Urinary iodine and thyroglobulin are useful markers in infants suspected of congenital hypothyroidism based on newborn screening

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Makiko Tachibana ◽  
Yoko Miyoshi ◽  
Miho Fukui ◽  
Shinsuke Onuma ◽  
Tomoya Fukuoka ◽  
...  
Keyword(s):  
Newborn Screening ◽  
Congenital Hypothyroidism ◽  
Clinical Course ◽  
Urinary Iodine ◽  
Iodine Status ◽  
Need For Treatment ◽  
Urine Creatinine ◽  
Few Data ◽  
The Relationship ◽  
Serum Tsh

Abstract Objectives Iodine deficiency and excess both cause thyroid dysfunction. Few data describe the relationship between iodine status and outcomes of congenital hypothyroidism (CH) in iodine-sufficient areas. We investigated urinary iodine (UI) concentration and its relationship with the clinical course of CH. Methods We reviewed and retrospectively analyzed patients with positive newborn screening (NBS) for CH from January 2012 to June 2019 in Japan, obtaining UI and UI-urine creatinine ratio (UI/Cr), serum TSH, free T4, free T3 and thyroglobulin (Tg) at the first visit, TSH at NBS, levothyroxine (LT4) dose, and subsequent doses. A UI value of 100–299 μg/L was considered adequate. Results Forty-eight patients were included. Median UI and UI/Cr were 325 μg/L and 3,930 µg/gCr, respectively. UI was high (≥300 μg/L) in 26 (54%) and low (≤99 μg/L) in 11 (23%). LT4 was administered to 34 patients. Iodine status was not related to the need for treatment. We found a U-shaped relationship between Tg and UI/Cr. Patients with high Tg (≥400 ng/mL) and abnormal UI levels required significantly lower LT4 doses (≤20 µg/day) at three years of age. Even if they showed severe hypothyroidism initially, they did not need subsequent dose increments. Conclusions Abnormal UI levels with Tg elevation were associated with lower LT4 dose requirements. The evaluation of iodine status and Tg concentrations were considered useful in patients suspected of CH.

scholarly journals Neonatal Thyroid-Stimulating Hormone Screening as an Indirect Method for the Assessment of Iodine Status in Central Siberia

2018 ◽  
Vol 3 (4) ◽  
Keyword(s):  
Newborn Screening ◽  
Congenital Hypothyroidism ◽  
Iodine Deficiency ◽  
Screening Program ◽  
Thyroid Stimulating Hormone ◽  
The Arctic ◽  
Central Siberia ◽  
Iodine Status ◽  
The Republic ◽  
Stimulating Hormone

Background: Iodine deficiency is associated with goiter and impaired brain function. Neonatal thyroid-stimulating hormone (TSH) screening for congenital hypothyroidism used as an indicator of the degree of iodine deficiency and of its control. An increased frequency of thyroid-stimulating hormone (TSH) measurements above 5 mIU/L in newborn screening corresponds to the impaired iodine status of the population. The aim: to estimate the iodine deficiency and the effectiveness of iodine prophylaxis in Krasnoyarsk territory, Republics of Tuva and Khakassia according the results of neonatal TSH_screening. Methods: An 18-year analysis was performed in 34,980 newborns participating in the national thyroid newborn screening program. The TSH concentration was measured in dry blood spots collected by heel stick on filter paper, 96 hours after birth, using DELFIA method. Results: According to the data of the congenital hypothyroidism screening the rate of TSH < 5 mU/1 was 11.8% in Krasnoyarsk territory (23.9% in 2000) and corresponded to mild iodine deficiency. In different regions of Krasnoyarsk territory the rate of TSH < 5 mU/1 in the newborn varied from 3.5% to 23.7%. The highest values were marked in the Arctic peninsula Taimyr, in cities Zheleznogorsk (nuclear facility) and Sosnovoborsk, in Irbeysky, Suchobuzimsky, Eniseysky, Tuchtetsky, Novoselovsky regions (20.9–23.7%). In the Republic of Khakasia the rate of TSH < 5 mU/1 was 12.5%. In the Republic of Tyva the rate of TSH < 5 mU/1 was – 6.6% (38.6% in 1997; 11.5% in 2000). These results indicate mild iodine deficiency. Conclusion: Our investigations show mild iodine deficiency in Central Siberia demanding continuous adequate iodine prevention. Additional assessment of the iodine intake in the regions with mild iodine deficiency is needed to prevent suboptimal cognitive and psychomotor outcomes.

The Relationship Between Physical Fitness, Urine Iodine Status, and Body-Mass Index in 6- to 7-year-old Polish Children

2011 ◽  
Vol 21 (4) ◽  
pp. 318-327 ◽  
Author(s):  
Sylwia Merkiel ◽  
Wojciech Chalcarz
Keyword(s):  
Body Mass Index ◽  
Physical Fitness ◽  
Body Mass ◽  
Body Height ◽  
Urinary Iodine ◽  
Physical Fitness Test ◽  
Iodine Status ◽  
Fitness Test ◽  
The Relationship ◽  
Urine Iodine

The aim of this study was to assess physical fitness in 6- to 7-yr-old children and determine if there is any relationship between children’s physical fitness, their urine iodine status, and their body-mass index (BMI). The studied population included 121 children from southern Poland. Physical fitness was measured using a physical fitness test for children age 3–7 yr. Urinary iodine concentrations were measured in the children’s first urine output on waking using the modified PAMM (Program Against Micronutrient Malnutrition) method. Body height and weight were measured and BMI was calculated. The subjects were characterized by low physical fitness. Boys obtained better results in agility, power, and strength exercises (p ≤ .05). In girls, 11 correlation coefficients between the scores obtained in the physical fitness test, urinary iodine, and anthropometric measures were statistically significant, and in boys, only 2. BMI correlated positively with agility in girls and with strength in girls and boys. Our study revealed low physical fitness in Polish 6- to 7-yr-old children, which shows the need to implement programs aimed at increasing their physical activity. The relationship found between physical fitness and urine iodine status in girls indicates that future research in this area is needed.

scholarly journals Newborn Iodine Status Is Not Related to Congenital Hypothyroidism

2020 ◽  
Vol 150 (9) ◽  
pp. 2429-2434
Author(s):  
James L Mills ◽  
Elijah C Reische ◽  
Kurunthachalam Kannan ◽  
Chongjing Gao ◽  
Gary M Shaw ◽  
...  
Keyword(s):  
United States ◽  
Newborn Screening ◽  
Congenital Hypothyroidism ◽  
Iodine Deficiency ◽  
Neonatal Intensive Care ◽  
Screening Program ◽  
Iodine Concentration ◽  
The United States ◽  
Dried Blood Spots ◽  
Iodine Status

ABSTRACT Background Severe iodine deficiency or excess during pregnancy can cause congenital hypothyroidism (CH). Iodine deficiency is common in pregnant women in the United States. Objectives We conducted a nested case–control study in a cohort of ∼2.5 million births in California to determine whether iodine status is related to CH in a US population. Methods Dried blood spots from 907 newborns with CH identified by newborn screening and 909 unaffected controls matched by month of birth were obtained from the California Newborn Screening Program to measure whole-blood iodine concentration. Iodine status was compared between cases and controls, and logistic regression was used to assess the association between CH status and blood iodine concentrations. Iodine status was also compared between cases and controls among infants treated in a neonatal intensive care unit (NICU) because CH has been reported in infants exposed to high levels of iodine in the NICU. Results Blood iodine concentrations did not differ significantly between cases (median: 20.0 ng/mL; IQR: 12.1–29.8 ng/mL) and controls (median: 20.3 ng/mL; IQR: 12.5–30.9 ng/mL; P = 0.59). Neither extremely high nor extremely low blood iodine concentrations (1st, 5th, 95th, and 99th percentiles of the distribution) were more common in cases. Among infants treated in NICUs, however, cases had significantly (P = 0.01) higher iodine (median: 22.7 ng/mL; IQR: 16.4–32.1 ng/mL) compared with controls (median: 17.3 ng/mL; IQR: 8.3–26.6 ng/mL). Conclusions CH cases did not have significantly higher or lower iodine in this population, which is reassuring given that maternal iodine deficiency is common in the United States. Among newborns in the NICU, CH cases had higher blood iodine concentrations compared with controls, suggesting that excess iodine exposure in the NICU could be causing CH. It may be beneficial to monitor iodine exposure from surgical procedures, imaging, and iodine-containing disinfectants and to consider non-iodine alternatives.

scholarly journals Newborn screening for congenital hypothyroidism: improvement in short-term follow-up by audit and monitoring

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Hafsa Majid ◽  
Sibtain Ahmed ◽  
Imran Siddiqui ◽  
Khadija Humayun ◽  
Hussain Karimi ◽  
...  
Keyword(s):  
Newborn Screening ◽  
Congenital Hypothyroidism ◽  
Thyroid Stimulating Hormone ◽  
Serum Samples ◽  
Critical Limit ◽  
Laboratory Service ◽  
A Value ◽  
General Paediatrician ◽  
Audit Period ◽  
Serum Tsh

Abstract Objective Newborn screening for congenital hypothyroidism (CH) at our hospital during this study was by measurement of thyroid stimulating hormone (TSH) in serum samples. This audit was conducted over a 2 year period, to determine the compliance of reporting of results greater than the screening cutoffs for serum TSH. Gaps of non-compliance were identified, and re-audit was undertaken after the corrective actions were taken. Results The critical limit was defined as serum TSH (≥ 20 µIU/ml) following consultation with a pediatric endocrinologist. All results above this limit were reported urgently to physicians. During the audit period, 27,407 tests were performed, 0.7% had a value of ≥ 20 µIU/ml, of those only 62% were reported to the general paediatrician or neonatologist. Reasons for not reporting results included non-availability of contact information, lack of policy awareness by technologists, critical results not highlighted on the computer display, and absence of regular monitoring. Corrective measures were taken, and re-audit was done. During the re-audit period, a total of 22,985 tests was performed, 0.6% had a value of ≥ 20 µIU/ml. Of these, 77% were reported to the general paediatrician or neonatologist. Critical result reporting was improved after the audit, and further enhanced the laboratory service of CH screening.

THE RELATIONSHIP BETWEEN SERUM PROTEIN-BOUND IODINE LEVELS AND URINARY IODINE EXCRETION AND SERUM THYROTROPHIN CONCENTRATIONS IN SUBJECTS FROM AN ENDEMIC GOITRE AREA IN CENTRAL JAVA

1978 ◽  
Vol 88 (3) ◽  
pp. 474-481 ◽  
Author(s):  
G. Hennemann ◽  
R. Djokomoeljanto ◽  
R. Docter ◽  
B. M. Goslings ◽  
C. van Hardeveld ◽  
...  
Keyword(s):  
Urinary Excretion ◽  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Serum Levels ◽  
Iodine Intake ◽  
Urinary Iodine Excretion ◽  
Central Java ◽  
Iodine Excretion ◽  
The Relationship ◽  
Serum Tsh

ABSTRACT Urinary 127I excretion, 24 h thyroid 131I uptake and serum values of thyrotrophin (TSH), triiodothyronine (T3) and protein-bound iodine (PBI) were measured in subjects from an area with severe (Segni) and moderate (Londjong) iodine deficiency. In Segni, 90 non-cretinous subjects and 40 cretins were studied. In both sub-groups from Segni non-compensated iodine deficiency was found. Although iodine excretion in these sub-groups was the same (mean: ± sd, 127I μg per g creatinine; non-cretins 16.9 ± 10.1 and cretins 15.2 ± 8.0) thyroid hormone serum levels were less in the cretins probably due to additional primary thyroid failure. In the subjects (non-cretins plus cretins) from Segni a positive relationship (r=0.39, P < 0.001) was found between urinary 127I excretion and serum PBI. Moreover in the same subjects a negative correlation was found between serum PBI and TSH (r=0.43; P < 0.001) while serum T3 did not correlate with TSH. In the Londjong area (mean ± sd 127I urinary excretion: 41.6 ± 18.6 μg per g creatinine) iodine deficiency appeared to be compensated in 52 subjects studied since mean serum levels of TSH, PBI and T3 were within normal range. No correlation between PBI and serum TSH was found. PBI too did not correlate with iodine excretion despite the fact that 37 subjects excreted less than 48 μg 127I per g creatinine below which value iodine excretion varied in all but one of the studied subjects from Segni. It is suggested on the basis of a difference in the average iodine intake between the groups from Segni and Londjong, that lack of "iodine buffer capacity" of the thyroid gland in the Segni subjects leads to a situation where changes in iodine intake are readily reflected in T4 production resulting in the correlation found between PBI and urinary excretion in this group.

scholarly journals Maternal Iodine Status and Thyroid Function during Pregnancy

1970 ◽  
Vol 10 (2) ◽  
pp. 56-59 ◽  
Author(s):  
Tahrim Mehdi ◽  
Md Mozammel Hoque ◽  
Zinnat Ara Nasreen ◽  
Farzana Shirin ◽  
Md Maqsudul Hakim Khan
Keyword(s):  
Thyroid Function ◽  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Thyroid Status ◽  
Iodine Nutrition ◽  
Iodine Status ◽  
Iodine Supplementation ◽  
Iodine Level ◽  
Thyroid Hormone Concentration ◽  
Serum Tsh

Background: Pregnant ladies are most likely to develop relative iodine deficiency during pregnancy to affect thyroid function in our population unless specific dietary care or therapeutic iodine supplementation is taken into account which is yet to be materialized. Methods: In this cohort study sixty uncomplicated normal pregnant women were enrolled in 1st trimester and followed up till delivery. In every trimester maternal iodine status & thyroid status were determined by urinary iodine & serum thyroid hormone concentration respectively. Results: Women progressively become more iodine deficient & tends to be hypothyroid as pregnancy advances. At 3rd trimester of pregnancy maternal Urinary Iodine found to be negatively correlated with their serum TSH. Conclusion: During pregnancy women develop iodine deficiency which adversely affects the thyroid function. So adequate iodine monitoring and iodine nutrition during pregnancy is necessary. Keywords: Urinary iodine level, TSH, FT3, FT4. doi: 10.3329/jom.v10i2.2815 J MEDICINE 2009; 10 : 56-59

Congenital hypothyroidism with delayed rise in serum TSH missed on newborn screening

1995 ◽  
Vol 37 (5) ◽  
pp. 634-637 ◽  
Author(s):  
TADASHI ASAMI ◽  
NAOKO OTABE ◽  
MARIKO WAKABAYASHI ◽  
TOURU KIKUCHI ◽  
MAKOTO UCHIYAMA
Keyword(s):  
Newborn Screening ◽  
Congenital Hypothyroidism ◽  
Serum Tsh

scholarly journals Oral Contraceptive Intake and Iodine Status in Young Women

2021 ◽  
pp. 1-5
Author(s):  
Carola Deischinger ◽  
Doris Deischinger ◽  
Irina Gessl ◽  
Michael Krebs ◽  
Rodrig Marculescu ◽  
...  
Keyword(s):  
Oral Contraceptive ◽  
Young Women ◽  
Urinary Iodine ◽  
Iodine Concentration ◽  
Control Group ◽  
Urinary Iodine Concentration ◽  
Cross Sectional ◽  
Iodine Status ◽  
Spot Urine ◽  
Urine Creatinine

<b><i>Objective:</i></b> Similar to pregnant women, women taking an oral contraceptive (OC) might have elevated iodine requirements due to the altered hormonal state. This is the first study aimed at investigating the prevalence of iodine deficiency and possible influences of OC intake on urine creatinine and iodine levels in young women. <b><i>Methods:</i></b> One hundred fifty-five women between the age of 18 and 35 years (62 taking an OC and 93 controls) participated in a cross-sectional pilot study at the Medical University of Vienna, which included a 1-spot urine sample and a questionnaire on OC intake as well as a food questionnaire. <b><i>Results:</i></b> The median urinary iodine concentration (UIC) in this study was 68 μg/L (41, 111 μg/L) suggesting an inadequate iodine status in the women according to the WHO guidelines. Median UIC (OC: 89 μg/L, IQR 55–120; control: 59 μg/L, IQR 39–91, <i>p</i> = 0.010) and urine creatinine (OC: median = 99.0 μg/L, IQR 74.9–175.5; control: 77.0 μg/L, IQR 49.6–147.2, <i>p</i> = 0.030) levels were significantly higher in OC women than in the control group. UIC corrected for urine creatinine was comparable between both groups. <b><i>Conclusion:</i></b> With similar creatinine-corrected UICs in both groups, OC intake might not have a significant impact on iodine status. However, the low median UIC in a vulnerable group of young women potentially conceiving in the following years points at the necessity of optimizing the iodine intake in the Austrian population and reiterates the insufficiency of the current iodine supplementation measures.

Urinary iodine in second trimester of pregnancy: A cross sectional study in tertiary care hospital of Belagavi

2020 ◽  
Vol 11 (5) ◽  
pp. 93-97
Author(s):  
Bibek Basnet ◽  
Anuradha Patil ◽  
Shridevi Metgud ◽  
Lokjan Singh ◽  
Keshab Parajuli ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Tertiary Care Hospital ◽  
Pearson Correlation ◽  
Tertiary Care ◽  
Urinary Iodine ◽  
Physiological Role ◽  
Care Hospital ◽  
Second Trimester ◽  
Iodine Status ◽  
Serum Tsh

Background: Iodine is a nutritionally important trace element and its deficiency is a common health problem affecting a huge population, particularly pregnant women and children. The physiological role of iodine in the human body is synthesis of thyroid hormones. Thyroxine is approximately 60% iodine by weight. If iodine intake falls below approximately 100μg/day, Thyroid Stimulating Hormone (TSH) secretion is augmented, which increases plasma inorganic iodide clearance. Aims and Objective: To correlate urinary iodine with serum TSH in the second trimester of pregnant women. Material and Methods: One hundred five subjects were included in the study from tertiary care hospital. A random urine sample was collected. Iodine was estimated by ammonium persulfate method and TSH values were collected from the OBG department of the subjects enrolled. Statistics: Pearson correlation coefficient was done. Results: Median UI 138.50 (29.80-350.51) μg/L, median TSH 1.90(0.17-7.46) mIU/L. There was no significant correlation between UI and serum TSH with r = (0.0873, (p = 0.3756). Conclusion: Urinary iodine is a marker for population iodine status. A preferable biomarker is necessary to know the iodine status of individual which include not only nutritional biomarker and also required to organise reference range for TSH.

scholarly journals The Relationship Between Iodine Status and Thyroid Function in Congenital Hypothyroidism With Eutopic Thyroid Gland

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A722-A722
Author(s):  
Yun Jeong Lee ◽  
You Joung Heo ◽  
Yunsoo Choe ◽  
Sang Hee Park ◽  
Jung Min Ko ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Congenital Hypothyroidism ◽  
Discharge Rate ◽  
Thyroid Function Test ◽  
Iodine Concentration ◽  
Estimating Equation ◽  
Iodine Status ◽  
Pathogenic Variants ◽  
Organification Defect ◽  
The Relationship

Abstract Background: We investigated the relationship between iodine status and thyroid function in children with congenital hypothyroidism (CH) with eutopic gland. We also evaluated whether the presence of iodine organification defect (IOD) or pathogenic genetic variants affects the association between iodine status and thyroid function. Methods: A total of 31 children (14 boys) with CH participated in the study, who repeatedly underwent thyroid function test and urine iodine concentration (UIC) without levothyroxine (LT4) medication after 3 years of age (1-5 times per patient). After confirming eutopic gland, IOD was demonstrated by the positive perchlorate discharge test with a discharge rate &gt;10%. Genetic analysis was performed using targeted gene sequencing including 23 genes. Results: We identified likely pathogenic or pathogenic variants in 14 cases (45.2%): 1 case with triallelic (digenic) variants (DUOX2 and TSHR), 4 cases with biallelic variants (3 DUOX2 and 1 TSHR), and 9 cases with monoallelic variants (7 DUOX2, 1 DUOXA2, and 1 TSHR). Among 26 cases treated with LT4 from neonatal period, thyroid function after LT4 discontinuation was euthyroid (n = 7), subclinically hypothyroid (n=15), and overtly hypothyroid requiring LT4 (n = 3). The other 5 cases without LT4 treatment remained subclinical hypothyroid. After excluding 2 cases with TSHR, 29 cases (with 72 samples) were included to analyze the relationship between iodine status and log-transformed TSH (log-TSH) using generalized estimating equation models. The positive IOD (n = 17) was not associated with presence of DUOX2/DUOXA2 variants (n = 12). Iodine status of urine samples was categorized into adequate (UIC &lt; 300 μg/L, n = 25), mild excessive (UIC = 300-599 μg/L, n = 14), and severe excessive (UIC ≥ 600 μg/L, n = 33) groups. When stratified by the presence of IOD, log-TSH significantly increased in severe excessive group (β = 0.52, P = 0.014 vs. iodine adequate group) among negative IOD group, but rather decreased in mild excessive group (β = -0.84, P &lt; 0.001 vs. iodine adequate group) among positive IOD group. Meanwhile, when stratified by the presence of DUOX2/DUOXA2 variants, no significant association was found between iodine status and log-TSH levels. Conclusion:DUOX2 mutation was most common in CH patients with eutopic gland. The relationship of iodine status with thyroid function differed by presence of IOD.

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