Frequency of Goiter and Urine Iodine Deficiency in 7-12 Years Old Students of Rafsanjan: 2018-2019: A Descriptive Study

OBJECTIVE: Iodine deficiency was the likely cause of a high prevalence of goitre previously in Sri Lankan schoolchildren. Salt iodination was made compulsory in 1993 but there has been no recent study, using modern techniques, of its benefits or harmful effects. METHODS: Three hundred and sixty-seven schoolgirls between the ages of 11 and 16 years had ultrasound thyroid volume, free thyroxine (T4), free tri-iodothyronine (T3), thyrotrophin (TSH), anti-thyroglobulin (TgAb) and thyroid peroxidase (TPOAb) antibodies, and urine iodine concentrations measured. RESULTS: Median ultrasound thyroid volume ranged from 4.8 ml (11-year-old girls) to 8.6 ml (16-year-old girls) with an age-related increase. Median urine iodine concentrations ranged from 105 to 152 microg/l. Free T4 and free T3 were normal in all, but TSH was elevated in four subjects (5. 53-41.29 mU/l). However, the prevalence of TgAb was markedly raised, ranging between 14.3% (11-year-old girls) and 69.7% (16-year-old girls) (P<0.03). In contrast, the prevalence of TPOAb was 10% or less in all age groups. CONCLUSIONS: Normal median thyroid volumes, iodine concentrations and thyroid function would indicate that iodine deficiency is not a major problem in this group. The high prevalence of TgAb, hitherto unreported, most likely reflects excessive iodination of Tg resulting in increased immunogenicity. There is an urgent need to continuously monitor the adequacy and risks of iodination in this population.

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Prevalence of iodine deficiency among pregnant women in Gwembe and Sinazongwe districts of Southern Province, Zambia: a cross-sectional study

BMC Nutrition ◽

10.1186/s40795-020-00397-w ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Trevor Kaile ◽

Bornwell Sikateyo ◽

Masauso M. Phiri ◽

Charles Michelo

Keyword(s):

Pregnant Women ◽

Iodine Deficiency ◽

Iodine Concentration ◽

Cross Sectional Study ◽

Iodine Intake ◽

Health Concern ◽

Cross Sectional ◽

Southern Province ◽

Food And Nutrition ◽

Urine Iodine

Abstract Background Maternal iodine deficiency is one of the common causes of morbidity and mortality during pregnancy. Maternal iodine deficiency during pregnancy is associated with a number of adverse outcomes such as abortion, stillbirth, congenital anomalies, perinatal mortality and irreversible mental retardation. A study conducted in Zambia among pregnant women in 2013 on the prevalence of iodine deficiency showed that iodine deficiency was not a public health concern. The previous study used Urine Iodine concentration (UIC) as a marker of iodine deficiency among the pregnant women. Our study was conducted to assess the prevalence of iodine deficiency among pregnant women in Gwembe and Sinazongwe districts of Southern Province, Zambia, using urine iodine concentration and goitre presence by manual palpation. Methods We carried out a community based, cross sectional study in rural areas of Gwembe and Sinazongwe districts between April 2016 to March 2018. Data were collected from 412 pregnant women by a multistage cluster sampling technique. The presence of a goitre was examined by manual palpation and urinary iodine concentration was determined by the Ultra Violet Method using PerkinElmer Labda UV Spectrometer equipment made in Jena Germany (Model 107,745). As part of the existing baseline data, we used results of a 2013 countrywide study (n = 489) for household salt iodine content which showed a greater than 40 ppm at 76.2%, between 15 and 40 ppm at 19.21% and less than 15 ppm at 4.59%. Statistical analysis was done using Stata version 14.0. The outputs of analysis are presented as median and Interquartile range (IQR) as the urine data were not normally distributed. Further, the categorical and independent variables were presented as proportions (percentages) to describe the distribution and trends in the target sample population. Results The median Urine Iodine concentration (UIC) of the pregnant women was 150 μg/L (Interquartile Range (IQR): 100–200 μg/L). Based on the UIC, There were 49% pregnant women who had inadequate iodine intake with urine iodine concentration of less than 150 μg/L, 34.0% had UIC of 150–249 μg/L indicating adequate iodine intake, 13.0% with UIC of 250–499 μg/L indicating more than adequate iodine intake, and 5.0% with UIC of above 500 μg/L indicating excessive iodine intake. To determine whether the women had access to iodized salt, we used baseline data from 2013 Zambia national survey for iodine concentration in household salt samples as being an average of 40 ppm, which also showed that 95.41% households consumed adequately iodized salt (≥15 ppm). The prevalence of goitre in our study was very low at 0.02% among the pregnant women of all ages who participated in the study (18–49 years). Conclusion Iodine deficiency was still not a public health concern among the pregnant women of Gwembe and Sinazongwe districts of Southern Province in Zambia. Goitre prevalence has remained very low in this study area. The UIC and goitre observations were consistent with the Zambia National Food and Nutrition Commission findings in 2013 report. However, our study showed more pregnant women with insufficient than adequate iodine status indicating the risk of developing IDD is still high in this region. It also reinforces the argument that strengthening of the existing salt iodization program is needed in order to make a homogenous iodated salt available to the communities. The National Food and Nutrition Commission of Zambia needs to find innovative ways of sensitizing people about the adverse effects of IDDs and how these could be prevented. It is recommended that iodine supplementation be introduced as part of the package of Antenatal clinic care for all pregnant women.

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Influence of Iodized Eggs on Urine Iodine Excretion of Iodine Deficiency Patients

Media Gizi Mikro Indonesia ◽

10.22435/mgmi.v8i1.7683.17-26 ◽

2017 ◽

Vol 8 (1) ◽

Author(s):

Kasmawati Kasmawati ◽

Veni Hadju ◽

Saifuddin Sirajudin

Keyword(s):

Iodine Deficiency ◽

Iodine Excretion ◽

Urine Iodine

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Insufficient Iodine Level in Urine among Children of a Secondary School: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.6084 ◽

2021 ◽

Vol 59 (242) ◽

pp. 890-893

Author(s):

Anand Ballabh Joshi ◽

Megha Raj Banjara ◽

Chitra Kumar Gurung ◽

Vivek Kumar Singh ◽

Krishna Pant ◽

...

Keyword(s):

Secondary School ◽

Confidence Interval ◽

Iodine Deficiency ◽

School Children ◽

Cross Sectional Study ◽

Sectional Study ◽

Iodine Deficiency Disorders ◽

Cross Sectional ◽

Iodine Level ◽

Urine Iodine

Introduction: Iodine deficiency disorders are common endocrinopathies in Nepal. Children are at risk for iodine deficiency disorders. Irreversible mental retardation and brain damage in children are the devastating disorders lead by iodine deficiency. Therefore, the main objective of the study was to find out the prevalence of insufficient iodine level among the children of a secondary school. Methods: This descriptive cross-sectional study was conducted in urine from April 2019 to July 2019 after obtaining ethical approval from Nepal Health Research Council (Registration number: 802/2018). Forty-six urine samples were collected from school children for iodine estimation. Convenience sampling was done. Data were entered into Statistical Package for the Social Science version 21 and descriptive analyses were done. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: Among the 46 students, majority 36 (78.30%) (95% Confidence Interval= 66.30-90.21) of the school children had insufficient urine iodine level. Among 36 salt samples collected from school children with low urine iodine level, 8 (22.2%) salt samples had iodine less than 15ppm. Conclusions: Iodine estimation revealed a very high percentage of urine samples containing insufficient levels of iodine is similar as compared to studies done in similar settings. Hence, the school children were at risk of iodine deficiency disorders. Iodine deficiency disorders prevention programs should be priority intervention based on available evidence.

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Longitudinal trends in thyroid function in relation to iodine intake: ongoing changes of thyroid function despite adequate current iodine status

Acta Endocrinologica ◽

10.1530/eje-13-0589 ◽

2014 ◽

Vol 170 (1) ◽

pp. 49-54 ◽

Cited By ~ 15

Author(s):

Annenienke C van de Ven ◽

Romana T Netea-Maier ◽

H Alec Ross ◽

Teun A E van Herwaarden ◽

Suzanne Holewijn ◽

...

Keyword(s):

Thyroid Function ◽

Iodine Deficiency ◽

Urinary Iodine ◽

Iodine Intake ◽

Thyroid Peroxidase ◽

Urinary Iodine Concentration ◽

Creatinine Concentration ◽

Iodine Status ◽

The Past ◽

Urine Iodine

ObjectiveSeveral cross-sectional studies on populations with iodine deficiency showed that TSH-levels are negatively associated with age, while in populations with high iodine intake TSH is positively associated with age. The question is whether such an age-thyroid function relation is an ongoing process apparent also in longitudinal studies and whether it reflects an actual iodine deficiency or an iodine insufficiency in the past.MethodsIn an area with a borderline iodine status in the past, we studied 980 participants of the Nijmegen Biomedical Study. We measured serum TSH, free thyroxine (FT4), total triiodothyronine (T3), peroxidase antibodies, and the urine iodine and creatinine concentration 4 years after our initial survey of thyroid function, in which we reported a negative association between TSH and age.ResultsWithin 4 years, TSH decreased by 5.4% (95% CI 2.5–8.3%) and FT4increased by 3.7% (95% CI 2.9–4.6%). Median urinary iodine concentration was 130 μg/l. Estimated 24-h iodine excretion was not associated with TSH, T3, change of TSH, or FT4over time or with the presence of antibodies against thyroid peroxidase. Only FT4appeared to be somewhat higher at lower urine iodine levels: a 1.01% (95% CI 0.17–1.84%) higher FT4for each lower iodine quintile.ConclusionsIn this longitudinal study, we found an ongoing decrease in TSH and increase in FT4in a previously iodine insufficient population, despite the adequate iodine status at present. This suggests that low iodine intake at young age leads to thyroid autonomy (and a tendency to hyperthyroidism) that persists despite normal iodine intake later in life.

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The Urine Iodine to Creatinine as an Optimal Index of Iodine During Pregnancy in an Iodine Adequate Area in China

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2015-3519 ◽

2016 ◽

Vol 101 (3) ◽

pp. 1290-1298 ◽

Cited By ~ 34

Author(s):

Chenyan Li ◽

Shiqiao Peng ◽

Xiaomei Zhang ◽

Xiaochen Xie ◽

Danyang Wang ◽

...

Keyword(s):

Receiver Operating Characteristic Curve ◽

Pregnant Women ◽

Receiver Operating Characteristic ◽

Iodine Deficiency ◽

Operating Characteristic ◽

Characteristic Curve ◽

Iodine Intake ◽

Excessive Iodine ◽

Operating Characteristic Curve ◽

Urine Iodine

Abstract Context: Iodine nutrition is a global event, especially for pregnant women. Objective: To develop applicable index of iodine intake for population during pregnancy. Design, Setting, and Participants: From 2012 to 2014, pregnant women at less than 8 weeks of gestation (n = 222) and reproductive-age women (n = 827) participated in this study. The pregnant women were evaluated at follow-up visits at 8, 12, 16, 20, 28, and 36 weeks of gestation and 3 and 6 months postpartum. Main Outcome Measures: Twenty-four-hour urine samples were collected at weeks 8 of gestation. Urine iodine (UI) and creatinine (Cr) and serum thyroglobulin were measured in all of the subjects. Circulatory iodine was measured using inductively coupled plasma-mass spectrometry at 8, 20, and 36 weeks of gestation and 6 months postpartum. Results: The median UI concentration decreased from 183.6 to 104.2 μg/L during pregnancy. The serum iodine (SI) changes were similar to the UI to creatinine ratio (UI/Cr). The SI level was lowest at the eighth week of gestation (60.5 μg/L), which rose significantly until 20 weeks (106.5 μg/L) and then began to decline (36 wk, 84.7 μg/L). The 24-hour UI excretion measurement was regarded as the gold standard. The area under the receiver-operating characteristic curve for UI/Cr was 0.92 for iodine deficiency diagnoses and 0.78 for SI. The area for SI was 0.82 for excessive iodine diagnoses and 0.75 for UI/Cr. The areas under these curves were significantly different (P < .001). The areas under the receiver-operating characteristic curve for UI were 0.61 (P = .11) and 0.65 (P = .08) for iodine deficiency and excessive iodine diagnoses, respectively. Additionally, for thyroglobulin, these values were 0.54 (P = .53) and 0.53 (P = .74), respectively. Conclusions: Iodine intake, as assessed by spot UI concentration in pregnant women, is inaccurate and increases the prevalence of iodine deficiency. The UI/Cr better reflects the 24-hour iodine excretion and circulating iodine levels during pregnancy and the postpartum period.

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Risk of Iodine Deficiency in Extremely Low Gestational Age Newborns on Parenteral Nutrition

Nutrients ◽

10.3390/nu12061636 ◽

2020 ◽

Vol 12 (6) ◽

pp. 1636

Author(s):

Neelakanta Kanike ◽

Sharon Groh-Wargo ◽

Megan Thomas ◽

Edward K. Chien ◽

Maroun Mhanna ◽

...

Keyword(s):

Parenteral Nutrition ◽

Pregnant Women ◽

Iodine Deficiency ◽

Gestational Age ◽

Critical Role ◽

Thyroid Function Tests ◽

Free T4 ◽

Iodine Supplementation ◽

Urine Iodine ◽

Extremely Low Gestational Age

Iodine is an essential component of thyroid hormones, which play a critical role in neurodevelopment. The iodine status of pregnant women and their newborns is not checked routinely. Extremely Low Gestational Age Newborns do not receive Iodine supplementation while on parenteral nutrition (PN). We measured urine iodine levels and thyroid function tests in 50 mother–infant dyads at birth, at 1 week, 1, 2, 3 months and near discharge. We correlated maternal and neonatal urine iodine levels with thyroid functions and measured iodine levels in milk and PN. In our study, 64% of mothers were iodine deficient at the time of delivery, their free T4 levels were 0.48 (0.41–0.54) ng/dL with normal thyroid-stimulating hormone (TSH). Iodine levels were thirty-fold higher in extremely low gestational age newborns (ELGAN) exposed to iodine comparing to full terms (p < 0.001), but this effect lasted <1 week. At 1 month of age, ELGAN on PN developed iodine deficiency (p = 0.017) and had high thyroglobulin levels of 187 (156–271) ng/mL. Iodine levels improved with enteral feeds by 2 months of age (p = 0.01). Iodine deficiency is prevalent among pregnant women and ELGAN; in particular, those on PN are at risk of hypothyroidism. Iodine supplementation during pregnancy and postnatally should be considered to avoid iodine deficiency.

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