Abstract
BackgroundThe principal function of iodine acts on thyroid function, but in recent years, the role of iodine deficiency in metabolism has also been gradually revealed. We aimed to investigate the current status of iodized salt consumption and urinary iodine concentration (UIC) in an urban Chinese population with type 2 diabetes, and to further explore whether UIC was associated with diabetic microvascular complications.MethodsFour thousand five hundred fifty-nine subjects with diabetes from 7 communities in downtown Shanghai were enrolled in the cross-sectional Metal Study in 2018. UIC was detected using an inductively coupled plasma-mass spectrometer. Diabetic kidney disease (DKD) was defined as urinary albumin-to-creatinine ratio (UACR) > 30 mg/g or estimated glomerular filtration rate < 60 mL/min/1.73 m2. Diabetic retinopathy (DR) was evaluated by high-quality fundus photographs and was remotely read by ophthalmologist.ResultsThe median UIC of subjects with diabetes was 115.4 μg/L (78.9–170.8) in downtown Shanghai. Among all the subjects, 52.7% consumed non-iodized salt and 40.4% were iodine deficient. Iodine deficiency (UIC < 100 μg/L) was associated with an increased odds of DKD (OR 1.17; 95%CI 1.01–1.37) after adjustment for age, sex, education, current smokers, BMI, HbA1c, duration of diabetes, dyslipidemia, thyroid-stimulating hormone and free thyroxine. No association was observed between UIC and DR after multivariable adjustment.ConclusionsA concerning number of subjects with diabetes consumed non-iodized salt and suffered from iodine deficiency in coastal regions of China. Low UIC might be a risk factor for DKD, which should be further confirmed by longitudinal prospective studies.
Highlights
Type 2 Diabetes Mellitus (T2DM) has become a serious global health care burden, causing microvascular complications which are associated with increased disability, reduced quality of life and life expectancy [1, 2]
The aim of this study was to investigate the current status of iodized salt consumption and urinary iodine concentration (UIC) in an urban Chinese population with T2DM, and whether UIC is associated with diabetic microvascular complications including diabetic kidney disease (DKD) and diabetic retinopathy (DR)
Iodine deficiency was significantly associated with a higher prevalence of elevated urinary albumin-to-creatinine ratio (UACR) and DKD, independently of age, sex, education, current smokers, Body mass index (BMI), HbA1C, duration of diabetes, dyslipidemia, thyroid-stimulating hormone (TSH) and FT4
Summary
Type 2 Diabetes Mellitus (T2DM) has become a serious global health care burden, causing microvascular complications which are associated with increased disability, reduced quality of life and life expectancy [1, 2]. Over the past 20 years, substantial progress has been achieved in the worldwide effort to eliminate iodine deficiency disorders (IDD) by salt iodization program. This program is vulnerable and requires a long-term commitment from governments. We aimed to investigate the current status of iodized salt consumption and urinary iodine concentration (UIC) in an urban Chinese population with type 2 diabetes, and to further explore whether UIC was associated with diabetic microvascular complications
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