Hypothyroidism due to biallelic variants in IYD: description of 4 families and a novel variant.

Biallelic loss-of-function variants in the IYD gene cause hypothyroidism resulting from iodine wasting. We describe 8 patients (from 4 families in which the parents are first cousins) who are homozygous for a variant in IYD (including a novel missense deleterious variant, c.791C>T [P264L], in 1 family). Seven patients presented between 5 and 16 years of age with a large goiter, overt hypothyroidism, and a high serum thyroglobulin. The goiter subsided with levothyroxine therapy in most. Upon stopping levothyroxine in 5 patients, goiter and hypothyroidism reappeared in 3. In these 3 patients, a rising serum thyroglobulin concentration preceded hypothyroidism and goiter and urinary iodine excretion was low. In patients who remained euthyroid, urinary iodine was normal. In conclusion, these patients bearing biallelic pathogenic variants in IYD developed a large goiter, a high serum thyroglobulin, and overt hypothyroidism when their iodine intake was low.

Salt Reduction and Iodine Fortification Policies Are Compatible: Perspectives for Public Health Advocacy.

Cardiovascular diseases account for almost 18 million deaths annually, the most of all non-communicable diseases. The reduction of dietary salt consumption is a modifiable risk factor. The WHO recommends a daily sodium intake of <2000 mg but average consumption exceeds this in many countries globally. Strategies proposed to aid effective salt reduction policy include product reformulation, front of pack labelling, behavioural change campaigns and establishing a low-sodium-supportive environment. Yet, salt for household and processed food use is, in countries wholly or partially adopting a universal salt iodisation policy, the principal vehicle for population-wide iodine fortification. With salt reduction policies in place, there is concern that iodine deficiency disorders may re-emerge. Recognising the urgency to tackle the rising prevalence of NCDs yet not risk the re-emergence and detrimental effect of inadequate iodine intakes, this review lays out the feasibility of integrating both salt reduction and salt iodine fortification strategies. Reducing the burden of health risks associated with an excessive sodium intake or inadequate iodine through population-tailored, cost-effective strategies involving salt is both feasible and achievable, and represents an opportunity to improve outcomes in public health.

Iodine and other factors associated with fertility outcome following oil-soluble contrast medium hysterosalpingography: a prospective cohort study.

Objective: To examine factors associated with fertility following hysterosalpingography (HSG) using an oil-soluble contrast medium (OSCM). Design: In a prospective cohort study on 196 women undergoing OSCM HSG, we showed that iodine excess was almost universal (98%) and mild subclinical hypothyroidism was frequent (38%). Here, we report the analyses of secondary outcomes examining factors associated with the likelihood of pregnancy following the HSG. Setting: Auckland, New Zealand (2019-2021). Sample: 196 women with primary or secondary infertility who underwent OSCM HSG. Methods: Baseline and serial urine iodine concentrations (UIC) and thyroid function tests were measured over six months following the HSG. Pregnancy and treatment with levothyroxine during the study period were documented. Results: Following OSCM HSG, pregnancy rates were 49% in women aged <40 years (77/158) but considerably lower (16%) among those ≥40 years (6/38). Similarly, live birth rates were markedly lower in women ≥40 years (17%; 1/6) versus <40 years (73%; 56/77). 29% of participants were iodine deficient at baseline despite advice recommending iodine fortification. Following HSG, the likelihood of pregnancy in women with moderate iodine deficiency was 64% higher than in women with normal iodine levels (p=0.048). Among women aged <40 years who had subclinical hypothyroidism (n=75), levothyroxine treatment was associated with higher pregnancy rates compared to untreated women [63% (26/48) vs 37% (10/27), respectively; p=0.047]. Conclusion: OSCM HSG was associated with higher pregnancy rates in women ≤40 than in those aged >40 years. Iodine deficiency was relatively common in this cohort, and increased iodine levels from OSCM exposure may contribute to the improved fertility observed with this procedure. Trial registration: This study is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR: 12620000738921) https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12620000738921.

Dietary Iodine Intake and Sources among Residents in Zhejiang Province 10 Years after Reducing Iodine Concentration in Iodized Salt.

We aimed to assess dietary iodine intake and sources in Zhejiang Province a decade after a reduction in iodine concentration in iodized salt. Three-day 24 h dietary recall and household weighing were used, complemented by "Chinese Food Composition" data. Household water and salt samples were collected from 5890 residents and analyzed. Differences in iodized salt consumption rates were observed across the following regions: inland (84.20%), subcoastal (67.80%), and coastal (37.00%) areas. The median (P25, P75) iodine concentration in water and diet were 2.2 (0.9, 4.0) µg/L and 142.05 (58.94, 237.11) µg/d, respectively, with significant regional differences in dietary concentration (inland [185.61 µg/d], subcoastal [153.42 µg/d], and coastal [75.66 µg/d]). Males (149.99 µg/d) and iodized salt consumers (191.98 µg/d) had a significantly higher dietary iodine intake than their counterparts. Regions were ranked as follows based on the proportions of individuals meeting the recommended dietary iodine intake: inland (69.40%), subcoastal (56.50%), and coastal (34.10%) areas. Dietary sources included salt (48.54%), other foods (32.06%), drinking water (8.84%), laver (4.82%), kelp (3.02%), and other seafood (2.32%). The qualified iodized salt consumption rate was significantly lower than the national standard. Zhejiang Province should continue implementing measures to control iodine deficiency through salt iodization, education efforts, and increasing the qualified iodized salt consumption rate.

Exploring the potential of genetic analysis in historical blood spots for patients with iodine-deficient goiter and thyroid carcinomas in Switzerland and Germany (1929-1989).

Iodine deficiency-induced goiter continues to be a global public health concern, with varying manifestations based on geography, patient's age, and sex. To gain insights into clinical occurrences, a retrospective study analyzed medical records from patients with iodine deficiency-induced goiter or thyroid cancer who underwent surgery at the Community Hospital in Riehen, Switzerland, between 1929 and 1989. Despite today's adequate iodine supplementation, a significant risk for iodine-independent goiter remains in Switzerland, suggesting that genetic factors, among others, might be involved. Thus, a pilot study exploring the feasibility of genetic analysis of blood spots from these medical records was conducted to investigate and enhance the understanding of goiter development, potentially identify genetic variations, and explore the influence of dietary habits and other environmental stimuli on the disease.Blood prints from goiter patients' enlarged organs were collected per decade from medical records. These prints had been made by pressing, drawing, or tracing (i.e., pressed and drawn) the removed organs onto paper sheets. DNA analysis revealed that its yields varied more between the prints than between years. A considerable proportion of the samples exhibited substantial DNA degradation unrelated to sample collection time and DNA mixtures of different contributors. Thus, each goiter imprint must be individually evaluated and cannot be used to predict the success rate of genetic analysis in general. Collecting a large sample or the entire blood ablation for genetic analysis is recommended to mitigate potential insufficient DNA quantities. Researchers should also consider degradation and external biological compounds' impact on the genetic analysis of interest, with the dominant contributor anticipated to originate from the patient's blood.

Iodine Status of Infants and Toddlers under 2 Years of Age and Its Association with Feeding Behaviors and Maternal Iodine Status in Shanghai: A Quantile Regression Analysis.

It is crucial to provide adequate iodine nutrition to infants and toddlers for proper thyroid function and subsequent brain development. Infants are particularly vulnerable to iodine deficiency during the transition from a milk-based diet (breast milk and/or infant formula) to solid food. This study examines the current iodine levels of children during their first two years of life and investigates the association between these levels and feeding behaviors and the iodine status of their mothers in Shanghai, a city located in eastern China. A hospital-based cohort study was conducted to enroll mother-child pairs, where the child is aged 6-23 months, who visited community health service centers in the 16 districts of Shanghai, China. Data on socio-demographic factors and feeding behavior data were collected from the participants. The urinary iodine concentration (UIC) in both the young children and their mothers were analyzed. A total of 2282 mother-child pairs were included in this analysis. The median (p25-p75) UIC for lactating women, weaning women, and children were 121.3 µg/L (68.1-206.4 µg/L), 123.4 µg/L (58.4-227.2 µg/L), and 152.1 µg/L (75.8-268.3 µg/L), respectively. The UIC in children was found to be higher than that in their mothers (p < 0.001). Children who consumed less than 500 mL per day of formula milk in the last week had lower UICs compared with those who consumed 500 mL per day or more (p = 0.026). Furthermore, the children's UIC was positively correlated with the maternal UIC (rs = 0.285, p < 0.001). Multiple quantile regression analysis revealed a statistically significant positive association between maternal UIC and children's UIC between the 0.1 and 0.9 quantiles (all p < 0.001). We found that the iodine status of infants and toddlers, as well as of mothers, was sufficient. However, a large minority of children and mothers may be at risk of iodine deficiency. Furthermore, no associations between children's UIC and feeding behaviors were observed. Moreover, there was a positive correlation between the UIC of young children and their mothers.

Maternal nutrition and its effects on fetal neurodevelopment.

Herein, we present a thorough examination of the impact of maternal nutrition on fetal and infant neurodevelopment, focusing on specific nutrients and their critical roles in perinatal and pediatric health. Through a comprehensive narrative review of the literature, this study highlights the importance of a balanced maternal diet rich in nutrients like eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), folic acid, iron, and iodine in shaping children's neurological functions. Key findings underscore the influence of maternal nutrition during pregnancy and the peri-gestational period on children's cognitive, motor, speech, and socio-emotional development. Deficiencies in essential nutrients, such as DHA, are linked to adverse long-lasting outcomes such as premature birth and intrauterine growth restriction, where a suitable intake of iron and folic acid is vital to prevent neural tube defects and promote healthy brain development. We highlight areas requiring further investigation, particularly regarding iodine's impact and the risks associated with alcohol consumption during pregnancy. In conclusion, this research sheds light on our current understanding of maternal nutrition and child neurodevelopment, offering valuable insights for health professionals and researchers.

Elevated thyroid manganese reduces thyroid iodine to induce hypothyroidism in mice, but not rats, lacking SLC30A10 transporter.

Elevated manganese (Mn) accumulates in the brain and induces neurotoxicity. SLC30A10 is an Mn efflux transporter that controls body Mn levels. We previously reported that full-body Slc30a10 knockout mice (1) recapitulate the body Mn retention phenotype of humans with loss-of-function SLC30A10 mutations and (2) unexpectedly develop hypothyroidism induced by Mn accumulation in the thyroid, which reduces intra-thyroid thyroxine. Subsequent analyses of National Health and Nutrition Examination Survey data identified an association between serum Mn and subclinical thyroid changes. The emergence of thyroid deficits as a feature of Mn toxicity suggests that changes in thyroid function may be an underappreciated, but critical, modulator of Mn-induced disease. To better understand the relationship between thyroid function and Mn toxicity, here we further defined the mechanism of Mn-induced hypothyroidism using mouse and rat models. Slc30a10 knockout mice exhibited a profound deficit in thyroid iodine levels that occurred contemporaneously with increases in thyroid Mn levels and preceded the onset of overt hypothyroidism. Wild-type Mn-exposed mice also exhibited increased thyroid Mn levels, an inverse correlation between thyroid Mn and iodine levels, and subclinical hypothyroidism. In contrast, thyroid iodine levels were unaltered in newly generated Slc30a10 knockout rats despite an increase in thyroid Mn levels, and the knockout rats were euthyroid. Thus, Mn-induced thyroid dysfunction in genetic or Mn exposure-induced mouse models occurs due to a reduction in thyroid iodine subsequent to an increase in thyroid Mn levels. Moreover, rat and mouse thyroids have differential sensitivities to Mn, which may impact the manifestations of Mn-induced disease in these routinely used animal models.

Prevalence of iodine deficiency and associated factors among school-age children in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Currently, iodine deficiency has become a significant burden globally; where 2 billion people and 29.8% of school-age children are iodine deficient. It is a leading cause of preventable brain damage among children, resulting in impaired cognitive and motor development. Even though salt iodization was started to be implemented to alleviate this burden in Ethiopia, primary studies assessing iodine deficiency in the country show highly variable findings, and no systematic review was conducted to determine the pooled prevalence of the problem which makes it difficult to assess the effect of the intervention as well as to design appropriate and timely measures. Therefore, this systematic review and meta-analysis aimed to determine the pooled prevalence of iodine deficiency and the common factors affecting its occurrence among school-age children in Ethiopia. METHOD: To obtain the eligible studies, databases (EMBASE, Scopus, Hinari, and PubMed), websites (Google and Google Scholar), and references of the eligible studies were searched systematically. Data were extracted using an Excel spreadsheet and analyzed using the STATA 17 version. The I2 test was used to assess heterogeneity between the studies. A DerSimonian and Laird random-effects model was used to estimate the pooled prevalence and pooled odds ratio. A funnel plot and Egger's test were used to detect publication bias. RESULT: A total of 15 eligible studies, representing 15,611 school-age children, were included in the systematic review and meta-analysis. The pooled prevalence of iodine deficiency among school-age children in Ethiopia was found to be 58% (95%CI 44.00-77.00), while the highest prevalence was recorded in the Oromia Region, which was 64% (95% CI 49-79). Goitrogenic food consumption (adjusted odds ratio (AOR) 2.93, 95% CI 1.60-5.35) and being female (adjusted odds ratio (AOR) 1.87, 95% CI 1.43-2.44) showed a significant association with the prevalence of iodine deficiency. CONCLUSION: Iodine deficiency among school-age children in Ethiopia was noticeably high. Goitrogenic food consumption and the sex of the child were determinant factors for the occurrence of iodine deficiency among the children. Therefore, appropriate advice should be given to households to limit goitrogenic foods in the diet of their children by giving due attention to their female children.

Pregnant women at risk for iodine deficiency but adequate iodine intake in school-aged children of Zhejiang Province, China.

The median urinary iodine concentration (UIC) of school-aged children has been commonly used as a surrogate to assess iodine status of a population including pregnant women. However, pregnant women have higher iodine requirements than children due to increased production of thyroid hormones. The aim of the study was to evaluate the iodine status of pregnant women and children as well as their household salt iodine concentration (SIC) in Quzhou, Zhejiang Province, China. Eligible pregnant women and children from all six counties of Quzhou in 2021 were recruited into the study. They were asked to complete a socio-demographic questionnaire and provide both a spot urine and a household table salt sample for the determination of UIC and SIC. A total of 629 pregnant women (mean age and gestation weeks of 29.6 years and 21.6 weeks, respectively) and 1273 school-aged children (mean age of 9 years and 49.8% of them were females) were included in the study. The overall median UIC of pregnant women and children in our sample was 127 (82, 193) µg/L and 222 (147, 327) µg/L, respectively, indicating sufficient iodine status in children but a risk of mild-to-moderate iodine deficiency in pregnant women. Distribution of iodine nutrition in children varied significantly according to their sex and age (P < 0.05). The rate of adequately household iodised salt samples (18-33 mg/kg) provided by pregnant women and children was 92.4% and 90.6%, respectively. In conclusion, our results indicated a risk of insufficient iodine status in pregnant population of China, but iodine sufficiency in school-aged children. Our data also suggested that median UIC of children may not be used as a surrogate to assess iodine status in pregnant women.

Effect of multiple micronutrient-fortified bouillon on micronutrient status among women and children in the Northern Region of Ghana: Protocol for the Condiment Micronutrient Innovation Trial (CoMIT), a community-based randomized controlled trial.

INTRODUCTION: Micronutrient deficiencies are prevalent in West Africa, particularly among women of reproductive age (WRA) and young children. Bouillon is a promising food fortification vehicle due to its widespread consumption. This study aims to evaluate the impact of multiple micronutrient-fortified bouillon cubes, compared to control bouillon cubes (fortified with iodine only), on micronutrient status and hemoglobin concentrations among lactating and non-lactating WRA and young children in northern Ghana. METHODS: This randomized, controlled doubly-masked trial will be conducted in the Kumbungu and Tolon districts in the Northern Region of Ghana, where prior data indicate multiple micronutrient deficiencies are common. Participants will be: 1) non-pregnant non-lactating WRA (15-49 y), 2) children 2-5 y, and 3) non-pregnant lactating women 4-18 months postpartum. Eligible participants will be randomly assigned to receive household rations of one of two types of bouillon cubes: 1) a multiple micronutrient-fortified bouillon cube containing vitamin A, folic acid, vitamin B12, iron, zinc, and iodine, or 2) a control cube containing iodine only. Each participant's household will receive a ration of bouillon cubes every 2 weeks, and households will be advised to prepare meals as usual, using the study-provided cubes. The trial duration will be 9 months for non-pregnant non-lactating WRA and children, and 3 months for lactating women. The primary outcomes will be changes in biomarkers of micronutrient status and hemoglobin among WRA and children and milk micronutrient concentrations among lactating women. Secondary outcomes will include change in prevalence of micronutrient deficiency and anemia; dietary intake of bouillon and micronutrients; inflammation, malaria, and morbidity symptoms; and child growth and development. DISCUSSION: Evidence from this study will inform discussions about bouillon fortification in Ghana and West Africa. TRIAL REGISTRATION: The trial was registered on ClinicalTrials.gov (NCT05178407) and the Pan-African Clinical Trial Registry (PACTR202206868437931). This manuscript reflects protocol version 4 (August 29, 2022).

Thyroid function and iodine intake: global recommendations and relevant dietary trends.

Iodine is a micronutrient that is essential for thyroid hormone production. Adequate iodine intake is especially important during pregnancy and early life, when brain development is dependent on thyroid hormones. Iodine intake recommendations vary around the world, but most recommendations generally reflect the increased requirements during pregnancy and lactation, although adequate iodine intake before pregnancy is also important. Tremendous progress has been made in improving iodine intake across the world over the past 30 years, mainly through salt-iodization programmes. However, in countries without strong iodine fortification programmes, and with shifts in dietary patterns, a need has arisen for health organizations, governments and clinicians to ensure that adequate iodine is consumed by everyone in the population. For example, in countries in which adequate iodine intake depends on individual food choice, particularly of iodine-rich milk and dairy products, intake can be highly variable and is also vulnerable to changing dietary patterns. In this Review, iodine is considered in the wider context of the increasing prevalence of overweight and obesity, the dietary trends for salt restriction for cardiovascular health and the increasing uptake of plant-based diets.

Are the elements zinc, copper, magnesium, and rubidium related to nutrition and iodine deficiency in pregnant Bulgarian women from iodine deficient region?

OBJECTIVE: Trace elements are essential for the biochemistry of the cell. Their reference values have been found to differ considerably in pregnant women stratified by age, place of residence, anthropometric status, and length of pregnancy. In optimal amounts, these elements reduce the risk of pregnancy complications. Subclinical hypothyroidism in pregnancy is associated with adverse maternal and neonatal outcomes. The aim of the study was to determine the effects of zinc (Zn), copper (Cu), magnesium (Mg), and rubidium (Rb) on pregnant women in an iodine deficiency region and find the relationship with the thyroid status and nutrition. METHODS: We evaluated the iodine status of 61 healthy pregnant women from an iodine deficient region in Bulgaria. Thyroid stimulating hormone (TSH) and thyroxin free (FT4) levels were measured using ELISA. RESULTS: We found elevated levels of copper that differed the most between the first and second trimesters; Cu and TSH were found to be positively correlated (р < 0.05). Lower Cu levels were found in pregnant women consuming pulses more than 2-3 times a week (р = 0.033). The women consuming fish more than 2-3 times a week had higher levels of Rb. We found a pronounced iodine deficiency in more than half of the examined women in the first to third trimesters, without any effect of pregnancy on the ioduria (р=0.834). All second and third trimester cases were associated with severe ioduria (< 150 µg/L). CONCLUSION: The high Cu levels were associated with subclinical hypothyroidism (SCH) and less pulse consumption during pregnancy in an iodine deficiency endemic area. SCH was found in 24% of the pregnant women in such an area while in 13% of them SCH had progressed to overt hypothyroidism.

The Danish investigation on iodine intake and thyroid disease (DanThyr): history and implications.

Due to mild-to-moderate iodine deficiency in Denmark, health authorities initiated a voluntary iodine fortification (IF) program in 1998, which became mandatory in 2000. In line with recommendations from the World Health Organization, the Danish investigation on iodine intake and thyroid disease (DanThyr) was established to monitor the effect on thyroid health and disease. The program involved different study designs and followed two Danish sub-populations in the years before IF and up till 20 years after. Results showed that the IF was successfully implemented and increased the level of iodine intake from mild-moderate iodine deficiency to low adequacy. The level of thyroglobulin and thyroid volume decreased following IF, and there was an indication of fewer thyroid nodules. The incidence of hyperthyroidism increased transiently following IF but subsequently decreased below the pre-fortification level. Conversely, thyroid-stimulating hormone levels and the prevalence of thyroid autoimmunity increased along with an increase in the incidence of hypothyroidism. These trends were mirrored in the trends in treatments for thyroid disease. Most differences in thyroid health and disease between regions with different iodine intake levels before IF attenuated. This review illustrates the importance of a monitoring program to detect both beneficial and adverse effects and exemplifies how a monitoring program can be conducted when a nationwide health promotion program - as IF - is initiated.

Changing trends in the global, regional, and national burden of iodine deficiency among adolescents and young adults: population-based study.

Iodine is a micronutrient required for the production of thyroid hormones, which regulate metabolism, growth, and neurodevelopment. Iodine deficiency among adolescents and young adults is a major global health issue. We analyzed data from the Global Burden of Disease 2019 database to calculate the prevalence, incidence, and disability-adjusted life-year (DALY) rates of iodine deficiency among adolescents and young adults. We explored the specific year with the most substantial changes in the trends of iodine deficiency among adolescents with annual percentage change (APC) by Joinpoint Regression analysis. Descriptive analyses were conducted to characterize the iodine deficiency burden according to age, sex, location, and sociodemographic index (SDI) quintiles. All measures are listed with 95% uncertainty intervals (UIs), and all rates are reported per 100,000 individuals. From 1990 to 2019, the iodine deficiency prevalence rate among adolescents decreased from 3082.43 (95% uncertainty interval [UI], 2473.01-3855.86) to 2190.84 (95% [UI], 1729.18-2776.16) per 100,000 population, with an AAPC of -1.15 (95% confidence interval [CI], -1.29 to -1.02). Regarding the SDI in 2019, the highest prevalence and DALY rates of iodine deficiency were reported in low-SDI countries. In 1990, Southeast Asia had the highest prevalence and DALYs rates for iodine deficiency among adolescents, while in 2019, Africa had the highest prevalence rate (3330.12). CONCLUSION: Globally, the iodine deficiency burden among adolescents has substantially decreased since 1990; however, low-SDI countries still bear a great burden. Implementation measures and monitoring systems should be strengthened to reduce the iodine deficiency burden, especially among adolescents. WHAT IS KNOWN: • Iodine deficiency can cause severe or irreversible developmental disorders, particularly in adolescents and young adults. • Universal Salt Iodization was implemented for ensuring appropriate iodine intake. WHAT IS NEW: • We found substantial declines in the prevalence rates of iodine deficiency among adolescents during the past three decades. Globally, the disability-adjusted life-year rate of iodine deficiency among adolescents decreased from 56.17 in 1990 to 35.38 in 2019. • Iodine deficiency among adolescents in low- sociodemographic index countries still bear a great burden.

Exploring Salivary Iodine Concentration as a Biomarker for Iodine Status and Thyroid Nodules in Females From Different Water Iodine Areas: a Cross-sectional Study.

BACKGROUND: It is unclear whether salivary iodine concentration (SIC) can assess iodine status in females from different water iodine regions. OBJECTIVES: Through a cross-sectional study, we explored the feasibility of SIC as a biomarker to assess iodine status in females and develop optimal cutoff values. METHODS: A total of 1991 females were analyzed in this cross-sectional study from the coastal iodine-deficient areas (CIDAs), inland iodine-deficient areas (IIDAs), iodine-adequate areas (IAAs), iodine-excess areas (IEAs), and iodine extra-high areas (IEHAs). SIC, spot urine iodine concentration (SUIC), and daily total iodine intake (TII) were assessed, and ultrasonography was performed in all subjects. RESULTS: There was a positive correlation between SIC and SUIC (r = 0.67; 95% CI: 0.64, 0.69; P < 0.001), and TII (r = 0.47; 95% CI: 0.43, 0.50; P < 0.001). The prevalence of thyroid nodules (TN) showed an upward trend with SIC increasing (Z = -2.83; P-trend = 0.005). The area under the receiver-operating characteristic (ROC) curve for SIC to assess iodine deficiency was 0.62 (95% CI: 0.60, 0.65; P < 0.001) and 0.75 (95% CI: 0.73, 0.77; P < 0.001) for iodine excess. The cutoff values were as follows: SIC < 93.32 µg/L, iodine deficiency; 93.32-224.60 µg/L, iodine adequacy; and >224.60 µg/L, iodine excess. When SIC > 224.60 µg/L, the odds ratio (OR) for UIC > 300 µg/L, excessive TII, and the prevalence of TN were 6.44, 3.68, and 1.27 (95% CI: 4.98, 8.31; 2.83, 4.79; and 1.02, 1.56, respectively; P < 0.05); when SIC < 93.32 µg/L, the OR for UIC < 100 µg/L and insufficient TII were 2.34 and 1.94 (95% CI: 1.73, 3.14 and 1.33, 2.83, respectively; P < 0.05). CONCLUSIONS: Using SIC as a biomarker, females in CIDA exhibited mild iodine deficiency, those in IIDA and IAA demonstrated moderate iodine deficiency, and those in IEA and IEHA exhibited an excess of iodine, consistent with SUIC to assess iodine status. SIC can be used as a good biomarker to evaluate the iodine status in population.

Prevalence of high neonatal thyroid stimulating hormone levels as an indicator of iodine deficiency in the province of La Pampa: An epidemiological analysis. / Prevalencia de hipertirotropinemia neonatal como indicador de deficiencia de yodo en la provincia de La Pampa: un análisis epidemiológico.

Introduction. Iodine plays a key role in human metabolism, growth, and development. During pregnancy and childhood, the demand for this micronutrient increases notably. Increased neonatal thyroid stimulating hormone (nTSH) levels, defined as nTSH ≥ 5 mIU/L, are a marker of iodine deficiency in a population if its prevalence is higher than 3%. Objective. To establish the prevalence of nTSH ≥ 5 in La Pampa in the 2021-2022 period, analyze its correlation with different variables, and compare it with data from a historical cohort. Population and methods. Cross-sectional, descriptive-analytical study in a population of newborn infants born in the 5 health regions of the province of La Pampa in 2021 and 2022. Results. Of the 5778 assessed newborn infants, 9.6% had nTSH levels ≥ 5 mIU/L. It was reported that 70.4% of these measurements were done after the third day of life. No significant differences were observed in the frequency of high nTSH levels by year of birth, birth weight, or days until sample collection. A higher prevalence was observed among male infants (10.6% versus 8.5%; p = 0.007) and term infants (9.8% versus 6.6%; p = 0.02). The prevalence of high TSH levels was superior to that observed in the 2001-2002 cohort. Conclusions. The prevalence of high nTSH levels in La Pampa during 2021 and 2022 was 9.6%, suggesting the presence of mild iodine deficiency in the population of this province, higher that what had been reported 2 decades ago.

Introducción. El yodo desempeña un rol fundamental en el metabolismo, el crecimiento y el desarrollo humano. Durante el embarazo y la infancia, la demanda de este micronutriente aumenta considerablemente. La tirotropinemia neonatal (TSHn) aumentada, definida como TSHn ≥5 mUI/l, es un marcador que señala la deficiencia de yodo en una población cuando su prevalencia supera el 3 %. Objetivo. Determinar la prevalencia de TSHn ≥ 5 en La Pampa durante el período 2021-2022, analizar su correlación con diferentes variables y compararla con datos de una cohorte histórica. Población y métodos. Estudio transversal, de diseño descriptivo-analítico, sobre una población de neonatos nacidos en las cinco zonas sanitarias de la provincia de La Pampa durante los años 2021 y 2022. Resultados. De los 5778 neonatos evaluados, el 9,6 % presentó niveles de TSHn ≥5 mUI/l. El 70,4 % de estas mediciones fueron realizadas después del tercer día de vida. No se observaron diferencias significativas en la frecuencia de niveles elevados de TSHn según el año de nacimiento, peso al nacer o días hasta la extracción. Se registró una mayor prevalencia en el sexo masculino (10,6 % versus 8,5 %; p = 0,007) y entre los neonatos nacidos a término (9,8 % versus 6,6 %; p = 0,02). La prevalencia de hipertirotropinemia fue superior a la observada en una cohorte de 2001-2002. Conclusiones. La prevalencia de hipertirotropinemia neonatal en La Pampa durante los años 2021 y 2022 fue del 9,6 %, lo que indica un estado de deficiencia leve de yodo en la provincia, superior al reportado hace dos décadas.

Thyroid neoplasia associated with nutritional deficiency in cultured jade perch in Hong Kong.

Non-neoplastic thyroid hyperplasia is common in terrestrial animals, secondary to nutritional imbalances or other goitrogenic compounds. Thyroid hyperplasia is relatively common in teleost fish; however, malignant thyroid neoplasia is rarely reported. We diagnosed cases of thyroid neoplasia in a population of jade perch (Scortum barcoo). The 3,000 affected fish had grossly apparent, bilateral pharyngeal swellings. Histologic examination confirmed proliferative thyroid lesions ranging from hyperplasia to well-differentiated follicular cell carcinoma. In addition, the younger population of animals on the farm also had bacterial septicemia and mild Dactylogyrus sp. gill infections. Feed analysis revealed a severe deficiency of iodine and vitamin C in the homemade fish diet used on the farm. The concentrations of other minerals, such as zinc, were also on the lower end of the recommended requirements for freshwater fish. The farm was using surface water in its recirculating aquaculture system. We recommended a switch to a commercial aquaculture diet, as well as to use well water rather than surface water to avoid any contaminants, and to treat the younger fish with an antibiotic for bacterial septicemia. Our case provides evidence of progression from nutritional-associated thyroid hyperplasia to neoplasia in farmed teleost fish.