Background: Iodine deficiency disorders have continued to be a significant health problem in some Nigerian communities despite universal salt iodization. Objective: This study was designed to assess the iodine status of school age children (6-12 years) in Umuahia South LGA of Abia State, Nigeria. Methods: A total of 414 school children were studied. Urine samples were obtained from 84 school children, 30 males and 54 females. The background and socio-economic information, food habit and dietary intake of the respondents were determined using validated questionnaires. Urinary iodine concentration analysis, using Sandell-Kolthoff reaction was used to determine the iodine status of the children. Chi-square was used to determine the relationship between urinary iodine status of the children and the socio-economic characteristics of their parents. Results: More than half (58.7%) of the children were females while 40.5% were males. About a quarter of the children (40.1%) were 9-10 years, 23.4% were 11-12 years while 36.5% were 6-8 years. Most of the respondents (72.2%) were aware of iodized salt; 14.3% heard about iodized salt from friends, 41.8% heard from the media while 13% heard about iodized salt from the market. Majority of the respondents (94.4%) claimed they consume iodized salt while 4.9% said they use salts that were measured in cups which was not iodized salt. The study revealed that 54.3% of the school children had optimal iodine status while 35.7% had mild iodine deficiency which was higher in males (46.7%) than in females (29.6%). About 5.6% of the respondents had grade 1 goiter. There was a significant association (p< 0.05) between urinary iodine status of the school children and educational status of their fathers’, mothers’, parents’ occupation and income level of fathers. Conclusion: Nutrition education should be aimed at mothers, caregivers, and school children to promote consumption of iodine rich foods.

scholarly journals Prevalence of goiter and iodine status among 6-12 years school age children in district Kohat, Pakistan

2015 ◽  
Vol 4 (2) ◽  
pp. 42-46 ◽  
Author(s):  
Fazli Subhan ◽  
Muhammad Jahangir ◽  
Saira Saira ◽  
Rehman Mehmood Khattak ◽  
Muhammad Shahab ◽  
...  
Keyword(s):  
Iodine Deficiency ◽  
School Children ◽  
Urinary Iodine ◽  
Iodine Content ◽  
Iodine Concentration ◽  
Iodized Salt ◽  
School Age Children ◽  
Urinary Iodine Concentration ◽  
Iodine Status ◽  
Mountainous Regions

Pakistan is considered to be one of the most severely iodine deficient countries in the region. A decade earlier, 70% of the population was estimated to be at risk of iodine deficiency. However, the recent use of iodized salt has reduced the intensity of the problem. Earlier studies regarding iodine deficiency in Pakistan were restricted to the northern mountainous regions, but have now been extended to the sub-Himalaya areas and the plains of Punjab. The aim of the present study was to investigate the prevalence of goiter and iodine status among school children in district Kohat, Pakistan. The 30 cluster approach was adopted for the study. From each cluster, 40 samples were collected from school going children. The palpation method was used to measure goiter grade, whereas, for urinary iodine estimation, the wet digestion method was used. The prevalence of goiter in the district was found to be 35% (37.16% in boys and 33% in girls). The median urinary iodine concentration was found to be 56±31.19?g/L. Estimation of iodine content in salt illustrated that 56.8% people were consuming non-iodized salt and 43.5% were using iodized salt. The current study suggests a severe iodine deficiency in school children of district Kohat and regular iodine supplementation is required on an instant basis.South East Asia Journal of Public Health Vol.4(2) 2014: 42-46

Iodized salt prophylaxis of endemic goiter: an experience in Toscana (Italy)

1993 ◽  
Vol 129 (6) ◽  
pp. 497-500 ◽  
Author(s):  
F Aghini-Lombardi ◽  
A Pinchera ◽  
L Antonangeli ◽  
T Rago ◽  
GF Fenzi ◽  
...  
Keyword(s):  
Iodine Deficiency ◽  
Endemic Goiter ◽  
Urinary Iodine ◽  
Thyroid Volume ◽  
Iodized Salt ◽  
Urinary Iodine Excretion ◽  
Goiter Prevalence ◽  
Iodine Excretion ◽  
Health Organization ◽  
Legislative Measures

It is well established that iodine supplementation is effective in correcting iodine deficiency and reducing goiter prevalence. In Italy, legislation has allowed the production of iodized salt since 1972, but its consumption is on a voluntary basis. In the present study, the efficacy of legislative measures that made compulsory the availability of iodized salt in foodstores has been evaluated. Urinary iodine excretion and thyroid size, scored according to Pan American Health Organization recommendations, were determined prior to (1981) and 10 years after (1991) the introduction of legislative measures in the whole schoolchildren population residing in a restricted area of the Tuscan Appennines. Moreover, in 1991, thyroid volume was determined by ultrasonography. In 1981, mean urinary iodine excretion was 47.1±22.4 mg/kg creatinine (0.412 μmol/l) and goiter prevalence was 60%, indicating a moderate iodine deficiency. Eighty of the families subsequently used iodized salt on a regular basis; as a result of this excellent compliance, in 1991 the mean urinary iodine excretion increased to 129.7±73 mg/kg creatinine (1.24 μmol/l) and goiter prevalence dropped to 8.1%. The results of this study underline the effectiveness of iodine prophylaxis in correcting iodine deficiency and abating endemic goiter in schoolchildren, and suggest that implementation of measures that make compulsory the availability of iodized salt in foodstores overcomes the fact that there is no law governing the exclusive production and trading of iodized salt.

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

2017 ◽  
Vol 39 (1) ◽  
pp. 75-85 ◽  
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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