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

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

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Assessment of iodine status among school age children and pregnant women of Belarus in 2017–2018

Clinical and experimental thyroidology ◽

10.14341/ket9732 ◽

2018 ◽

Vol 14 (3) ◽

pp. 149-155

Author(s):

Tatiana V. Mokhort ◽

Sergei V. Petrenko ◽

Boris Y. Leushev ◽

Ekaterina V. Fedorenko ◽

Natalia D. Kolomiets ◽

...

Keyword(s):

Pregnant Women ◽

Iodine Deficiency ◽

Urinary Iodine ◽

Thyroid Volume ◽

Iodine Concentration ◽

School Age Children ◽

Normative Values ◽

Urinary Iodine Concentration ◽

School Age ◽

Iodine Sufficiency

Background. Despite the measures taken by the Government of Belarus, the problem of iodine deficiency among the population remains actual. Aims. To determine iodine sufficiency in children and pregnant women living in Belarus. Materials and methods. The study included 873 schoolchildren aged 9–12 years of both sexes, of which 650 children were in regular schools, and the remaining children in boarding schools. A separate group consisted of 700 practically healthy pregnant women (during gestation from 16 to 36 weeks). Questioning, determination of urinary iodine concentration and thyroid volume with ultrasound was carried out. Results. Urine iodine median was 191 µg/L in the 873 children in 16 regions of Belarus. Thyroid volume corresponds to the normative values in children. According to the survey, 81% of households used iodized salt, constantly – 46%. Indicator of iodine sufficiency of 700 pregnant women (median urinary iodine concentration was 121 µg /l) is a non-optimal for this population group. Conclusions. Currently adequate iodine supplementation in school age children has been achieved. The prevalence of thyroid gland diseases caused by iodine deficiency in children decreased significantly. In pregnant women iodine supply is still insufficient.

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High Iodine Deficiency among Pregnant Women in Periurban Ghana: A Hospital-Based Longitudinal Study

Journal of Nutrition and Metabolism ◽

10.1155/2018/9706805 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5

Author(s):

David Larbi Simpong ◽

Yaw Asante Awuku ◽

Kenneth Kwame Kye-Amoah ◽

Martin Tangnaa Morna ◽

Prince Adoba ◽

...

Keyword(s):

Longitudinal Study ◽

Pregnant Women ◽

Iodine Deficiency ◽

Urinary Iodine ◽

Clinical Information ◽

Iodine Concentration ◽

Iodized Salt ◽

Urinary Iodine Concentration ◽

Study Cohort ◽

Iodine Sufficiency

Background. Iodine deficiency causes maternal hypothyroidism which can lead to growth, cognitive, and psychomotor deficit in neonates, infants, and children. This study examined the iodine status of pregnant women in a periurban setting in Ghana. Methods. This longitudinal study recruited 125 pregnant women by purposeful convenience sampling from the antenatal clinic of the Sefwi Wiawso municipal hospital in Ghana. Urinary iodine concentration (UIC) was estimated by the ammonium persulfate method at an estimated gestational age (EGA) of 11, 20, and 32 weeks. Demographic information, iodized salt usage, and other clinical information were collected using a questionnaire. Results. The prevalence of iodine deficiency among the pregnant women was 47.2% at EGA 11 and 60.8% at both EGA of 20 and 32, whereas only 0.8% of participants not using iodized salt had iodine sufficiency at EGA 32. 18.4%, 20%, and 24% of participants using iodized salt had iodine sufficiency at EGA 11, 20, and 32, respectively. Conclusion. A high prevalence of iodine deficiency was observed among our study cohort.

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

Food and Nutrition Bulletin ◽

10.1177/0379572117738883 ◽

2017 ◽

Vol 39 (1) ◽

pp. 75-85 ◽

Cited By ~ 2

Author(s):

Fan-Fen Wang ◽

Kam-Tsun Tang ◽

Wen-Harn Pan ◽

Justin Ging-Shing Won ◽

Yao-Te Hsieh ◽

...

Keyword(s):

Age Groups ◽

Urinary Iodine ◽

Iodine Concentration ◽

World Health ◽

Urinary Iodine Concentration ◽

Taiwanese Population ◽

Iodine Nutrition ◽

Iodine Status ◽

Salt Iodization ◽

Health Organization

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

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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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Endemic goitre and excessive iodine in urine and drinking water among Saharawi refugee children

Public Health Nutrition ◽

10.1017/s1368980010000650 ◽

2010 ◽

Vol 13 (9) ◽

pp. 1472-1477 ◽

Cited By ~ 41

Author(s):

Sigrun Henjum ◽

Ingrid Barikmo ◽

Anne Karine Gjerlaug ◽

Abderraháman Mohamed-Lehabib ◽

Arne Oshaug ◽

...

Keyword(s):

Drinking Water ◽

Urinary Iodine ◽

Thyroid Volume ◽

Iodine Concentration ◽

Refugee Children ◽

Urinary Iodine Concentration ◽

Endemic Goitre ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Excessive Iodine

AbstractObjectiveTo assess the prevalence of enlarged thyroid volume (Tvol) in Saharawi refugee children, and their urinary iodine concentration (UIC), and to identify possible sources of excess iodine intake.DesignA cross-sectional survey was performed during January–February 2007. Tvol was measured by ultrasound and iodine concentration was analysed in casual urine samples, in household drinking water and in milk samples from household livestock.SettingThe study was undertaken in four refugee camps in the Algerian desert.SubjectsThe subjects were 421 Saharawi children, 6–14 years old.ResultsEnlarged Tvol was found in 56 % (Tvol-for-age) and 86 % (Tvol-for-body-surface-area) of the children. The median (25th percentile–75th percentile, P25–P75) UIC was 565 (357–887) μg/l. The median (P25–P75) iodine concentration in household drinking water was 108 (77–297) μg/l. None of the children had UIC below 100 μg/l, 16 % had UIC between 100 and 299 μg/l, and 84 % had UIC above 300 μg/l. There was a positive association between Tvol and whether the household possessed livestock.ConclusionsThe children are suffering from endemic goitre and high UIC caused probably by an excessive intake of iodine. The excessive iodine intakes probably originate from drinking water and milk.

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Assessment of the iodine nutritional status among Chinese school-aged children

Endocrine Connections ◽

10.1530/ec-19-0568 ◽

2020 ◽

Vol 9 (5) ◽

pp. 379-386

Author(s):

Ning Yao ◽

Chunbei Zhou ◽

Jun Xie ◽

Xinshu Li ◽

Qianru Zhou ◽

...

Keyword(s):

Nutritional Status ◽

Urinary Iodine ◽

Thyroid Volume ◽

Iodine Content ◽

Iodine Concentration ◽

Iodine Intake ◽

Iodized Salt ◽

Urinary Iodine Concentration ◽

School Aged Children ◽

Goiter Prevalence

Objective The remarkable success of iodine deficiency disorders (IDD) elimination in China has been achieved through a mandatory universal salt iodization (USI) program. The study aims to estimate the relationship between urinary iodine concentration (UIC) and iodine content in edible salt to assess the current iodine nutritional status of school aged children. Methods A total of 5565 students from 26 of 39 districts/counties in Chongqing participated in the study, UIC and iodine content in table salt were measured. Thyroid volumes of 3311 students were examined by ultrasound and goiter prevalence was calculated. Results The overall median UIC of students was 222 μg/L (IQR: 150-313 μg/L). Median UIC was significantly different among groups with non-iodized salt (iodine content <5 mg/kg), inadequately iodized salt (between 5 and 21 mg/kg), adequately iodized (between 21 and 39 mg/kg) and excessively iodized (>39 mg/kg) salt (P < 0.01). The total goiter rate was 1.9% (60/3111) and 6.0% (186/3111) according to Chinese national and WHO reference values, respectively. Thyroid volume and goiter prevalence were not different within the three iodine nutritional status groups (insufficient, adequate and excessive, P > 0.05). Conclusions The efficient implementation of current USI program is able to reduce the goiter prevalence in Chongqing as a low incidence of goiter in school aged children is observed in this study. The widened UIC range of 100–299 μg/L indicating sufficient iodine intake is considered safe with a slim chance of causing goiter or thyroid dysfunction. Further researches were needed to evaluate the applicability of WHO reference in goiter diagnose in Chongqing or identifying more accurate criteria of normal thyroid volume of local students in the future.

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An epidemiological survey of children's iodine nutrition and goitre status in regions with mildly excessive iodine in drinking water in Hebei Province, China

Public Health Nutrition ◽

10.1017/s1368980012000146 ◽

2012 ◽

Vol 15 (7) ◽

pp. 1168-1173 ◽

Cited By ~ 12

Author(s):

Shengmin Lv ◽

Jun Zhao ◽

Dong Xu ◽

Zhengshui Chong ◽

Lihui Jia ◽

...

Keyword(s):

Drinking Water ◽

Urinary Iodine ◽

Thyroid Volume ◽

Iodine Concentration ◽

Hebei Province ◽

Systematic Sampling ◽

Urinary Iodine Concentration ◽

Iodine Nutrition ◽

Excessive Iodine ◽

Salt Iodine

AbstractObjectiveTo identify children's iodine nutrition and goitre status in areas with mildly excessive iodine in drinking water.DesignA cross-sectional survey. Probability proportional to size sampling was employed to randomly select children from thirty townships where the median iodine content in drinking water ranged from 150 to 300 μg/l; their urinary iodine concentrations were determined and their thyroid volumes were measured by ultrasound. Drinking water samples and salt samples from the villages where the children lived were collected using a systematic sampling method.SettingHebei Province of China.SubjectsA total of 1259 children aged 8–10 years (621 boys and 638 girls).ResultsChildren's median urinary iodine concentration was found to be 418·8 μg/l, and the iodine concentration was >300 μg/l for 68·3 % (248/363) of the urine samples. Children's median urinary iodine concentration in villages with median salt iodine >10 mg/kg was significantly higher than that in villages with median salt iodine <5 mg/kg (442·9 μg/l v. 305·4 μg/l, P ≈ 0). The goitre rate of 1259 children examined by ultrasound was 10·96 %.ConclusionsThe iodine intake of children living in areas with mildly excessive iodine in drinking water in Hebei Province was found to be excessive. The measured iodine excess in the sampled children is exacerbated by consumption of iodized salt. Goitre was identified in these areas; however, due to the limitation of the current criteria for children's thyroid volume, a comprehensive assessment of the prevalence of goitre in these regions could not be made and further study is required.

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Iodine nutrition in pregnancy and lactation in Iran

Public Health Nutrition ◽

10.1017/s1368980007360977 ◽

2007 ◽

Vol 10 (12A) ◽

pp. 1596-1599 ◽

Cited By ~ 22

Author(s):

Fereidoun Azizi

Keyword(s):

Pregnant Women ◽

Urinary Iodine ◽

Thyroid Volume ◽

Iodine Concentration ◽

Iodine Intake ◽

Urinary Iodine Excretion ◽

Urinary Iodine Concentration ◽

Lactating Women ◽

Iodine Excretion ◽

Pregnancy And Lactation

AbstractObjective: To describe studies evaluating urinary iodine excretion during pregnancy and lactation in women living in cities with adequate or more than adequate iodine intake.Design: Cross-sectional study conducted between 1996 and 1998 in pregnant women and a study of lactating women conducted in 2003.Settings and Subjects: Pregnant women attending prenatal clinics in four cities in the Islamic Republic of Iran. Urinary iodine excretion and thyroid volume was measured in 403 women. In a second study, 100 lactating women from Taleghani Hospital in Gorgan, Iran were evaluated for thyroid size, and both urinary and breast milk iodine concentrations were determined.Results: In Rasht city, 84% of pregnant women had a urinary iodine concentration of ≥ 200 μg l-1, while in the other cities this percentage ranged from 45 to 55%. When data were combined for the cities of Ilam, Isfahan and Tehran, where women have an adequate or more than adequate median urinary iodine concentration, 51% of pregnant women had a urinary iodine concentration less than that recommended during pregnancy. In Rasht, where the median urinary iodine concentration indicates an excessive iodine intake, 15.4% of pregnant women had a urinary iodine concentration < 200 μg l-1. The mean urinary iodine concentration in lactating women was 250 μg l-1, and 16% of women had a urinary iodine concentration < 100 μg l-1. Grade 1 goitre was present in 8% of lactating women, and another 8% had grade 2 goitre.Conclusions: Findings of this study call for further attention to iodine intake during pregnancy and lactation. The currently recommended intake of iodine through universal salt iodisation may not be adequate for pregnant and lactating women, and supplementation during pregnancy and lactation should be further considered in light of the latest recommendations.

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Iodine concentration and prevalence of thyroid disease in older people after salt iodization in Turkey

Eastern Mediterranean Health Journal ◽

10.26719/2021.27.2.151 ◽

2021 ◽

Vol 27 (2) ◽

pp. 151-158

Author(s):

Volkan Atmis ◽

Buket Bülbül ◽

Remzi Bahşi ◽

Mesut Gümüşsoy ◽

Ahmet Yalçin ◽

...

Keyword(s):

Older People ◽

Thyroid Disease ◽

Demographic Data ◽

Urinary Iodine ◽

Iodine Concentration ◽

Needle Aspiration ◽

Thyroid Stimulating Hormone ◽

Urinary Iodine Concentration ◽

Salt Iodization ◽

Stimulating Hormone

Background: Iodine uptake is a main factor affecting thyroid disease. In Turkey, mandatory salt iodization began in 1999–2000. Aims: This study in 2009 determined the prevalence of thyroid diseases in older people in Mamak district, Ankara after iodization to ascertain if salt iodization alone is sufficient to reach adequate iodine levels in the older population. Methods: All Mamak residents ≥ 65 years were eligible for inclusion in the study. Demographic data and medical history were recorded. All participants had a thyroid ultrasound. Blood samples were taken to assess thyroid function and autoantibodies, and urine samples to assess iodine concentration. Participants with low levels of thyroid stimulating hormone underwent scintigraphy to assess thyroid uptake. Fine-needle aspiration biopsy was done of nodules ≥ 1.5 cm where thyroid stimulating hormone was not suppressed. Results: Of 1200 eligible residents, 979 were included. Their mean age was 70.9 (standard deviation (SD) 5.7) years; 49.7% were women. Mean urinary iodine concentration was 98 (SD 81.29) µg/L. Goitre was found in 18.2% (89/487) of women and 6.7% (33/492) of men (P < 0.001) and 43.8% (428/979) had nodules. Subclinical hypothyroidism was found in 5.8% (57/979) of the participants, overt hyperthyroidism in 0.8% (8/979), subclinical hyperthyroidism in 2.2% (22/979) and T3 thyrotoxicosis in 0.3% (3/979). Toxic multinodular goitre and toxic adenoma caused 80% of hyperthyroidism cases. Biopsy detected no malignant pathology. Conclusion: After salt iodization, iodine levels have not yet reached favourable levels in older people. Iodization of salt seems insufficient to achieve these levels in older people; alternative iodine supplementation should be considered.

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Salt Iodization and Urinary Iodine Concentration Levels among Primary School Children in Mt. Elgon Sub-County, Kenya

Asian Food Science Journal ◽

10.9734/afsj/2021/v20i130249 ◽

2021 ◽

pp. 10-17

Author(s):

Stephen N. Onteri ◽

Anselimo O. Makokha ◽

Beatrice Nyanchama Kiage Mokua ◽

Philip Ndemwa

Keyword(s):

Primary School ◽

School Children ◽

Water Samples ◽

Urinary Iodine ◽

Iodine Concentration ◽

Primary School Children ◽

Urinary Iodine Concentration ◽

Iodine Status ◽

Salt Iodization ◽

The Impact

Aims: Iodine plays a key role in thyroid hormone production and functioning. Inadequate iodine intake results in iodine deficiency (ID) which impairs the normal functioning of the thyroid. The deficiency is responsible for damage to brain development, growth retardation, cretinism, and thyroid dysfunction. Millions of people have been condemned to a life of few prospects and continued underdevelopment due to ID. The study was conducted to assess iodine status among primary school children in the Mt. Elgon region and the impact of salt iodization on this status. Study Design: A school-based cross-sectional descriptive study to assess iodine status among primary school children was employed in the study. Study Area and Duration: The study was carried out in Kenya, Bungoma County, Mount Elgon Sub-County. The study period was between 27th November 2018 and 26th November 2019. Methodology: Healthy primary school children aged 6 to 12 years who met the inclusion criteria were included in the study. Spot urine samples were collected in schools, while water samples were collected from different water sources. Salt was collected from households (HH) and at distribution outlets. The Sandell Kolthoff reaction was used to analyse urine and water samples while salt was analysed using iodometric titration. Results: The median urinary iodine concentration (UIC) was 200.7 µg/l. Out of which 0.55% were severely deficient, 5.25% moderately deficient, 18.23% with a mild deficiency, 25.69% had adequate iodine levels, 22.38% had more than adequate, and 27.90% had excess iodine levels. Household and salt samples from different distribution outlets that conformed to set standards of iodization were 49.4% and 63.64%, respectively. Iodine was not detected in all the water samples collected. Conclusion: The study population was found to have adequate iodine based on the median UIC of 200.7 µg/l. However, there was a coexistence of both deficiency and excessive UIC and salt iodization within the population. No iodine was detected in the water samples in the region.

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