Abstract
BackgroundOver the past decade, the phenomenon of high urine iodine (HUI) and high water iodine (HWI) has become more common. But the risk of goiter caused by different levels of HUI and HWI remains unclear.ObjectivesTo explore the risk of goiter development caused by HUI and HWI, and compare the risk of goiter development from different levels of high iodine.MethodsThe Medline, Cochrane library, Embase, China National Knowledge Infrastructure and Wan fang databases were searched for relevant population-based studies investigating the link between high iodine levels and goiter development in mainland China. Three reviewers extracted data from the included studies independently, assessing the prevalence of goiter development due to high iodine.ResultsTaking 100 μg/L ≤ UIC < 300 μg/L (UIC = urinary iodine concentration) as the reference group, the odds ratio (OR) regarding high iodine levels and goiter formation was 1.74 (95% CI 1.50, 2.01, P < 0.001), if the water iodine concentration (WIC) was greater than 100 μg/L, the OR between goiter development and WIC was 4.74 (95% CI 1.15, 19.46, P = 0.001). The Linear trend analysis of HUI and goiter showed that the prevalence of goiter increased with the increase of UIC (χ2 = 734.605, P < 0.001).ConclusionsWhen the UIC ≥ 300 μg/L or the WIC ≥ 100 μg/L, the risk of goiter will increase. The higher the UIC, the greater the risk of goiter development. In order to improve the public thyroid health, we should adhere to the monitoring of urinary iodine and water iodine, and keep them at an appropriate level.Trial registrationPROSPEROCR, CRD42020197620. Registered 8 August 2020, https://www.crd.york.ac.uk/PROSPERO/.
Highlights
Iodine is an essential trace element in the human body and is a crucial component of both thyroxin and triiodothyronine, key hormones produced by the thyroid
A urinary iodine concentration (UIC) of 100–300 μg/L was selected as the reference group. 7 articles reported the prevalence of goiters, which included 16 studies
It indicated that a UIC ≥ 300 μg/L was associated with an increased risk of developing a goiter compared to a UIC from 100– 300 μg/L
Summary
Iodine is an essential trace element in the human body and is a crucial component of both thyroxin and triiodothyronine, key hormones produced by the thyroid. High iodine levels can be caused by dietary intake, with food high in iodine and iodized salt proving problematic; high background levels of iodine in drinking water may cause this and exacerbate the problem of a high dietary intake. Both the WHO and the Chinese government recommended monitoring goiter rates in children as an indicator for long-term iodine nutrition in the population [6]. It was shown that when iodized table salt was consumed in areas with high iodine level water (iodine salt concentration of 10.4–34.1 mg/kg), the average UIC increased to 518 μg/L and the prevalence of goiters was 32.96% [8]. The risk of goiter caused by different levels of HUI and HWI remains unclear
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