Iodine Areas Research Articles

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

BackgroundIt is unclear whether salivary iodine concentration (SIC) can assess iodine status in females from different water iodine regions. ObjectivesThrough a cross-sectional study, we explored the feasibility of SIC as a biomarker to assess iodine status in females and develop optimal cutoff values. MethodsA 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. ResultsThere 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). ConclusionsUsing 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.

Analysis of Thyroid Autoantibodies and Thyroid Stimulating Hormone Expression in Patients with Thyroid Diseases in High Iodine Areas of Cangzhou

Objective: To analyze the differences in the expression of thyroid autoantibodies and thyroid-stimulating hormone in people with thyroid disease in the high iodine area of Cangzhou City. Methods A total of 90 patients with thyroid disease from high iodine area of Cangzhou City were enrolled, including 30 patients with hypothyroidism, 30 patients with goiter and 30 patients with thyroid cancer. A total of 30 healthy patients at the same time and in the same region were selected as the control. The subjects were divided into four groups: hypothyroidism group, Goiter group, Thyroid cancer group, and control group. The TSH levels and thyroid autoantibody levels of the four groups were analyzed. Results Compared with the control group, the levels of thyroid autoantibodies in the hypothyroidism, Goiter group and thyroid cancer group were significantly higher (P&amp;lt;0.05), and compared with the control group, the TSH levels in the hypothyroidism group and the thyroid cancer group were higher, and the TSH levels in the Goiter group were lower (P&amp;lt;0.05). Conclusion: Thyroid autoantibodies and thyroid-stimulating hormone are differentially expressed in different types of thyroid diseases in the high iodine area of Cangzhou City, which can be used as reference indicators for the identification and diagnosis of different types of thyroid diseases.

A Meta-Analysis of the Prevalence of Children Goiter in High Water Iodine Areas of China.

Although there are now a large number of studies confirming that high iodine levels can cause goiter, there is controversy and a lack of quantitative data. A systematic search of PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang Database, and China Biomedical Database for literature on high iodine and goiter in children was performed with a time limit from January 2013 to October 2023. After screening the literature based on the inclusion criteria, extracting the literature data, and evaluating the risk of bias of the included studies, a single-arm meta-analysis was performed using R 4.0.4 software. Twenty-three studies with a total of 50,980 subjects were included. Meta-analysis showed that the prevalence of goiter among children in water-borne iodine-excess areas was 6.0% [95% CI (4.3%, 7.6%)], and subgroup analyses showed that the prevalence of goiter in children with water iodine 100.1-150 µg/L, 150.1-300 µg/L, and > 300 µg/L was 7.5% [95% CI (0.0%, 15.8%)], 5.5% [95% CI (3.1%, 8.0%)], and 10.2% [95% CI (6.7%, 13.6%)], respectively, and the difference was statistically significant (P < 0.01); The prevalence of goiter among children in the northern China (5.8% [95% CI (4.1%, 7.5%)]) was higher than that in the southern China (3.5% [95% CI (1.0%, 6.0%)]) (P < 0.01); the prevalence of goiter in children with urinary iodine levels 100-199 µg/L, 200-299 µg/L, and ≥ 300 µg/L was 2.4% [95% CI (1.9%, 2.9%)], 3.3% [95% CI (1.9%, 4.8%)], and 7.3% [95% CI (4.4%, 9.9%)], respectively, the difference was statistically significant (P < 0.01); the prevalence of goiter in children aged 8, 9, 10, 11, and 12 years old was 5.1% [95% CI (3.9%, 6.4%)], 8.0% [95% CI (4.0%, 11.9%)], 6.2% [95% CI (3.9%, 8.5%)], 5.5% [95% CI (0.0%, 13.2%)], and 5.4% [95% CI (0.0%, 15.1%)], and when age ≥ 9 years, the relationship between goiter prevalence and age showed a trend toward decreasing with age, but the relationship between different age was no statistical difference in the prevalence of goiter between ages. urinary iodine. The prevalence of goiter in children was higher in areas with high water iodine; the prevalence of goiter in children in the north was significantly higher than that in the south; the prevalence of goiter in children tends to increase with increased urinary iodine levels.

The whole blood DNA methylation of RAB8A and RAP1A in autoimmune thyroiditis: evidence and validation of iodine exposure in a population from different water iodine areas

ABSTRACT Our study aimed to identify and verify G protein-related methylated genes in AIT patients, while also investigate those genes in AIT patients exposed to iodine in different water iodine areas. Different areas were classified by median water iodine (MWI) concentrations: Iodine-Fortified Areas (IFA, MWI<10µg/L), Iodine-Adequate Areas (IAA, 40≤MWI≤100 µg/L), and Iodine-Excessive Areas (IEA, MWI>100 µg/L). We studied 176 AIT cases and 176 controls, with 89, 40, and 47 pairs in IFA, IAA, and IEA, respectively. Using the Illumina Human Methylation 850k BeadChip, we identified candidate methylated genes. MethylTargetTM and QRT-PCR validated DNA methylation and mRNA expression. Results showed hypomethylation and high expression of RAB8A and RAP1A in all 176 AIT cases. RAB8A's CpG sites were mainly hypomethylated in IFA and IEA, while RAP1A's sites were primarily hypomethylated in IEA. This study underscores how water iodine exposure may influence RAB8A and RAP1A methylation in AIT.

Association between different water iodine exposures and thyroid cancer: A retrospective study of high water iodine areas in China from 2009 to 2020

In recent years, the incidence of thyroid cancer has been on a significant rise worldwide, and a number of environmental factors have been suspected to be risk factors for thyroid cancer, especially the relationship between iodine intake and thyroid cancer has attracted attention. In this study, we want to assess the relationship between different water iodine exposures and thyroid cancer incidence before and after water alteration in areas with high water iodine in China. Thyroid cancer patients (2009–2020) were enrolled at two hospitals, both in Heze City, Shandong Province, an area with high water iodine levels. According to the criteria of the study, 5826 cases out of 8785 cases were selected for inclusion in the study. Before and after water alteration, the incidence of thyroid cancer was highest in areas with water iodine concentrations of 200–300 μg/L in high iodine areas. In areas where water iodine decreased to adequate iodine levels, there was a strong negative correlation between the decreased level of water iodine and the incidence of thyroid cancer. In addition, in cases with pathology reports, we found that the greater the decrease in water iodine values, the markedly smaller the maximum diameter of the thyroid cancer lesions. Taken together, these findings suggest that we should continue to monitor the incidence of thyroid cancer in areas with high water iodine and continue to optimize population iodine intake to reduce the incidence of thyroid cancer.

Serum thyroglobulin as a biomarker of iodine excess and thyroid disease occurrence in adults

BackgroundThyroglobulin (Tg) is considered a sensitive indicator of iodine deficiency. However, the usefulness of Tg as a biomarker of excess iodine is uncertain. The present study aimed to determine the influence of different iodine intake on serum Tg levels, evaluate the influence of thyroid diseases on the distribution of Tg, and identify the factors that may affect Tg levels. MethodsA cross-sectional survey with a total of 1208 adults was conducted in different water iodine areas in China. Urinary iodine concentration (UIC), water iodine concentration (WIC), serum Tg, thyroid-stimulating hormone (TSH), and thyroid antibodies were measured. The thyroid volumes and nodules were measured by B-scan ultrasound. ResultsBased on the WIC data, subjects were divided into three groups. Based on the median urinary iodine concentration (MUIC) data, the iodine levels were adequate, more than adequate, and excess for the WIC < 10 μg/L group, 10 μg/L ≤ WIC ≤ 100 μg/L g, and WIC > 100 μg/L groups, respectively. The median Tg was significantly higher in the excess iodine group than in the adequate iodine group and the more than adequate iodine group (14.6 μg/L vs.12.7 μg/L, P = 0.042; 14.6 μg/L vs.12.5 μg/L, P = 0.004). Multiple linear regression analysis showed that excess iodine intake, goitre, thyroid nodules, and hypothyroidism were significantly related to higher serum Tg levels. ConclusionSerum Tg level can be a promising biomarker of excessive iodine intake, but other factors, especially the presence of thyroid disease, should be considered when using this parameter.

The clinical, laboratory and anatomical pathology profiles of Hashimoto’s Thyroiditis patients at Dr. Soetomo General Academic Hospital Surabaya 2015 – 2020

The primary cause of hypothyroidism in the ​​sufficient iodine area is Hashimoto's thyroiditis. Hashimoto's thyroiditis, also known as chronic autoimmune thyroiditis or chronic lymphocytic thyroiditis, is an autoimmune condition in which B cells and T cells slowly destroy the thyroid gland. To determine the diagnosis, we need the clinical, laboratory, cytological, and/or histopathology profiles. It aims to distinguish Hashimoto's thyroiditis from other diseases such as nontoxic goiter and Graves' disease. This retrospective descriptive study used data from the medical record of Dr. Soetomo General Hospital from 2015-2020. This study used total sampling and got 18 patients in total. The patients were mostly females (n=15), in the age group of 40-49 years old (n=8). The main complaint was an enlargement or nodule in the neck. The TSH (thyroid stimulating hormone) levels were majorly higher than the normal range (n=8) meanwhile the FT4 levels were mostly normal (n=6) and low (n=6). The positivity of TPOAb (antibody against thyroid peroxidase) is merely found in one patient. The majority of the result of the Doppler ultrasound examinations revealed Hashimoto’s thyroiditis (n=7). FNAB (fine needle aspiration biopsy) was performed on 11 patients. A histopathology examination was also conducted on 9 patients who underwent thyroidectomy. All of the cytology and histopathology examinations confirmed Hashimoto’s thyroiditis. Non-Hodgkin Lymphoma was found to coexist with 2 Hashimoto's thyroiditis cases. The findings were similar to the previous studies, except that among all the subjects, those who are 40-49 in age were primarily found in this study.

Experimental optimization of single-exposure dual-energy angiography with photon-counting x-ray detectors.

Photon-counting x-ray detectors may enable single-exposure dual-energy (DE) x-rayangiography. The purpose of this paper is to experimentally optimize the energy thresholds and tube voltage for single-exposure DE x-rayangiography. We optimized single-exposure DE x-ray angiography using the iodine signal-difference-to-noise ratio (SDNR) per root patient air kerma (κ) as a figureof merit. We measured the iodine SDNR by imaging an iodine stepwedge immersed in a water tank with a depth of 30cm in the direction of x-ray propagation. The stepwedge was imaged using tube voltages ranging from 90 to 150kV and a cadmium telluride (CdTe) x-ray detector with two energy bins and analog charge summing for charge sharing suppression. The energy threshold that separates the two energy bins was varied from approximately 35keV to approximately 75% of the maximum energy of the x-ray beam. Curve fitting was used to determine the threshold that maximized . The effect of scatter was determined from measurements of the scatter-to-primary ratios (SPRs) of the low-energy and high-energy images and a semi-empirical model of the relationship between SDNR and SPR. Using the optimal parameters, we imaged a phantom with vessel-simulating structures and backgroundclutter. The optimal energy thresholds increased monotonically from ∼50 to ∼85keV over the range of tube voltages considered. For tube voltages greater than 90kV, the optimal energy thresholds consistently allocated approximately two thirds of all detected primary photons to the low energy bin; this ratio was preserved without scatter. Consistent with prior modeling studies, increased monotonically with tube voltage from 90 to 150kV; at 150kV was approximately 38% higher than that at 90kV for an iodine area density of ∼50mg/cm2 . Scatter reduced SDNR by approximately 25% for SPRs of ∼1 and 0.4 in low-energy and high-energy images, respectively. Achieving optimal image quality in single-exposure DE angiography with photon-counting x-ray detectors will require high tube voltages (i.e.,>130kV) and, for thick patients, energy thresholds that allocate approximately two thirds of all primary photons to the low-energy image. Future work will compare the image quality of singe-exposure photon-counting and kV-switching approaches to DE x-rayangiography.

Effect of different iodine levels on the DNA methylation of PRKAA2, ITGA6, THEM4 and PRL genes in PI3K-AKT signaling pathway and population-based validation from autoimmune thyroiditis patients.

Autoimmune thyroiditis (AIT) is one of the most common autoimmune endocrine diseases. The currently recognized causes are genetic susceptibility, environmental factors and immune disorders. It is important to clarify the pathogenesis for the prevention, diagnosis, treatment of AIT and scientific iodine supplementation. This study analyzed the DNA methylation levels of PRKAA2, ITGA6, PRL and THEM4 genes related to PI3K-AKT signaling pathway, compared the DNA methylation levels between cases and controls from different water iodine levels in Shandong Province of China, and evaluated the contribution of PI3K-AKT signaling pathway-related genes in AIT. A total of 176 adult AIT patients were included from three different water iodine areas, and 176 healthy controls were included according to gender, age and BMI. According to the results of the Illumina Methylation 850K BeadChip in our previous research, the significant methylation differences of genes on the PI3K-AKT signaling pathway related to AIT were determined. The MethylTarget™ assay was used to detect the methylation levels of the target genes, and real-time PCR experiments were used to verify the mRNA expression levels. Compared with the control group, PRKAA2_3 and 15 CpG sites were hyper-methylated. ITGA6 gene and 2 CpG sites were hypo-methylated in AIT cases. The mRNA expression of ITGA6 gene was negatively correlated with the DNA methylation levels of ITGA6 gene and 2 CpG sites. Compared with cases and controls in areas with different water iodine levels, methylation differences were mainly in PRKAA2 and ITGA6 genes. The methylation levels of PRKAA2_1 and PRKAA2_3 were positively correlated with age. The methylation levels of PRL and THEM4 genes were negatively correlated with age. The methylation level of PRKAA2_3 was positively correlated with FT4. In summary, we identified aberrant DNA methylation levels of PRKAA2 and ITGA6 genes related to PI3K-AKT signaling pathway in the blood of AIT patients. Both iodine supplementation after long-term iodine deficiency and iodine excess can affect the DNA methylation levels of PRKAA2 and ITGA6 genes, and the former affects more obviously. In ITGA6 gene, this aberrant epigenetic modification is associated with the increased mRNA expression.

What Iodine Intervention Measures Should Be Taken in Different Water Iodine Areas? Evidence from a Cross-sectional Chinese Survey.

The aim of this study was to assess the population's iodine nutrition and thyroid diseases in different water iodine areas and to offer suggestions to the governments of different countries to adjust the present policy in different water iodine areas. A cross-sectional survey was conducted in different water iodine areas in China. Urinary iodine, water iodine, salt iodine and thyroid function were determined. The thyroid volumes and nodules were measured by ultrasound. Upon categorization by water iodine level for the 10.0 ~ 39.9μg/L, 40.0 ~ 100.0μg/L and 100.1 ~ 150.0μg/L areas, in adults, the prevalence of subclinical hypothyroidism was 9.28%, 5.35% and 11.07%, and the median urinary iodine (MUI) was 153.7μg/L, 189.8μg/L and 317.0μg/L; in children of the three areas, the prevalence of goitre was 3.83%, 4.47% and 16.02%, and the MUI was 164.1μg/L, 221.0μg/L and 323.3μg/L; in pregnant women of those areas, the MUI was 148.6μg/L, 176.9μg/L and 324.9μg/L. Logistic regression results indicated that low iodine intake was a risk factor for developing hypothyroxinaemia in pregnant women. The iodine status of pregnant women is insufficient in areas with a median water iodine level of 10.0 ~ 39.9μg/L. Low iodine intake increases the risk of developing hypothyroxinaemia in pregnant women. The iodine status of adults and children is excessive, and the iodine status of pregnant women is above the requirements in areas with a median water iodine concentration of 100.1 ~ 150.0μg/L. Iodized salt, especially for pregnant women, should be supplied in areas with a median water iodine concentration of 10.0 ~ 39.9μg/L to improve the iodine status of pregnant women. Supplying non-iodized salt is not enough to protect local residents from the harm from excess iodine in areas with a median water iodine concentration above 100.0μg/L.

DNA Methylation Patterns in the HLA-DPB1 and PDCD1LG2 Gene Regions in Patients with Autoimmune Thyroiditis from Different Water Iodine Areas.

Background: Epigenetic disorders play an important role in the pathogenesis of autoimmune thyroiditis (AIT). Therefore, the study of the possible role of DNA methylation in AIT is of great significance to explore the pathogenesis of AIT. Methods: From May 2019 to June 2019, whole blood samples were collected from 176 AIT patients and 176 controls from different water iodine levels in Shandong Province, China. We used the Illumina Methylation 850K BeadChip to determine significant differences in methylation status of genes and used the MethylTarget™ assay to verify the methylation level in 176 cases and 176 controls. The relative mRNA levels of genes were detected by quantitative real-time-polymerase chain reaction. Results: There were multiple differential methylation sites in the HLA-DPB1 and PDCD1LG2 genes between the case and control population with different water iodine levels. Some target regions of HLA-DPB1 and PDCD1LG2 genes were negatively correlated with relative mRNA expression in the case and control populations and with different water iodine levels. Conclusions: There is differential methylation status in genomic DNA in patients with AIT. The methylation patterns of HLA-DPB1 and PDCD1LG2 genes related to cell adhesion molecule pathway may be different based on different water iodine levels. HLA-DPB1 and PDCD1LG2 genes related to the cell adhesion molecules pathway may play a role in the development of AIT. This study is registered with Chinese Clinical Trial Registry, www.chictr.org.cn, number ChiCTR2000039105.

Аутоиммунный тиреоидит и пищевые факторы

Аутоиммунный тиреоидит (АИТ) считается самым распространенным аутоиммунным заболеванием. В настоящее время признано, что генетическая восприимчивость, факторы окружающей среды и иммунные расстройства способствуют его развитию. Что касается пищевых факторов, данные свидетельствуют о высоком уровне потребления йода, дефиците селена и железа с потенциальной значимостью статуса витамина D. Для выяснения роли факторов питания в риске, патогенезе и лечении АИТ использованы источники PubMed относительно йода, железа, селена, витамина D, мио-инозитола и лечения АИТ. Хроническое воздействие чрезмерного потребления йода индуцирует аутоиммунный тиреоидит отчасти потому, что йодированный тиреоглобулин (Tg) более иммуногенный. Селенопротеины необходимы для поддержания функционального состояния щитовидной железы. Существуют данные рандомизированных конт­ролируемых исследований, что селен/селенопротеины могут уменьшить титры антител к тиреоидной пероксидазе (ТПО) у больных гипотиреозом и послеродовым тиреоидитом. У больных АИТ часто наблюдается дефицит железа, поскольку аутоиммунный гастрит, который ухудшает всасывание железа, является довольно частым сопутствующим заболеванием. В последние годы возникли доказательства, указывающие на положительную роль витамина D, включая пролиферацию и дифференциацию нормальных и раковых клеток, сердечно-сосудистую функцию и иммуномодуляцию. Дефицит витамина D особенно продемонстрирован у больных АИТ. У пациентов с АИТ обнаружен более низкий уровень витамина D, чем у лиц из контрольной группы, и сообщается об обратной зависимости содержания сывороточного витамина D от титра антител к ТПО/Tg. Адекватное потребление селена является жизненно важным в районах дефицита/избытка йода, а в регионах с низким потреблением селена может быть целесо­образным добавление 50–100 мкг/день селена. Мио-инозитол и селен способны восстановить эутиреоидное состояние, а также улучшить самочувствие у больных АИТ с субклиническим гипотиреозом. Принимая во внимание также безопасность использования двух молекул, отсутствие побочных эффектов, комбинацию мио-инозитола и селена можно считать очень эффективной и безопасной терапией для лечения АИТ.

Identifying potential metabolic tissue biomarkers for papillary thyroid cancer in different iodine nutrient regions.

To investigate the applicability of metabolomics to select thyroid cancer-associated biomarkers and discover the effects of iodine on metabolic changes in thyroid cancer. In this study, a total of 33 papillary thyroid cancer (PTC) patients from areas with iodine excess and 32 PTC patients from areas with adequate iodine were recruited, and their cancerous tissue and paracancerous tissue were collected. These specimens were analyzed by ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC/QTOF/MS) in conjunction with multivariate statistical analysis. Good separations were obtained for PTC tissue vs. paracancerous tissue, and 15 metabolites, including L-octanoylcarnitine, N-arachidonoylglycine, and others were found to be disturbed in PTC tissue. Moreover, the metabolic profile presented considerable separation between PTC tissue from different iodine areas, and 15 metabolomic biomarkers were found to be differentially expressed. Among them, 10 metabolites, including arachidonoylcarnitine and LysoPCs, were related to thyroid cancer and excess iodine. These biomarkers play a role in arachidonic acid metabolism pathways and others. In addition, biomarkers such as 3,5-tetradecadiencarnitine and oxidized glutathione were significantly correlated with thyroid function, and biomarkers such as L-octanoylcarnitine and arachidonic acid were significantly correlated with the clinical characteristics of PTC. Distinct differences in metabolic profiles were found to exist between PTCs from areas with different levels of iodine nutrition. The identified biomarkers have significant potential for diagnosing PTC and investigating its underlying mechanisms.

Stabilizing 30ppm Iodine in Iodized Salt: The Effect on Iodine Status and Thyroid Function in Children

Background: Salt iodization considers an effective way of ensuring iodine sufficiency, but a wide variation range of household salt iodine levels existed. Research in iodized salt intervention on preschool-age children had not been found. Objective: Analyse the effect of stabilizing 30 ppm household iodized salt for six months on iodine nutrition status and thyroid function. Method: This was a pre post-test experiment study, with 76 preschool-age children in a replete iodine area in Purworejo Regency. Iodized salt at 30ppm was given for six months. Thyroid function (TSH and FT4) were assessed at 0 and 6 months. Iodine status (UIE) were assessed at 0, 3, and 6 months. ANOVA RM mixed methods were used to interpret the result. Results: Before the study, 51.9% of households had an inadequate level of iodized salt. There were a significant increase of TSH (t=-3.184; p

Assessing the impact of drinking water iodine concentrations on the iodine intake of Chinese pregnant women living in areas with restricted iodized salt supply

The supply of non-iodized salt and the water improvement project have been conducted to reduce the iodine concentration in drinking water in areas with elevated water iodine. We aimed to assess the impact of water iodine concentration (WIC) on the iodine intake of pregnant women in areas with restricted iodized salt supply, and determine the cutoff values of WIC in areas with non-iodized salt supply. Overall, 534 pregnant women who attended routine antenatal outpatient visits in Zibo Maternal and Child Health Hospital in Gaoqing County were recruited. The 24-h urine iodine excretion (UIE) in 534 samples and the iodine concentration in 534 drinking water samples were estimated. Urinary iodine excretion, daily iodine intake, and daily iodine intake from drinking water (WII) were calculated. The relationship between WIC and daily iodine take was analyzed. The median WIC, spot urine iodine concentration (UIC), and 24-h UIE were 17 (6, 226) μg/L, 145 (88, 267) μg/L, and 190 (110, 390) μg/day, respectively. A significant positive correlation was found between WIC and UIE (R2 = 0.265, p < 0.001) and UIC (R2 = 0.261, p < 0.001). The contribution rate of WII to total iodine intake increased from 3.0% in the group with WIC of < 10μg/L to 45.7% in the group with WIC of 50-99μg/L. The iodine content in drinking water is the major iodine source in pregnant women living in high-water iodine areas where iodized salt supply is restricted. The contribution rate of daily iodine intake from drinking water increases with the increase in water iodine concentration.

Stopping the supply of iodized salt alone is not enough to make iodine nutrition suitable for children in higher water iodine areas: A cross-sectional study in northern China

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. 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. 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%. 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.

Prevalence of thyroid function in pregnant and lactating women in areas with different iodine levels of Shanxi province

Objective: To investigate the effects of high iodine intake on thyroid function in pregnant and lactating women. Methods: A cross sectional epidemiological study was conducted among 130 pregnant women and 220 lactating women aged 19-40 years in areas with high environment iodine level (>300 μg/L) or proper environment iodine level (50-100 μg/L) in Shanxi in 2014. The general information, urine samples and blood samples of the women surveyed and water samples were collected. The water and urine iodine levels were detected with arsenic and cerium catalysis spectrophotometric method, the blood TSH level was detected with electrochemiluminescence immunoassay, and thyroid stimulating hormone (FT(4)), antithyroid peroxidase autoantibody (TPOAb) and anti-thyroglobulin antibodies (TGAb) were detected with chemiluminescence immunoassay. Results: The median urine iodine levels of the four groups were 221.9, 282.5, 814.1 and 818.6 μg/L, respectively. The median serum FT(4) of lactating women in high iodine area and proper iodine area were 12.96 and 13.22 pmol/L, and the median serum TSH was 2.45 and 2.17 mIU/L, respectively. The median serum FT(4) of pregnant women in high iodine area and proper iodine area were 14.66 and 16.16 pmol/L, and the median serum TSH was 2.13 and 1.82 mIU/L, respectively. The serum FT(4) levels were lower and the abnormal rates of serum TSH were higher in lactating women than in pregnant women in both high iodine area and proper iodine area, the difference was statistically significant (FT(4): Z=-6.677, -4.041, P<0.01; TSH: Z=8.797, 8.910, P<0.01). In high iodine area, the abnormal rate of serum FT(4) in lactating women was higher than that in pregnant women, the difference was statistically significant (Z=7.338, P=0.007). The serum FT(4) level of lactating women in high iodine area was lower than that in proper iodine area, the difference was statistically significant (Z=-4.687, P=0.000). In high iodine area, the median serum FT(4) in early pregnancy, mid-pregnancy and late pregnancy was 16.26, 14.22 and 14.80 pmol/L, respectively, and the median serum TSH was 1.74, 1.91 and 2.38 mIU/L, respectively. In high iodine area, the serum FT(4) level in early pregnancy was higher than that in mid-pregnancy and late pregnancy, and the serum TSH level was lower than that in mid-pregnancy and late pregnancy, the difference was statistically significant (FT(4): Z=-2.174, -2.238, P<0.05; TSH: Z=-2.985, -1.978, P<0.05). There were no significant differences in the positive rates of serum thyroid autoantibodies among the four groups of women and women in different periods of pregnancy (P>0.05). The morbidity rates of subclinical hyperthyroidism in pregnant women and lactating women in high iodine area were obviously higher than those in proper iodine areas, the difference was statistically significant (χ(2)=5.363, 5.007, P<0.05). Conclusions: Excessive iodine intake might increase the risk of subclinical hypothyroidism in pregnant women and lactating women. It is suggested to strengthen the iodine nutrition and thyroid function monitoring in women, pregnant women and lactating women in areas with high environmental iodine.

High prevalence of iodine deficiency in pregnant women living in adequate iodine area.

ObjectivesIodine deficiency during pregnancy is associated with obstetric and neonatal adverse outcomes. Serum thyroglobulin (sTg) and thyroid volume (TV) are optional tools to urinary iodine concentration (UIC) for defining iodine status. This cross-sectional study aims to evaluate the iodine status of pregnant women living in iodine-adequate area by spot UIC and correlation with sTg, TV and thyroid function.MethodsTwo hundred and seventy-three pregnant women were evaluated at three trimesters. All had no previous thyroid disease, no iodine supplementation and negative thyroperoxidase and thyroglobulin antibodies. Thyroid function and sTg were measured using electrochemiluminescence immunoassays. TV was determined by ultrasonography; UIC was determined using a modified Sandell–Kolthoff method.ResultsMedian UIC was 146 µg/L, being 52% iodine deficient and only 4% excessive. TSH values were 1.50 ± 0.92, 1.50 ± 0.92 and 1.91 ± 0.96 mIU/L, respectively, in each trimester (P = 0.001). sTg did not change significantly during trimesters with median 11.2 ng/mL and only 3.3% had above 40 ng/mL. Mean TV was 9.3 ± 3.4 mL, which positively correlated with body mass index, but not with sTg. Only 4.5% presented with goitre.When pregnant women were categorized as iodine deficient (UIC < 150 µg/L), adequate (≥150 and <250 µg/L) and excessive (≥250 µg/L), sTg, thyroid hormones and TV at each trimester showed no statistical differences.ConclusionsIodine deficiency was detected frequently in pregnant women living in iodine-adequate area. sTg concentration and TV did not correlate to UIC. Our observation also demonstrated that the Brazilian salt-iodization programme prevents deficiency, but does not maintain iodine status within adequate and recommended ranges for pregnant women.

Kajian Patofisiologis Gejala Klinis dan Psikososial Sebagai Dampak Gangguan Fungsi Tiroid pada Wanita Usia Produktif

Indonesia has not been free from iodine deficiency, demonstrated by the increased prevalence oftotal goitre rate (TGR) from 9.8% in 1998, to 11.1% in 2003. New problem that occurs in endemic areas ofiodine deficiency is the presence of iodine excessive, one of them as the impact of universal salt iodizationprogram (USI) and iodiol supplementation in a long period of time. Both deficiency and excessive of iodinecan result in thyroid dysfunction. Impaired thyroid function is manifest broadly on biopsychosocial aspects,which is detrimental especially for childbearing women, as a determinant of survival and quality of life forfuture generations. Based on the measurement of TSH and FT4, were childbearing women who suffersubclinical hypothyroidism were 2%, subclinical hyperthyroidism were 26% and euthyroid were 76%.Biopsychosocial characteristics that can be described from hypothyroid subjects are visible goiter, puffyface, dry skin, fatigue, decreased concentration, menorrhagia, easily upset, depressed, apathetic and withdrawn.Meanwhile, the varying percentage of subjects with subclinical hyperthyroidism showed signs andsymptomsinclude a palpablegoiter,heat intolerance, exophthalmos, tiredness, pritibial edema, muscleweakness,delicated skin, poor memory,decreased concentration, menstrual disorders, decreased sexuallibido,anxiety,sleep disturbances, irritability,decreased motivation and decreased social activity.Thereforethatthe impact of thyroid dysfunction on a biopsychosocial characteristics, does not continue to secondarydiseases,efforts are needed to increase community awareness to recognize the signs and symptoms ofbiopsychosocialchanges. Therefore, the condition of iodine deficiency and excessive can be detected earlyandovercame with adequate therapy.

Association between chronic exposure to different water iodine and thyroid cancer: A retrospective study from 1995 to 2014

The controversy that iodine intake may increase the risk of thyroid cancer has heightened over the past twenty years. In this retrospective study, we mainly analyzed the association between water iodine and thyroid cancer and discussed the possible cause of the increase in thyroid cancer. This study was supported by three hospitals in areas with different water iodine concentration. 5574 patients with thyroid disease were recruited, of which 1429 patients had been diagnosed with thyroid cancer. These samples collectively were used to analyze the relationship of incidence and prevalence associated with water iodine. In addition, the ratio of maximum tumor diameter was analyzed. By analyzing the proportion of patients with thyroid cancer in thyroid diseases, we found a decrease in the proportion of thyroid cancer with increasing water iodine (P<0.0001). In addition, there was no significant correlation between the median water iodine and the prevalence of thyroid cancer, including papillary thyroid cancer (P>0.05). Meanwhile, the 5years' cumulative incidence of thyroid cancer increased with years (P<0.01). Comparing Cao county and Shan county, which are areas with high water iodine, to adequate iodine area such as in Mudan district, an increasing incidence is observed in 2010–2014 in Mudan district. Again, we observed a significant increase in the proportion of thyroid cancer with tumor size <1cm (P<0.01). Therefore, we concluded that cause(s) of increase in thyroid cancer may be ascribed to the sensitive diagnostic techniques and the improvement of living condition, but not water iodine.