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1.
Ecotoxicol Environ Saf ; 188: 109930, 2020 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-31727496

RESUMO

BACKGROUND: For the sake of children's health, iodized salt supply has been stopped in many areas with excessive iodine in the drinking water, but children's iodine nutrition status and thyroid function after terminating the iodized salt supply is unknown. Objective We assessed the iodine nutrition, thyroid function and influencing factors for thyroid abnormalities in children from areas with different concentrations of water iodine; the supply of iodized salt has been stopped in high water iodine areas. This study aimed to evaluate whether the strategy of stopping the supplies of iodized salt alone is enough to avoid thyroid dysfunction in all areas with excess water iodine while still meeting the iodine nutrition needs of children. METHODS: A cross-sectional study was conducted in children from four areas with different drinking water iodine concentrations in Tianjin, China. The drinking water samplings and spot urine samples were collected to estimate the external and internal iodine exposure levels. The thyroid volume was measured, and blood samples were collected to assess thyroid function. Logistic regression analysis was used to analyze risk factors for thyroid abnormalities. A dietary survey was conducted to determine the sources of iodine nutrition among the areas with different iodine concentrations in the drinking water. RESULTS: In the area with a drinking water iodine concentration ≥300 µg/L, the median urinary iodine concentration (UIC) in children was 476.30 (332.20-639.30) µg/L, which was higher than that in other groups (all P < 0.05), and the prevalence of thyroid nodules and the thyroid goiter rate were higher than those in the <100 µg/L, 100-150 µg/L and 150-300 µg/L areas (all P < 0.01). Binary logistic regression analysis indicated that the risk of thyroid abnormalities was significantly increased in the UIC 200-299 µg/L group (OR: 4.534; 95% CI: 1.565, 13.135; bootstrapped 95% CI: 1.689, 21.206, P = 0.004) and in the UIC ≥ 300 µg/L group (OR: 6.962; 95% CI: 2.490, 19.460; bootstrapped 95% CI: 2.838, 32.570, P = 0.001) compared to the 100-199 µg/L group. The iodine contribution rates from water in areas with water iodine concentrations ≥300 µg/L are up to 63.04%. CONCLUSIONS: After termination of the iodized salt supply, the level of iodine nutrition of children in the area with drinking water iodine concentrations ≥300 µg/L is still excessive. The water source needs to be replaced in this area. In the area with a water iodine concentration of 150-300 µg/L, it is proposed that stopping the supply of iodized salt is sufficient to achieve the proper iodine nutrition status in children.


Assuntos
Exposição Dietética/análise , Água Potável/química , Bócio/epidemiologia , Iodo/administração & dosagem , Iodo/análise , Cloreto de Sódio na Dieta/administração & dosagem , Cloreto de Sódio na Dieta/análise , Criança , China/epidemiologia , Estudos Transversais , Feminino , Bócio/urina , Humanos , Iodo/urina , Masculino , Estado Nutricional , Prevalência , Fatores de Risco , Cloreto de Sódio na Dieta/urina , Inquéritos e Questionários
2.
Environ Health Prev Med ; 24(1): 73, 2019 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-31810448

RESUMO

BACKGROUND: Before iodination of Swedish table salt in 1936, iodine deficiency resulting in goitre and hypothyroidism was common. Sweden has become iodine sufficient, as shown in a national survey in 2007, proving its iodination fortification programme effective for the general population. The objective of this study was to collect drinking water from water treatment plants nationally and test if water iodine concentration (WIC) correlated to urinary iodine concentration (UIC) of school-aged children in a national survey 2007 to former goitre frequency in 1929 and to thyroid volume data in 2007. METHODS: In 2012, 166 treatment plants, located in 57% (166 of 290) of all Swedish municipalities, were asked to collect drinking water samples of approximately 10 ml. In 2007, tap water samples of the same volume were collected from 30 randomly selected schools for the national survey. Analysis of WIC was done in both treatment plants in 2012 (n = 166) and tap water in 2007 (n = 30). The correlation of WIC to the children's UIC and thyroid volume after iodination was tested based on data from the national survey in 2007. The association of WIC to former goitre frequency was tested based on pre-iodination data, derived from a map of goitre frequency drawn in 1929. RESULTS: The median WIC from water treatment plants was 4.0 µg/L (range 0-27 µg/L). WIC was similar in coastal and inland areas, for both ground and surface water. WIC correlated with historical goitre areas and was lower in the goitre areas than in non-goitre areas (p < 0.001). WIC in the same municipalities as the schools correlated with the UIC of children (p < 0.01), but not with their thyroid volume. CONCLUSIONS: WIC still contributes to iodine nutrition in Sweden, but iodination overrides the goitre effect.


Assuntos
Água Potável/química , Alimentos Fortificados/análise , Bócio/epidemiologia , Iodo/análise , Cloreto de Sódio na Dieta/análise , Adolescente , Criança , Feminino , Bócio/história , História do Século XX , História do Século XXI , Humanos , Iodo/urina , Masculino , Suécia/epidemiologia , Glândula Tireoide/anatomia & histologia
3.
Medicine (Baltimore) ; 98(41): e17539, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593131

RESUMO

Research on the relationship between iodine intake and thyroid cancer (TC) risk is limited, and the findings are inconclusive. The objective of this study was to provide emerging evidence for the association between iodine intake and TC risk in a Chinese population.An ecological study of epidemiology is used to compare the iodine intake among populations with different TC incidence in Zhoushan, China. Incidence rates of TC were investigated and compared among four counties of the Zhoushan Islands from 2014 to 2018. Iodized salt consumption rate and the level of urinary iodine concentration (UIC) were analyzed for pupils and pregnant women from four counties.During 2014 to 2018, a total of 2495 new cases of TC were diagnosed in Zhoushan Islands. The mean crude incidence rate of TC was 51.29 per 100,000 inhabitants, and the standardized (world population) incidence rate (SIR) was 31.34 per 100,000 population. Incidence rates (SIR and crude incidence rates) were significantly higher in women than in men (χ test, P < .05). Both male and female, the incidence of TC in Daishan County is higher than the other three counties of Zhoushan. Iodized salt consumption rate and median UIC in pupils and pregnant women in Daishan County was significantly lower than the other three counties (χ test and Kruskal-Wallis test, all P < .05). The population with high TC incidence has a lower iodized salt consumption and a lower level of UIC compare with the relative low TC incidence populations.The low consumption of iodized salt with mild iodine deficiency may contribute to explain the exceptionally high incidence of TC in Daishan County. Further subtle designed studies are needed to provide additional insights into the epidemiology and etiology of TC and help identify the safe limit of iodine intake for prevention.


Assuntos
Iodo/efeitos adversos , Neoplasias da Glândula Tireoide/epidemiologia , Adulto , China/epidemiologia , Ecologia , Economia/estatística & dados numéricos , Feminino , Humanos , Incidência , Iodo/administração & dosagem , Iodo/urina , Masculino , Pessoa de Meia-Idade , Gestantes , Cloreto de Sódio na Dieta/administração & dosagem , Cloreto de Sódio na Dieta/efeitos adversos , Neoplasias da Glândula Tireoide/etiologia , Neoplasias da Glândula Tireoide/patologia , Oligoelementos/efeitos adversos , Oligoelementos/urina
4.
Eur J Endocrinol ; 181(5): 519-524, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31536966

RESUMO

Objectives: Amiodarone-induced thyrotoxicosis (AIT) affects up to 3% of treated patients. Type 2 AIT (AIT2) is a destructive thyroiditis and is usually treated with medium-high oral doses of prednisone. As AIT may worsen the underlying heart disease, a rapid control of thyroid function is desirable. We aimed to determine whether a combined intravenous methylprednisolone (IVMP) pulses therapy associated to prednisone in the interpulse period can represent an efficient and safe alternative to urgent total thyroidectomy in patients with AIT2 not responsive to prednisone alone. Design and methods: Patients presenting with a severe AIT2 studied in a tertiary referral Center from August 2018 to April 2019. We included four patients requiring a rapid improvement of thyroid function for their underlying cardiac disorders. The baseline doses of oral prednisone (range: 5-12.5 mg/day) and IVMP (range: 250-500 twice a week) were determined according to the severity of the thyrotoxicosis and were titrated based on clinical response. Results: Combined treatment was effective in all patients in the prompt restoration of euthyroidism and no major adverse events were reported during the follow-up. In all cases, FT4 and FT3 levels normalized at 3-5 weeks of treatment. A permanent hypothyroidism was observed in one patient, 3 months after the discontinuation of treatment. Conclusions: We report for the first time that the combined intravenous and oral steroid therapy is effective in patients with AIT2. The treatment is well tolerated and leads to a rapid improvement of thyroid function, avoiding urgent total thyroidectomy and favoring a quick functional recovery and rehabilitation of cardiac patients.


Assuntos
Amiodarona/efeitos adversos , Antiarrítmicos/efeitos adversos , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/uso terapêutico , Metilprednisolona/administração & dosagem , Metilprednisolona/uso terapêutico , Tireotoxicose/induzido quimicamente , Tireotoxicose/tratamento farmacológico , Administração Intravenosa , Idoso , Humanos , Iodo/urina , Masculino , Pessoa de Meia-Idade , Tireoglobulina/sangue , Testes de Função Tireóidea , Tireotropina/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue
5.
Nutrients ; 11(7)2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31323889

RESUMO

The inhabitants of Lazio, similarly to those of other Italian regions, have been historically exposed to the detrimental effects of an inadequate intake of iodine. The latter is a micronutrient essential for the biosynthesis of thyroid hormones (TH). Iodine deficiency is responsible for a number of adverse effects on human health known as iodine deficiency disorders (IDD), the most common of which worldwide are goiter and hypothyroidism. In order to reduce IDD, a national salt iodination program was started in Italy in 2005. In this article we reviewed the available data regarding iodine intake in the Lazio population before and after the introduction of the national salt iodination program, in order to evaluate its efficacy and the eventual problem(s) limiting its success. On the whole, the information acquired indicates that, following the introduction of the program, the dietary iodine intake in the Lazio population is improved. There is, however, still much work ahead to ameliorate the iodine prophylaxis in this region. In fact, although a generally adequate iodine intake in school-age children has been observed, there are still areas where a mild iodine insufficiency is present. Moreover, two independent epidemiological surveys on pregnant women evidenced a low urinary iodine concentration with respect to the reference range conceived by the World Health Organization. These findings demonstrate the need for greater attention to the iodine prophylaxis by health care providers (i.e., obstetricians, gynecologists, pediatricians, etc.), and the implementation of effective advertising campaigns aimed at increasing the knowledge and awareness of the favorable effects of iodine supplementation on population health.


Assuntos
Iodo/deficiência , Iodo/urina , Estado Nutricional , Cloreto de Sódio na Dieta/administração & dosagem , Adolescente , Criança , Feminino , Bócio/epidemiologia , Humanos , Hipotireoidismo/epidemiologia , Hipotireoidismo/prevenção & controle , Iodo/administração & dosagem , Itália/epidemiologia , Masculino , Programas Nacionais de Saúde , Gravidez
6.
Asia Pac J Clin Nutr ; 28(2): 356-361, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31192565

RESUMO

BACKGROUND AND OBJECTIVES: Iodine deficiency disorders (IDD) has been a major public health challenge for the Indian subcontinent over many years. Our study was conducted in Tikamgarh district of Madhya Pradesh, an iodine deficiency disorders-endemic district, with the objective to estimate total goitre rate and iodine nutrition status. METHODS AND STUDY DESIGN: A cross-sectional study with 30 cluster sampling was conducted between June to July 2016 among school-going children in the age group of 6-12 years. Ninety children from each school (30x90=2700) were selected for the assessment of Goitre. Total 540 salt samples and 270 urine samples were collected to estimate salt iodine content from their house-hold and urine iodine excretion (UIE) respectively. A total of 150 households and 30 shopkeepers were interviewed to understand the awareness level for salt iodization. RESULTS: Goitre rate in Tikamgarh district was 1.9% with prevalence of grade I & II was 1.7% and 0.2% respectively. The median UIE level was 200 mcg/L. The 20% the population had iodine deficiency, 28.9% population had adequate iodine nutrition and 51.1% population had either more than adequate level of iodine. The 72.4% of the population consume adequately iodized salt (>=15 ppm). CONCLUSIONS: Our study concludes that Tikamgarh district is non-endemic for IDDs against the earlier classification as an IDD-endemic district. About 20% population has 'iodine deficiency' and approximately 51.1% population has 'more than adequate iodine intake'. We recommend stringent programme monitoring, undertake periodic assessment of IDD and explore manifestations of excess iodine intake (>=300 mcg/L) such as Iodine-induced hyperthyroidism in future.


Assuntos
Bócio/epidemiologia , Iodo/deficiência , Iodo/urina , Estado Nutricional , Criança , Análise por Conglomerados , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Masculino , Prevalência , Cloreto de Sódio na Dieta
7.
Endocr Pract ; 25(10): 987-993, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31170368

RESUMO

Objective: Iodine is a necessary nutrient for the synthesis of thyroid hormones and essential in human development. Being naturally deficient in iodine, Armenia launched a national universal salt iodization (USI) strategy in 2004. Although high rates of goiter continued to be reported, iodine status has not been studied since 2005. Therefore, this study sought to assess the current situation of population iodine nutrition in Armenia. Methods: We used a selective cross-sectional model to recruit three groups: school-age children (SAC), pregnant women (PW), and nonpregnant women of reproductive age (WRA) from each province. We collected casual urine and table salt samples from each participant, which were analyzed for iodine concentration. A repeat urine sample was collected in a subset of participants to adjust the results for within-person variation in iodine concentration. Group-wise urinary iodine concentrations (UICs) were compared with international reference criteria for iodine status. Results: Urine samples were collected from 1,125 participants from 13 different towns in Armenia; a total of 1,078 participants were included in the final analysis: 361 SAC (mean age, 10.5 years, 46.6% female), 356 PW (mean age, 26.1 years), and 361 WRA (mean age, 35.5 years). Population and geographically weighted median UIC were: SAC, 242 µg/L ([25th percentile] 203 to [75th percentile] 289 µg/L); PW, 226 µg/L (209 to 247 µg/L); WRA, 311 µg/L (244 to 371 µg/L). A total of 1,041 table salt samples were sufficient for laboratory analysis: 973 (93.4%) of the salt iodine measurements were within the national standard range of 40 ± 15 mg/kg. Conclusion: The results of household salt sampling indicated a successful USI strategy. While the present study did not achieve a truly representative sample of Armenia's population, the UIC results support the conclusion that iodine deficiency has not recurred and is not an underlying factor for any remaining high goiter prevalence in Armenia. Abbreviations: PW = pregnant women; SAC = school-age children; SI = salt iodine; UIC = urinary iodine concentration; USI = universal salt iodization; WHO = World Health Organization; WRA = women of reproductive age.


Assuntos
Iodo/urina , Adulto , Armênia , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Estado Nutricional , Gravidez , Cloreto de Sódio na Dieta , Inquéritos e Questionários
8.
PLoS One ; 14(5): e0216931, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31150410

RESUMO

Iodine deficiency (ID) during pregnancy results in pregnancy losses, intrauterine growth retardation, and lower IQ in the offspring. Even after two decades of universal salt iodization (USI) implementation, the efficacy of USI has not been reported in high risk groups in vulnerable regions in Ghana. We aimed to assess and improve ID status in childbearing age women (all lactating women) and their toddlers in northern Ghana, a geographically and socioeconomically vulnerable region. We provided weekly supply of household iodized salt and community-based feeding of native Hibiscus Sabdariffaa leaves meal (HSM) prepared with iodized salt to women and their toddlers in intervention (n = 60) vs. control group (n = 60). At baseline, ID was prevalent in women (36%) and their toddlers (29%). For women, both median UIC values for intervention (57.4 ug/l) and control group (65.1 ug/l) were below the recommended UIC value of 100 ug/l with no significant differences between the two groups (p = 0.2778). At the endpoint, median UIC for the intervention group (123.6 ug/l) was significantly higher (p = 0.008) than the control group (59.7 ug/l). Our results suggest that weekly supply of iodized salt along with the feeding HSM is an effective channel for improving iodine status of economically disadvantaged groups in communities remote from coastal lands. Furthermore, our results suggest that decreased median UIC among lactating mothers does not necessarily imply lower iodine status for their breastfed toddlers. And finally, the observed median UIC<100 ug/l may point to a non-improvement in iodine status for the past decade for Ghana. There is a need to revisit, assess, and ascertain the challenges in preventing populations from attaining the intended benefits of the USI policy in Ghana.


Assuntos
Hibiscus/química , Iodo/urina , Medicina Tradicional/métodos , Estado Nutricional , Cloreto de Sódio na Dieta/administração & dosagem , Adulto , Pré-Escolar , Características da Família , Feminino , Gana/epidemiologia , Humanos , Lactente , Iodo/administração & dosagem , Iodo/deficiência , Lactação/fisiologia , Masculino , Folhas de Planta/química , Áreas de Pobreza , Gravidez , Prevalência
9.
Biochem Med (Zagreb) ; 29(2)2019 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-31223253

RESUMO

Introduction: The aim of the study was to evaluate the analytical performance of the new colorimetric, automatic analyser, Seal AutoAnalyzer 3 High Resolution (Seal AA3 HR) (Seal Analytical, Wisconsin, USA) for urinary iodine measurement. Materials and methods: This study included testing of several analytical features of the method involving: imprecision (within-run %CVr, between-run %CVb and total laboratory precision %CVl), measurement uncertainty, carryover, linearity and method comparison, with 70 urine samples including the measuring range (20 - 700 µg/L). Results: Within-run, %CVb and %CVl of two control levels were 2.03% and 3.04%, 0.51% and 2.61%, and 2.09% and 4.01%, respectively. Carryover effect was less than 1%. The linearity was good in the range of urinary iodine values between 60 and 500 µg/L (R2 = 0.99). Good agreement of urinary iodine values was found between manual technique and Seal AA3 HR, using Passing-Bablok regression (y = 7.84 (- 3.00 to 15.29) + 0.95 (0.90 to 1.00) x) and Blant-Altman test. Cusum test for linearity indicates that there is no significant deviation from linearity (P > 0.1). Conclusions: The obtained results proved excellent precision, reproducibility and linearity, comparable to the already used, manual method. The New Seal AA3 HR automatic analyser is acceptable for urinary iodine measurement with very good analytical characteristics and can be used for urinary iodine epidemiological studies of the Croatian population.


Assuntos
Autoanálise , Iodo/urina , Criança , Croácia/epidemiologia , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes
10.
BMC Res Notes ; 12(1): 294, 2019 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-31133065

RESUMO

OBJECTIVES: Deficiency as well as excess dietary iodine is associated with several thyroid disorders including Grave's disease and goitre. Previously, cross sectional studies conducted among school children in Nepal showed high prevalence of iodine deficiency. In contrast, recently, few studies have revealed emerging trends of excess urinary iodine concentration in children. This paper, reports excess urinary iodine excretion and thyroid dysfunction among school age children from eastern Nepal. RESULTS: It was a community based cross sectional study in which we measured urinary iodine excretion levels among school age children at baseline and after educational program. The educational program consisted of audio-visual and pamphlets on thyroid health. We also screened them for thyroid function status by physical examination and measuring serum thyroid hormones. Our results show that 34.4% of the children had excess urinary iodine concentration above the WHO recommended levels. Overall, 3.2% of the children were identified to have thyroid dysfunction. Urinary iodine concentration was significantly different between types of salt used and between salt iodine content categories.


Assuntos
Hipertireoidismo/epidemiologia , Hipotireoidismo/epidemiologia , Iodo/urina , Cloreto de Sódio na Dieta/efeitos adversos , Criança , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Hipertireoidismo/induzido quimicamente , Hipertireoidismo/metabolismo , Hipertireoidismo/fisiopatologia , Hipotireoidismo/induzido quimicamente , Hipotireoidismo/metabolismo , Hipotireoidismo/fisiopatologia , Iodo/administração & dosagem , Iodo/efeitos adversos , Masculino , Nepal/epidemiologia , Estado Nutricional/fisiologia , Cloreto de Sódio na Dieta/administração & dosagem , Glândula Tireoide/efeitos dos fármacos , Glândula Tireoide/metabolismo , Glândula Tireoide/patologia , Tireotropina/sangue , Tiroxina/sangue
11.
J Med Food ; 22(4): 421-426, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30990756

RESUMO

Dietary iodine is important to human health, and both low and high iodine intake levels increase the risk of disease. Seaweed is rich in iodine and it is a common component in both Asian and in Arctic cuisines. While the intake and impact are known for Asian people, data are lacking for Arctic people. We aimed to (1) measure iodine content of dietary seaweeds in Greenland, (2) estimate iodine absorption, and (3) assess the impact on iodine intake in Arctic people. A hunter in East Greenland donated household seaweed for (1) measurement of iodine content and (2) ingestion of 45 g by each of eight individuals with subsequent urine collections. (3) In Ammassalik, 96% of 50-69-year-old Inuit reported on the frequency of intake of seaweed and provided a spot urine sample for iodine measurement. Seaweed species provided were Chondrus crispus and Ascophyllum nodosum. (1) The iodine content was 47 and 102 mg/g, respectively. (2) An estimated 1.1 and 1.9 mg of the ingested 2.1 and 4.6 of iodine in seaweed were excreted in the urine within 2 days. (3) More than two in three Inuit reported some dietary use, and 41% (109 of 268) reported a weekly intake of dietary seaweed, which was associated with iodine excretion. In conclusion, the iodine content of edible seaweeds in the Arctic is very high and bioavailable. Dietary intake contributed to the recommended iodine intake level, but marked variation in iodine excretion calls for evaluation of the impact on thyroid function.


Assuntos
Iodo/metabolismo , Alga Marinha/metabolismo , Idoso , Feminino , Groenlândia , Humanos , Iodo/urina , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Alga Marinha/química , Verduras
12.
Am J Clin Nutr ; 109(4): 1080-1087, 2019 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-30982855

RESUMO

BACKGROUND: Iodine is an essential micronutrient for intellectual development in children. Information on iodine intakes based on 24-h urinary iodine excretion (UIE) is scant, because iodine status is only assessed by the measurement of urinary iodine concentration (UIC) in spot urine samples. OBJECTIVES: The aim of our study was to evaluate the iodine intake of school-age children and adolescents, using UIE measurement in 24-h urine collections. METHODS: The study population included 1270 healthy subjects (677 boys, 593 girls) aged 6-18 y (mean age ± SD: 10.3 ± 2.9) from 10 Italian regions. Daily iodine intake was estimated as UIE/0.92, based on the notion that $\sim$92% of the dietary iodine intake is absorbed. The adequacy of intakes was assessed according to the Dietary Reference Values for iodine of the European Food Safety Authority (EFSA). Body mass index (BMI) and UIC were also measured for each subject. RESULTS: Based on the scientific opinion of EFSA, 600 of 1270 subjects (47.2%) had a lower than adequate iodine intake, with a higher prevalence among girls (54.6%) compared with boys (40.2%) (P < 0.001). Although UIE and 24-h urinary volumes increased with age (P < 0.001), a progressive decrease in the percentage of subjects with iodine excretion <100 µg/24 h (P < 0.001) was observed, without any significant difference in the percentage of subjects with UIC <100 µg/L. No significant association was detected between BMI z-score and UIE (P = 0.603) or UIC (P = 0.869). CONCLUSIONS: A sizable proportion of our population, especially girls, appeared to be at risk of iodine inadequacy. The simple measurement of UIC could lead to underestimation of the occurrence of iodine deficiency in younger children, because of the age-related smaller urine volumes producing spuriously higher iodine concentrations.


Assuntos
Iodo/deficiência , Iodo/urina , Adolescente , Índice de Massa Corporal , Criança , Feminino , Humanos , Itália , Masculino , Micronutrientes/deficiência , Micronutrientes/urina , Estado Nutricional
13.
Endocr J ; 66(6): 497-514, 2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-30890682

RESUMO

Excessive iodine intake has been associated with increased risk of thyroid cancer (TC) in many studies, but the results have not been consistent. Since it was common knowledge that urinary iodine (UI) is considered a sensitive marker of current iodine intake, we conducted a meta-analysis to clarify the association between high UI and TC. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, and the Cochrane Collaboration. Between-group meta-analyses were performed to compare UI between TC patients and the healthy/euthyroid subjects in local residents and benign thyroid nodules (BTN) patients. Then, between-group meta-analyses to compare the incidence rate of iodine excess were also conducted. The 22 case-control studies included in the meta-analyses represented 15,476 participants. It is the first time to clarify that UI was increased in PTC patients, but was not altered by regional population iodine intake status. Compared with BTN patients, PTC patients exhibited both higher UIC and higher odds ratio of iodine excess only in adequate iodine intake status subgroup; UIC, not the odds ratio of iodine excess, was higher in patients with PTC than those with BTN in above requirements iodine intake subgroup. A novel insight is offered that high UI in PTC patients was less influenced by regional population iodine intake status. It is indicted that high iodine intake is not a risk factor for PTC and high urinary iodine is just a specific characteristic of the disease.


Assuntos
Dieta , Iodo/administração & dosagem , Iodo/urina , Câncer Papilífero da Tireoide/urina , Neoplasias da Glândula Tireoide/urina , Humanos , Estado Nutricional
14.
Ann Agric Environ Med ; 26(1): 73-77, 2019 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-30922033

RESUMO

INTRODUCTION: Iodine deficiency is one of the most important public health problems in the world. It mostly affects pregnant women and children. The lack of iodine leads to an increase in the numbers of perinatal mortality and mental retardation. MATERIAL AND METHODS: In 2012-2014, a survey was carried out of 2,342 women, of whom 2284 were analyzed for salt to measure the content of iodine, and 2,242 women of reproductive age had their urine samples analyzed by the cerium-arsenite method based on the Sandell-Kolthoff reaction. Determination of the medical and social effectiveness of biological monitoring of IDS was carried out in 3 stages. RESULTS: The study revealed that in the eastern Kazakhstan region the relative risk (RR) of overall prevalence of iodine deficiency among women was 1.1 times higher (95% ID: 0.35-3.61; Z statistic = 0.192) among household respondents (≤15mkg/kg). In the Pavlodar region, the RR of the prevalence of total iodine deficiency is 0.5 times higher in households where the salt was not sufficiently iodized. In the Zhambyl region the RR of the iodine deficiency prevalence was about twice as high due to insufficient iodized salt. CONCLUSIONS: The introduction of biological monitoring of IDS among women, especially pregnant women, may positively affect the detection of the risk limits for the birth of infants with reduced mental abilities or other diseases during pregnancy, using timely targeted preventive measures to exclude factors that affect the spread of IDS.


Assuntos
Deficiências Nutricionais/epidemiologia , Iodo/deficiência , Cloreto de Sódio na Dieta/provisão & distribução , Adulto , Estudos Transversais , Monitoramento Ambiental/métodos , Características da Família , Feminino , Humanos , Iodo/provisão & distribução , Iodo/urina , Cazaquistão , Gravidez , Cloreto de Sódio na Dieta/análise , Inquéritos e Questionários
15.
Appl Microbiol Biotechnol ; 103(8): 3537-3547, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30850874

RESUMO

Iodine is an important trace element involved in thyroid hormone biosynthesis, while diet-induced obesity is reported to disturb the trace element metabolic balance. Herein, we studied the host-specific responses involved in modulating thyroid function and gut microbiota in obese mice after the iodine treatment and analyzed the possible causes for these responses. Obesity in the mice was induced by a high-fat diet, and the obese and normal mice were treated with the same iodine dosage (18 µg/kg/day) continuously for 8 weeks. Iodine treatment in the obese mice showed a weight-reducing effect, increased the thyroid hormone concentrations, altered the transcriptions of genes involved in thyroid hormone biosynthesis, and modulated the gut microbiota with an increased abundance of pathogenic bacteria and decreased the proportion of beneficial bacteria. However, completely different or even opposite response profiles were observed in the normal hosts. Our work indicated that obesity may exacerbate the risk of thyroid disease with a relatively safe dose of iodine, and individual differences should be considered with trace element supplementation.


Assuntos
Suplementos Nutricionais , Microbioma Gastrointestinal/fisiologia , Iodo/administração & dosagem , Obesidade/microbiologia , Obesidade/fisiopatologia , Glândula Tireoide/fisiologia , Animais , Dieta Hiperlipídica/efeitos adversos , Fezes/química , Fezes/microbiologia , Feminino , Microbioma Gastrointestinal/efeitos dos fármacos , Iodo/farmacologia , Iodo/urina , Redes e Vias Metabólicas/efeitos dos fármacos , Redes e Vias Metabólicas/genética , Camundongos Endogâmicos ICR , Obesidade/etiologia , Obesidade/patologia , Glândula Tireoide/efeitos dos fármacos , Hormônios Tireóideos/sangue , Hormônios Tireóideos/metabolismo
16.
Nutrients ; 11(3)2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30823683

RESUMO

Iodine deficiency in pregnancy is a common problem in the United States and parts of Europe, but whether iodine deficiency is associated with increased pregnancy loss has not been well studied. The LIFE study provided an excellent opportunity to examine the relationship between iodine status and pregnancy loss because women were monitored prospectively to ensure excellent ascertainment of conceptions. The LIFE study, a population-based prospective cohort study, monitored 501 women who had discontinued contraception within two months to become pregnant; 329 became pregnant, had urinary iodine concentrations measured on samples collected at enrollment, and were followed up to determine pregnancy outcomes. Of the 329, 196 had live births (59.5%), 92 (28.0%) had losses, and 41 (12.5%) withdrew or were lost to follow up. Urinary iodine concentrations were in the deficiency range in 59.6% of the participants. The risk of loss, however, was not elevated in the mildly deficient group (hazard ratio 0.69, 95% confidence interval 0.34, 1.38), the moderately deficient group (hazard ratio 0.81, 95% confidence interval 0.43, 1.51), or the severely deficient group (hazard ratio 0.69, 95% confidence interval 0.32, 1.50). Iodine deficiency, even when moderate to severe, was not associated with increased rates of pregnancy loss. This study provides some reassurance that iodine deficiency at levels seen in many developed countries does not increase the risk of pregnancy loss.


Assuntos
Aborto Espontâneo/etiologia , Iodo/deficiência , Iodo/urina , Complicações na Gravidez/urina , Aborto Espontâneo/epidemiologia , Aborto Espontâneo/urina , Adolescente , Adulto , Feminino , Humanos , Nascimento Vivo , Estado Nutricional , Gravidez , Complicações na Gravidez/etiologia , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Adulto Jovem
17.
Nutrients ; 11(2)2019 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-30791590

RESUMO

Severe iodine deficiency in mothers is known to impair foetal development. Pregnant women in the UK may be iodine insufficient, but recent assessments of iodine status are limited. This study assessed maternal urinary iodine concentrations (UIC) and birth outcomes in three UK cities. Spot urines were collected from 541 women in London, Manchester and Leeds from 2004⁻2008 as part of the Screening for Pregnancy End points (SCOPE) study. UIC at 15 and 20 weeks' gestation was estimated using inductively coupled plasma-mass spectrometry (ICP-MS). Associations were estimated between iodine status (UIC and iodine-to-creatinine ratio) and birth weight, birth weight centile (primary outcome), small for gestational age (SGA) and spontaneous preterm birth. Median UIC was highest in Manchester (139 µg/L, 95% confidence intervals (CI): 126, 158) and London (130 µg/L, 95% CI: 114, 177) and lowest in Leeds (116 µg/L, 95% CI: 99, 135), but the proportion with UIC <50 µg/L was <20% in all three cities. No evidence of an association was observed between UIC and birth weight centile (-0.2% per 50 µg/L increase in UIC, 95% CI: -1.3, 0.8), nor with odds of spontaneous preterm birth (odds ratio = 1.00, 95% CI: 0.84, 1.20). Given the finding of iodine concentrations being insufficient according to World Health Organization (WHO) guidelines amongst pregnant women across all three cities, further studies may be needed to explore implications for maternal thyroid function and longer-term child health outcomes.


Assuntos
Iodo/deficiência , Estado Nutricional , Complicações na Gravidez/epidemiologia , Resultado da Gravidez/epidemiologia , Fenômenos Fisiológicos da Nutrição Pré-Natal , Adulto , Peso ao Nascer , Cidades , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Iodo/urina , Avaliação Nutricional , Gravidez , Complicações na Gravidez/etiologia , Complicações na Gravidez/urina , Nascimento Prematuro/epidemiologia , Nascimento Prematuro/etiologia , Diagnóstico Pré-Natal/métodos , Reino Unido/epidemiologia
18.
Cochrane Database Syst Rev ; 2: CD010734, 2019 02 12.
Artigo em Inglês | MEDLINE | ID: mdl-30746700

RESUMO

BACKGROUND: Iodine deficiency disorders (IDD) affect close to 1.9 billion people worldwide, and are a major public health concern in many countries. Among children, iodine deficiency is the main cause of potentially preventable deficits of central nervous system development and impairment of cognitive function, as well as goitre and hypothyroidism in people of all ages. Salt iodisation is the preferred strategy for IDD prevention and control, however, in some instances where salt is not the major condiment, alternate vehicles for iodine fortification have been considered. OBJECTIVES: To assess the effects of fortifying foods, beverages, condiments, or seasonings other than salt with iodine alone or in conjunction with other micronutrients, on iodine status and health-related outcomes in all populations. SEARCH METHODS: Studies were identified through systematic searches of the following databases from their start date to January 2018: Cochrane Public Health Group Specialised Register; CENTRAL; MEDLINE; MEDLINE in Process; Embase; Web of Science; CINAHL; POPLINE; AGRICOLA; BIOSIS; Food Science and Technology Abstracts; OpenGrey; Bibliomap and TRoPHI; AGRIS; IBECS; Scielo; Global Index Medicus-AFRO and EMRO; LILACS; PAHO; WHOLIS; WPRO; IMSEAR; IndMED; and Native Health Research Database. We also searched reference list of relevant articles, conference proceedings, and databases of ongoing trials, and contacted experts and relevant organisations to identify any unpublished work. We applied no language or date restrictions. SELECTION CRITERIA: Studies were eligible if they were randomised or quasi-randomised controlled trials (RCT) with randomisation at either the individual or cluster level (including cross-over trials), non-randomised RCTs, or prospective observational studies with a control group, such as cohort studies, controlled before-and-after studies, and interrupted time series. We included studies that examined the effects of fortification of food, beverage, condiment, or seasoning with iodine alone, or in combination with other micronutrients versus the same unfortified food, or no intervention. We considered the following measures: death (all-cause), goitre, physical development, mental development, cognitive function and motor skill development, cretinism, hypothyroidism, adverse effects (any reported by trialists), urinary iodine concentration, thyroid-stimulating hormone (TSH) concentration, and serum thyroglobulin concentration. We included all populations, including pregnant women, from any country. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed study eligibility, extracted data, and assessed risk of bias of included studies.We used random-effects meta-analyses to combine data and generate an overall estimate of treatment effect, when more than one study examined the same outcome measure. The overall effect estimate was calculated as the mean difference (MD) or standardised mean difference (SMD) between the intervention group and the comparison group for continuous outcomes, and as odds ratio (OR) for dichotomous outcomes. We assessed the level of heterogeneity through the I² statistic. We conducted post-hoc subgroup analyses to explore possible sources of heterogeneity, and sensitivity analyses to check the robustness of the findings from the primary analyses. We assessed the quality of the evidence for each outcome using the GRADE framework.Where it was not possible to pool the results in a meta-analysis, we provided a narrative summary of the outcomes. MAIN RESULTS: Eleven studies met the criteria, providing 14 comparisons, and capturing data on 4317 participants. Seven studies were RCTs, three were cluster non-RCTs, and one was a randomised cross-over design. Seven studies were carried out among school children (N = 3636), three among women of reproductive age (N = 648), and one among infants (N = 33). The studies used diverse types of food as vehicle for iodine delivery: biscuits, milk, fish sauce, drinking water, yoghourt, fruit beverage, seasoning powder, and infant formula milk. Daily amounts of iodine provided ranged from 35 µg/day to 220 µg/day; trial duration ranged from 11 days to 48 weeks. Five studies examined the effect of iodine fortification alone, two against the same unfortified food, and three against no intervention. Six studies evaluated the effect of cofortification of iodine with other micronutrients versus the same food without iodine but with different levels of other micronutrients. We assessed one study to be at low risk of bias for all bias domains, three at low risk of bias for all domains apart from selective reporting, and seven at an overall rating of high risk of bias.No study assessed the primary outcomes of death, mental development, cognitive function, cretinism, or hypothyroidism, or secondary outcomes of TSH or serum thyroglobulin concentration. Two studies reported the effects on goitre, one on physical development measures, and one on adverse effects. All studies assessed urinary iodine concentration.The effects of iodine fortification compared to control on goitre prevalence (OR 1.60, 95% CI 0.60 to 4.31; 1 non-RCT, 83 participants; very low-quality evidence), and five physical development measures were uncertain (1 non-RCT, 83 participants; very low-quality evidence): weight (MD 0.23 kg, 95% CI -6.30 to 6.77); height (MD -0.66 cm, 95% CI -4.64 to 3.33); weight-for-age (MD 0.05, 95% CI -0.59 to 0.69); height-for-age (MD -0.30, 95% CI -0.75 to 0.15); and weight-for-height (MD -0.21, 95% CI -0.51 to 0.10). One study reported that there were no adverse events observed during the cross-over trial (low-quality evidence).Pooled results from RCTs showed that urinary iodine concentration significantly increased following iodine fortification (SMD 0.59, 95% CI 0.37 to 0.81; 6 RCTs, 2032 participants; moderate-quality evidence). This is equivalent to an increase of 38.32 µg/L (95% CI 24.03 to 52.61 µg/L). This effect was not observed in the meta-analysis of non-RCTs (SMD 0.25, 95% CI -0.16 to 0.66; 3 non-RCTs, 262 participants; very low-quality evidence). Sensitivity analyses did not change the effect observed in the primary analyses. AUTHORS' CONCLUSIONS: The evidence on the effect of iodine fortification of foods, beverages, condiments, or seasonings other than salt on reducing goitre, improving physical development measures, and any adverse effects is uncertain. However, our findings suggest that the intervention likely increases urinary iodine concentration. Additional, adequately powered, high-quality studies on the effects of iodine fortification of foods on these, and other important outcomes, as well as its efficacy and safety, are required.


Assuntos
Condimentos , Alimentos Fortificados , Iodo/administração & dosagem , Iodo/deficiência , Oligoelementos/administração & dosagem , Oligoelementos/deficiência , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Bócio/epidemiologia , Bócio/prevenção & controle , Humanos , Lactente , Iodo/urina , Micronutrientes/administração & dosagem , Prevalência , Ensaios Clínicos Controlados Aleatórios como Assunto , Oligoelementos/urina , Adulto Jovem
19.
J Clin Lab Anal ; 33(4): e22837, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30737844

RESUMO

BACKGROUND: Iodine, an essential nutrient, is the most important trace element in thyroid hormone synthesis and maintenance of thyroid function. This study investigated the iodine nutrition status in healthy Chinese adults and assessed the relationship between urinary iodine concentration (UIC) and thyroid hormone levels. METHODS: A cross-sectional, multicenter study was conducted between October 2017 and January 2018, with 1017 adults recruited from five cities in China. All subjects underwent thyroid ultrasonography, and only those with normal results were included in the study. UICs were measured by inductively coupled plasma mass spectroscopy and adjusted using urine creatinine levels. Thyroid hormone levels were measured using an automated immunoassay analyzer. RESULTS: The median UIC and adjusted UIC were 134.0 µg/L and 114.2 µg/g, respectively. UIC was not significantly different between males and females (P = 0.737). However, the adjusted UIC was significantly different between sexes (P < 0.001). The median UIC was higher than 100 µg/L. According to the World Health Organization criterion (100 µg/L), the total prevalence of iodine deficiency is 33.1% (n = 271). The prevalence rates of iodine deficiency in our study were 33.2% and 32.9% in males and females, respectively, and had no difference between sexes and among cities (P > 0.05). Serum thyroid-stimulating hormone (TSH) levels increased when UIC increased. The Kruskal-Wallis test showed no significant differences in free triiodothyronine, free thyroxine, and TSH, with different levels of UIC (all P > 0.05). CONCLUSIONS: Chinese adults with normal thyroid structure have relatively sufficient iodine levels.


Assuntos
Iodo/urina , Hormônios Tireóideos/sangue , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Asiático , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes de Função Tireóidea
20.
Nutrients ; 11(2)2019 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-30781393

RESUMO

BACKGROUND: Iodine deficiency in pregnant women, defined as a median urinary iodine concentration (UIC) of less than 150 µg/L, is an important public health issue. To improve their iodine intake, it is important to understand the knowledge and practices regarding iodine. METHODS: A cross-sectional investigation was conducted on 2642 pregnant women during 2016⁻2017 in Zhejiang province, China. A 3-point Likert scale questionnaire was used to record knowledge. The UIC and iodine content in household salt were determined. RESULTS: Coastal participants were iodine deficient (median UIC 127.6 µg/L) while inland participants were iodine sufficient (median UIC 151.0 µg/L). The average knowledge scores were significantly lower for the coastal participants (24.2 points vs. 25 points for the inland participants; p < 0.001). The percentage for iodized salt consumption was significantly lower for the coastal participants (88.9% vs. 96.0% for those inland; p < 0.001). A generalized linear model analysis showed that non-iodized salt consumption, coastal region, and low knowledge scores were independently associated with a low UIC. CONCLUSIONS: Comprehensive interventional strategies are needed to develop to achieve an optimal iodine status. We recommend that coastal pregnant women should take iodine supplements based on the consumption of iodized salt, and improvement of iodine-related knowledge.


Assuntos
Ingestão de Alimentos/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Iodo/deficiência , Complicações na Gravidez/psicologia , Gestantes/psicologia , Adolescente , Adulto , China , Estudos Transversais , Feminino , Humanos , Iodo/análise , Iodo/urina , Estado Nutricional , Gravidez , Complicações na Gravidez/etiologia , Complicações na Gravidez/urina , Cloreto de Sódio na Dieta/análise , Sódio na Dieta/análise , Inquéritos e Questionários , Adulto Jovem
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