Abstract

Iodine intake in the US has declined in recent years. Iodine insufficiency increases the risk for inadequate thyroid hormone production and there is growing evidence that sub-clinical hypothyroidism may be disruptive to metabolic health, including insulin resistance (IR). We investigated the association between urinary iodine concentrations (UIC), a measurement of iodine status, and IR in adults. Data from 1286 US adults (≥20 years) in the NHANES 2011–2012 were analyzed. Two subgroups (low = UIC < 100 µg/L and normal = UIC ≥ 100 µg/L) were compared for markers of IR, including fasting plasma glucose (FPG) and insulin, homeostatic model assessment of insulin resistance (HOMA-IR), and glycated hemoglobin (HbA1C). Chi-square test, both linear and logistic regression models were used. In males, there were no significant associations between UIC and markers of IR; however, females with normal UIC had greater risks for elevated HOMA-IR (AOR = 0.56, 95% CI= 0.32–0.99) and HbA1C (AOR = 0.56, 95% CI = 0.34–0.90), while females with low UIC had a greater risk for FPG ≥ 5.6 mmol/L (AOR = 1.73, 95% CI = 1.09–2.72). Results only partially support our hypothesis that UIC is associated with the odds of IR in adults. The finding of an increased risk for elevated FPG, a marker of prediabetes, in female adults with low iodine status requires further investigation.

Highlights

  • The Institute of Medicine (IOM) recommends a dietary iodine intake of 150 ug/day for adults based on adequate thyroid iodine accumulation to support thyroid hormone (TH) production [1]

  • (mUIC) of the low group was 55.8 μg/L compared to 199.6 μg/L for the normal group

  • The objectives of the present study were to use NHANES 2011–2012 data to: (1) identify socioeconomic and lifestyle variables affecting urinary iodine concentration (UIC) and markers of insulin resistance (IR); (2) determine the association of UIC with markers of IR; and to (3) estimate the risks of IR by UIC in adults. This analysis showed that the median UIC of adults in the U.S population is above the minimum cut-off for normal iodine status, there are a few vulnerable groups

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Summary

Introduction

The Institute of Medicine (IOM) recommends a dietary iodine intake of 150 ug/day for adults based on adequate thyroid iodine accumulation to support thyroid hormone (TH) production [1]. Iodine intake within the U.S population has declined from 250 ug/day to 157 ug/day, a trend that mirrors the decrease in sales of iodized salt (from 70% to 53%) [2]. The speculative reasons for this decline are replacement of home-prepared foods with commercially-prepared foods made with non-iodized salts and increased preferences for other salt types for cooking which are non-iodized [3]. All of these have raised concerns about potentially inadequate intakes of iodine despite high intakes of salt from processed foods [4].

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