Iodine Areas Research Articles

Multiple Nutritional Factors and the Risk of Hashimoto's Thyroiditis.

Hashimoto's thyroiditis (HT) is considered to be the most common autoimmune disease. It is currently accepted that genetic susceptibility, environmental factors, and immune disorders contribute to its development. With regard to nutritional factors, evidence implicates high iodine intake and deficiencies of selenium and iron with a potential relevance of vitamin D status. To elucidate the role of nutritional factors in the risk, pathogenesis, and treatment of HT, PubMed and the Cochrane Library were searched for publications on iodine, iron, selenium, and vitamin D and risk/treatment of HT. Chronic exposure to excess iodine intake induces autoimmune thyroiditis, partly because highly iodinated thyroglobulin (Tg) is more immunogenic. Recent introduction of universal salt iodization can have a similar, though transient, effect. Selenoproteins are essential to thyroid action. In particular, the glutathione peroxidases protect the thyroid by removing excessive hydrogen peroxide produced for Tg iodination. Genetic data implicate the anti-inflammatory selenoprotein S in HT risk. There is evidence from observational studies and randomized controlled trials that selenium/selenoproteins can reduce thyroid peroxidase (TPO)-antibody titers, hypothyroidism, and postpartum thyroiditis. Iron deficiency impairs thyroid metabolism. TPO, the enzyme responsible for the production of thyroid hormones, is a heme (iron-containing) enzyme which becomes active at the apical surface of thyrocytes only after binding heme. HT patients are frequently iron deficient, since autoimmune gastritis, which impairs iron absorption, is a common co-morbidity. Treatment of anemic women with impaired thyroid function with iron improves thyroid-hormone concentrations, while thyroxine and iron together are more effective in improving iron status. Lower vitamin D status has been found in HT patients than in controls, and inverse relationships of serum vitamin D with TPO/Tg antibodies have been reported. However, other data and the lack of trial evidence suggest that low vitamin D status is more likely the result of autoimmune disease processes that include vitamin D receptor dysfunction. Clinicians should check patients' iron (particularly in menstruating women) and vitamin D status to correct any deficiency. Adequate selenium intake is vital in areas of iodine deficiency/excess, and in regions of low selenium intake a supplement of 50-100 μg/day of selenium may be appropriate.

MODEL ANALYSIS, DESIGN, DEVELOPMENT, IMPLEMENTATION, EVALUATION (ADDIE) UNTUK PENGEMBANGAN MEDIA EDUKASI PENANGGULANGAN GANGGUAN AKIBAT KEKURANGAN IODIUM

Background . Need analysis of media development in early stage showed that Pulosaren villagers wanted Iodine Deficiency Disorders (IDD) health education supported by attractive, easy to understand, long lasting, and inexpensive media. Objective. The purpose of this research is to develop IDD education media which could be used by people in Pulosaren village. Methods. This was a qualitative research in developing media using ADDIE model. Focus Group Discussion (FGD) supported by indepth interviews were used. Informants consisted of village heads, youth leaders, religious leaders, cadres, member of women organization, stakeholders in the local government of Wonosobo district, village chiefs and Pulosaren village midwives. Results . Based on the results of FGD shows the required education media in the form of handbook and flipchart. The media is hopefully made of thick and colored paper, not easily wet, and the form of writing from the computer. Development of handbook and flipchart through several stages of activity consist of analysis, design, development, implementation, and evaluation (ADDIE models). Contained in media were: iodine understanding, potentially deficient areas of iodine, foods contain iodine, effects of iodine deficiency, spectrum of IDD, how to prevent IDD, goitrogenic, and iodized salt. In the implementation and evaluation phase, input from the village community was obtained in addition to the font size of the paper, the simplification of the term, and the addition of the illustration of the drawings in several sections. Views with more images than posts are more easily understood by the community. Conclusion . The ADDIE model can be used for the development of education media in the form of handbook and flipchart for countermeasures of IDD in Pulosaren Village.

Iodine nutritional status in the adult population of Shandong Province (China) prior to salt reduction program.

Tremendous differences in iodine status and daily iodine intake persist across provinces of China. The objective of the present study was to evaluate the iodine status and dietary iodine intake of Shandong adults before the implementation of the salt reduction program and a new salt iodization standard. Data from a baseline survey of the Shandong and Ministry of Health Action on Salt Reduction and Hypertension project (2011) were analyzed. The iodine contents of 1949 24-h urine samples and 136 drinking water samples were assayed. Daily urinary iodine excretion and daily iodine intake were calculated, analyzed, stratified by different analytical variables and compared with Chinese Dietary Reference Values. The median urinary iodine concentration and median daily iodine intake of Shandong adults were 248.5μg/L and 368.2μg/day, respectively. The median iodine intake of different groups was between the estimated average requirements and the upper limit, except group in water iodine >300μg/L with median iodine intake of 1200.7μg/L. Salt intake and iodine levels in drinking water related to iodine intake significantly. Shandong adults had more than adequate iodine nutrition, and the dietary iodine intake of the population was generally appropriate and safe except residents in high water iodine areas. In the context of the implementation of a salt reduction program and a new salt iodization standard, the iodine status of high water iodine areas may remain in the recommended level, but in low water iodine areas, the risk of inadequate iodine intake may increase, needing monitoring of urine iodine excretion, dietary iodine intake and iodized salt consumption regularly.

SU-E-I-45: Feasibility for Using Iodine Quantification to Assist Diagnosis in Dual Energy Contrast-Enhanced Digital Mammography

Purpose: The objective of this study is to develop quantitative calibration between image quality indexes and iodine concentration with dual-energy (DE) contrast-enhanced digital mammography (CEDM) techniques and further serve as the assistance for diagnosis. Methods: Custom-made acrylic phantom with dimensions of 24×30 cm{sup 2} simulated breast thickness from 2 to 6 cm was used in the calibration. The phantom contained matrix of four times four holes of 3 mm deep with a diameter of 15 mm for filling contrast agent with area density ranged from 0.1 to 10 mg/cm{sup 2}. All the image acquisitions were performed on a full-field digital mammography system (Senographe Essential, GE) with dual energy acquisitions. Mean pixel value (MPV), and contrast-to-noise ratio (CNR) were used for evaluating the relationship between image quality indexes and iodine concentration. Iodine map and CNR map could further be constructed with these calibration curves applied pixel by pixel utilized MATLAB software. Minimum iodine concentration could also be calculated with the visibility threshold of CNR=5 according the Rose model. Results: When evaluating the DE subtraction images, MPV increased linearly as the iodine concentration increased with all the phantom thickness surveyed (R{sup 2} between 0.989 and 0.992). Lesions with increased iodine uptake couldmore » thus be enhanced in the color-encoded iodine maps, and the mean iodine concentration could be obtained through the ROI measurements. As for investigating CNR performance, linear relationships were also shown between the iodine concentration and CNR (R{sup 2} between 0.983 and 0.990). Minimum iodine area density of 1.45, 1.73, 1.80, 1.73 and 1.72 mg/cm{sup 2} for phantom thickness of 2, 3, 4, 5, 6 cm were calculated based on Rose’s visualization criteria. Conclusion: Quantitative calibration between image quality indexes and iodine concentrations may further serving as the assistance for analyzing contrast enhancement for patient participating the dual energy CEDM procedures.« less

Prevalence of thyroid dysfunction with adequate and excessive iodine intake in Hebei Province, People's Republic of China.

To explore (i) the prevalence of thyroid dysfunction in populations with adequate and excessive iodine intakes and (ii) the effect of iodine exposure on the prevalence of thyroid dysfunction. Cross-sectional study was conducted in Hebei in 2010. The population was classified as having adequate or excessive iodine intake according to the iodine concentration in drinking water. Demographic information was collected by questionnaire. Levels of serum thyroid hormones, thyroid autoantibodies and iodine in drinking water and urine were measured. Villages with adequate or excessive drinking water iodine in Hebei Province, People's Republic of China. A total of 854 men and women aged 20-50 years who had lived in the surveyed areas for over 5 years, including 348 from the adequate iodine area (AIA) and 506 from the excessive iodine area (EIA). Median urinary iodine concentration was 185 μg/l in AIA and 1152 μg/l in EIA. The prevalence of thyroid dysfunction in AIA was 10.3%, which included 1.1% with hypothyroidism and 8.1% with subclinical hypothyroidism; and 20.6% in EIA, which included 3.6% with hypothyroidism and 13.6% with subclinical hypothyroidism. The positive rates of thyroglobulin antibody were 16.1% in AIA and 11.9% in EIA; the positive rates of thyroperoxidase antibody were 20.7% in AIA and 16.4% in EIA. Excessive iodine intake may lead to increased prevalence of biochemical thyroid dysfunction, especially biochemical hypothyroidism. This is not related to an increase in prevalence of thyroid antibodies. Women are more susceptible to iodine excess.

Neonatal thyroid function born to mothers living with long-term excessive iodine intake from drinking water.

The effects of long-term excessive maternal iodine intake on neonatal thyroid function are less known. This study aimed to assess the effects of maternal excessive iodine intake from drinking water on thyroid functions of both mothers and their neonates. This observational study was performed in high iodine (HI) areas and adequate iodine (AI) intake areas, including 384 healthy pregnant women in late gestation (mean week 39·3 ± 1·6 weeks) and their newborns. Blood and urine samples were obtained from pregnant women, while cord blood samples were obtained from neonates. Urinary iodine concentration (UIC) and thyroid function were evaluated. The median maternal UIC was 1241 and 217 μg/l in HI and AI areas, respectively (P < 0·001). The concentrations of serum thyroid-stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) in neonates in HI areas were 7·33 mIU/l (range 5·47, 11·06 mIU/l), 2·93 ± 0·59 and 15·03 ± 1·92 pmol/l, respectively, while that were 4·71 mIU/l (range 3·96, 6·04 mIU/l), 2·31 ± 0·28 and 16·50 ± 1·35 pmol/l in AI neonates (P < 0·05). Similar changes were also observed in neonates in HI areas when excluding the effect of maternal thyroid autoimmunity. Cord blood TSH concentration (r = 0·31, P = 0·001) and FT3 concentration (r = 0·43, P = 0·001) were positively correlated with maternal UIC. Cord blood FT4 concentration was negatively correlated with maternal UIC (r = -0·25, P = 0·001). Mothers living in HI areas (β = 0·296, 95% CI: 0·163, 0·255) and with subclinical hypothyroidism (β = 0·360, 95% CI: 0·034, 0·175) contributed to elevated cord blood TSH concentration in neonates, while male neonates were more likely to present with higher TSH concentration compared with female infants (β = -0·760, 95% CI: -0·119, -0·033). Excessive iodine intake during pregnancy was associated with an increased rate of hyperthyrotropinaemia in neonates and their mothers, especially in male neonates.

ANEMIA PADA IBU USIA 17-35 TAHUN DI DAERAH ‘REPLETE’ ENDEMIK DEFISIENSI IODIUM

ANEMIA OF CHILD BEARING AGE MOTHERS 17-35 YEARS OF AGE IN ENDEMIC IODINE ‘REPLETE’ AREA Iron Deficiency Anemia (IDA) as well as Iodine Deficiency Disorder (IDD) both have adverse effects on cognitive and neuropsychomotor, and adverse pregnant outcomes. Both iron and iodine have role on nuero development. Iron interact with iodine through the activity of thyroid peroxidase (TPO), an iron-dependent enzyme. IDA in iodine replete area (IRA) have not been reported. Assesments IDA (Hb), free thyroxine (fT4), Thyrotropin hormone (TSH) of reproductive mothers 17-35 years of age were conducted in IRA and non-endemic deficiency iodine area (NEDIA). Casual iodine urin concentration (UIC) of school age children was also assesed to confirm iodine endemicity of study area. Analysis of risk for anemia according to iodine status and correlation hemoglobin and thyrotropin were performed. The study area was confirmed to be non endemic iodine deficiency (UIC criteria). Median EIU were 242 (24-880) µg/L in IRA and 211 (44-387) µg/L in NEDIA respectively. Proportion of EIU less than 100 µg/L in IRA were 5.0 % and in NEDIA 1.2 %. Proporsion of EIU greater than 300 µg/L were 29.6 dan 24.7 persen respectively. The results indicated that study areas were no longer endemic iodine deficiency and the people where they live consumed iodine tend to excess. These situation may effect on thyroid function as indicated by suppressed TSH and fT4 in normal range. Those two thyroid function parameters significantly different in the IRA and NEDIA. The everages serum concentration of TSH in the study area were 1,96(1,56-2,36) in IRA compared to 1,38 (1,09-1,67) mUI/L in NEDIA(p=0,23); while fT4 were 1,29 (1,14-1,44) and 0,98 (0,90-1,05) µg/dL respectively. Hemoglobin serum concentration of mothers in those two area was not signicantly different; 12,45 (12,19-12,71) in IRA compared to 12,21 (11,96-12,46) mg/dL di NEDIA. Iron deficiency anemia was found 23,3 % in IRA and 35,7 % in NEDIA; however mothers in IRA have risk for anemia as big as mothers in NEDIA OR: 0,54(0,24-1,24). Analysis correlation (Spearman’s) between TSH and Hb provided coefisient correlation Rho as much as 0.072 indicated very weak correlation between the two parameters. There were no difference in proportion of hypothyroidism in the two study areas (OR: 0,68 (0,207-2,25). Although the proportion of iron deficiensi anemia (IDA) in IRA much less than the proportion in NEDIA; there were no relationship between IDA and Iodine deficiency. Absorption of Fe in IRA may be more efficient than did in NEDIA. More studies are needed to confirm this finding. Keywords : IDA, TSH, fT4, Hb, EIU, NEDIA, IRA

The Standard, Intervention Measures and Health Risk for High Water Iodine Areas

Our study aims to clarify the population nutrient status in locations with different levels of iodine in the water in China; to choose effective measurements of water improvement(finding other drinking water source of iodine not excess) or non-iodised salt supply or combinations thereof; to classify the areas of elevated water iodine levels and the areas with endemic goiter; and to evaluate the risk factors of water iodine excess on pregnant women, lactating women and the overall population of women. From Henan, Hebei, Shandong and Shanxi province of China, for each of 50∼99 µg/L, 100∼149 µg/L, 150∼299 µg/L, and ≥300 µg/L water iodine level, three villages were selected respectively. Students of 6–12 years old and pregnant were sampled from villages of each water-iodine level of each province, excluded iodized salt consumer. Then the children's goiter volume, the children and pregnant's urinary iodine and water iodine were tested. In addition, blood samples were collected from pregnant women, lactating women and other women of reproductive age for each water iodine level in the Shanxi Province for thyroid function tests. These indicators should be matched for each person. When the water iodine exceeds 100 µg/L; the iodine nutrient of children are iodine excessive, and are adequate or more than adequate for the pregnant women. It is reasonable to define elevated water iodine areas as locations where the water iodine levels exceed 100 µg/L. The supply of non-iodised salt alone cannot ensure adequate iodine nutrition of the residents, and water improvement must be adopted, as well. Iodine excess increases the risk of certain thyroid diseases in women from one- to eightfold.

Epidemiological investigation on thyroid disease among fertile women in different iodine intake areas of Shanxi province

To understand the prevalence of thyroid diseases and its influencing factors of iodine on thyroid gland function and autoimmune among fertile women in different iodine intake areas. Cross-sectional method was used for descriptive epidemiology. 236 women aged 19 to 45 years were sampled in 2011, in Shanxi province. Questionnaire was used to include general data on place, name, age etc. Sample of water from home, one time random urine sample and venous blood were collected to test the iodine contents using arsenic and cerium catalysis spectrophotometric methods. Finally, in blood, free triiodothyronine (FT3), free thyroxine (FT4), thyrotrophin (TSH) in blood were tested under auto-CLIA and anti-thyroid peroxidase (anti-TPO), anti-thyroglobulin (anti-TG) through radio-immunological methods. 1)The urine iodine's medians were 486.9 µg/L for fertile women in high iodine areas, and 192.6 µg/L in low iodine areas, with difference on urine iodine level statistically significant (Z = -10.676, P = 0.000). 2) Levels of blood FT3 and FT4 in women from high iodine areas were obviously lower than those from proper iodine areas(t = -2.884, P = 0.004; t = -2.862, P = 0.005), but the level of TSH in high iodine areas was higher than that of proper iodine areas(t = 2.332, P = 0.021). 3) In both areas, the rate of the thyroid dysfunction with positive antibodies was obviously higher than those with negative antibodies (χ² = 20.941, P = 0.000;χ² = 5.596, P = 0.018), while the rate of the thyroid dysfunction with positive antibodies and the level of TSH in the blood for high iodine women higher than those in women with proper iodine level(χ² = 5.708, P = 0.37;t = -2.177, P = 0.031). 4)The morbidity rate of inferior clinical hyperthyroidism for women in high iodine areas was obviously higher than those in proper iodine areas(χ² = 9.542, P = 0.003), while the morbidity rate of inferior clinical hypothyroidism for women with positive antibodies in two areas obviously higher than those with negative antibodies (χ² = 17.264, P = 0.000; χ² = 6.002, P = 0.044). Morbidity rate of inferior clinical hypothyroidism for women in high iodine areas was obviously higher than those in proper iodine areas, suggesting that there were potential risks of hypothyroidism for overdose iodine intake which causing the existence of positive thyroid antibodies. Monitoring programs on iodine nutrition and thyroid function among women living in high iodine areas should be strengthened.

Long-Term Exposure to Excessive Iodine from Water Is Associated with Thyroid Dysfunction in Children

Previous studies have indicated an association between iodine excess and increased incidence of thyroid dysfunction in adults. However, there have been few studies on how the intake of excessive iodine affects thyroid function in children. The objective of this study was to assess the effects of a long-term exposure to excessive iodine on thyroid dysfunction in children. Urinary iodine concentration (UIC) and thyroid function in 371 children from a high iodine (HI) area (water iodine: 150–963 μg/L) and 150 children from an adequate iodine (AI) area (water iodine: 12.8–50.9 μg/L) were measured. The water iodine concentration in the HI area was higher than that in the AI area (P < 0.001) and the median urinary iodine concentration of children in the HI area was 1030 μg/L, which was 8.6 times that of children in the AI area (123 μg/L) (P < 0.001). Children in the HI area had a higher concentration of sensitive thyroid stimulating hormone and higher positivity of both thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb). The prevalence of thyroid diseases was higher in HI area children than that in AI area children (P = 0.000), especially subclinical hypothyroidism (SCH; P = 0.004). A body mass index (BMI) of ≥22.3 kg/m2 was associated with the incidence of SCH (OR: 5.51; 95% CI: 1.52, 19.9; P = 0.009). UIC ≥600 μg/L (OR: 3.62; 95% CI: 1.22, 10.8; P = 0.024) and TPOAb or TGAb-positivity (Ab+ OR: 6.48; 95% CI: 1.78, 23.6; P = 0.005) in children were significantly and independently associated with SCH. Interactions between UIC ≥800 μg/L and Ab+ (P-interaction = 0.004) were found. Furthermore, increased thyroid volume was correlated with higher UIC (β = 0.22; P = 0.002). Excessive iodine intake in children in HI areas is associated with impaired thyroid function; UIC ≥600 μg/L and Ab+ are the risk factors for SCH. Effective measures need to be taken for reducing excessive iodine intake.

Development and production of a prototype iodine contrast phantom for CEDEM

Phantoms containing iodine details with clinically relevant iodine concentrations are required to systematically study dose requirements, for quality assurance and optimizing exposure parameters and protocols for contrast enhanced dual energy mammography (CEDEM) applications. Most such phantoms use liquid iodine solutions, challenging the user with air inclusions, evaporation or the necessity for changing the iodine concentration through refilling. A prototype phantom with an array of sintered solid iodine-containing platelets with iodine area weights of 0, 0.25, 0.5, 1, 1.5 and 2 mg cm−2 is described. Disks containing various iodine concentrations were produced using polymer sintering of Iopamidol embedded into a polystyrene/graphite matrix. Iopamidol-containing platelets with a diameter of 0.5 cm and thickness of 550 µm forming an array with gradually increasing iodine area weight, were embedded in PMMA to allow statistical analysis of contrast and contrast-to-noise ratio (CNR). The homogeneity of the plates was tested and images of the phantom were acquired to assess the iodine area density progression and to evaluate phantom accuracy. The phantom was imaged on a mammography system applying low and high energy spectra as used for CEDEM. The disks show good homogeneity. Uncertainties in absolute iodine area weight were estimated ±5%. The iodine CNR showed a linear correlation with R2 > 0.99. Polymer powder sintering works well for producing stable iodine contrast phantoms without the necessity to handle liquid iodine solutions. Thus, it is a promising approach to construct phantoms not only for CEDEM but also angiography or other contrast enhanced methods with iodine details for quality control or research purposes and optimization.

Spatial distribution characteristics of iodine in drinking water in Shandong province between year 2008 and 2010

To detect the spatial distribution characteristics of iodine in drinking water of residents in Shandong province with spatial autocorrelation analysis. The county-based study set Shandong province as a research site. A total of 108 164 water samples from 140 counties were collected. The drinking water iodine data in county-level city between 2008 to 2010 were obtained from Shandong Institute of Prevention and Control for Endemic Disease and was merged with an electronic map to build a spatial database. Global and local Moran's I index were calculated, respectively, and spatial autocorrelation and cluster range of iodine distribution in drinking water in Shandong province were studied by SaTScan software. All counties were further grouped according to the "criteria of delimitation for IDD endemic areas" and "determination and classification of the areas of high water iodine and the endemic areas of iodine excess goiter", and 90 counties were iodine deficiency (< 10 µg/L), 31 were iodine suitable (10 - 150 µg/L), and 19 (> 150 µg/L) were high iodine. For the overall study area, the iodine distribution in drinking water in Shandong province existed spatial autocorrelation (Moran's I = 0.52, Z = 7.4, P < 0.01). For the local scale, the drinking water iodine in 18 counties of Dezhou, Liaocheng and Heze city in western Shandong province was clustered, the local Moran's I were between 0.22 - 1.00 (P < 0.01), which were all high-high clusters, indicating the positive spatial correlation. Spatial analysis using SaTScan software detected two cluster areas including 20 counties, which the centers located in Xiajin and Dingtao county, the cluster radiuses were 57.47 km and 65.58 km respectively. The analysis results were consistent with the results of local spatial autocorrelation. There are apparent spatial autocorrelation and strong spatial heterogeneity existed in the iodine distribution in drink water in Shandong province.

The Hydrogeochemical Characteristics of High Iodine and Fluoride Groundwater in the Hetao Plain, Inner Mongolia

Twenty groundwater samples and two surface water samples were collected to determine the occurrence and distribution of iodine and fluoride in groundwater in the area of Hangjinhouqi, the Hetao Plain, Inner Mongolia. Currently, 65% and 50% of samples exceeded the Chinese standard (I=150μg/L, F=1mg/L) for drinking water for iodine and fluoride, respectively. No correlation has been shown between I and F, although the spatial distribution of high iodine and high fluoride groundwater samples overlaps, with 80% of the high fluoride groundwater samples located in the high iodine areas. Different enrichment mechanisms of fluoride and iodine are involved. Water-rock interaction processes are at the origin of fluoride rich-groundwater, whereas evaporation of shallow groundwater and the oxidation by microorganisms of elevated organic matter content in deep groundwater contribute to the enrichment of iodine.

Study on the prevalence of thyroid diseases during pregnancy in excess and sufficient water iodine area in Jiangsu Province

Objective To study the prevalence of thyroid disease in pregnant women living in both excess and sufficient water iodine area of in Jiangsu Province,and to establish an epidemiological database of thyroid disorders among pregnant women in different water iodine area in Jiangsu Province in order to guide our clinical practise.Methods Fengxian and Suining of Xuzhou were selected as excess and sufficient water iodine region.All the 439 pregnant women within the first trimester were enrolled in our study.The name,age,and previous history were recorded on questionnaire.The samples of fasting blood were obtained.Serum parameters such as free triiodothyronine ( FT3 ),free thyroxine ( FT4 ),total thyroxine ( TT4 ),thyrotropic stimulating hormone ( TSH ),and thyroid peroxidase (TPOAb) were measured by electrochemiluminescence assay.The data of the eligible 396 subjects were stored and analyzed by Epidata after excluding subjects with previous thyroid dysfuncion,renal disease,heart disease,and pregnancy-induced hypertension syndrome.Results Among the 396 subjects,197 women ( 49.7％ ) had thyroid disorders. The prevalence of hyperthyroidism, subclinical hyperthyroidism, hypothyroidism, subclinical hypothyroidism,hypothyroxinaemia,and thyroid autoimmunity were 0.5％,6.3％,3.3％,29.3％,9.3％,and 1.0％,respectively.The prevalence of subclinical hypothyroidism was significantly higher in excess water iodine region (32.4％) than that in sufficient water iodine area ( 19.6％ ),while the prevalence of other types of thyroid diseases such as subclinical hyperthyroidism,hyperthyroidism,hypothyroidism,hypothyroxinaemia,and TPOAbpositive cases in either excess or sufficient water iodine regions was not different.Conclusions Subclinical hyperthyridism,hypothyroxinaemia,and subclinical hypothyroidism are the main thyroid disorders in pregnant women in both excess and sufficient water iodine area.The prevalence of subclinical hypothyroidism increases obviously in excess water iodine region,indicating the relationship between thyroid disease and high iodine intake. Key words: Pregnancy; Thyroid diseases; Prevalence; Excess iodine region; Sufficient iodine region

Study on the iodine status of pregnant women and thyroid function of neonate in high iodine area

To reveal the iodine status of pregnant women and its impact on thyroid function of neonates in high iodine area. A total of 210 pregnant women were chosen from a hospital in Haixing county, Hebei province. Pregnant women's random urinary and neonates' cord blood were collected. The urinary iodine concentration (UIC) was examined by arsenic-cerium catalytic spectrophotometry. The levels of free triiodothyronine (FT3), free thyroxine (FT4) and sensitive thyroid-stimulating hormone (sTSH) in serum were measured by chemiluminescence. The age of 210 pregnant women was (27.69 +/- 4.73) years old, whose urinary iodine median (inter-quartile range ) was 1240.70 (1292.68) microg/L. 84.3% (177/210) of the pregnant women had excessive iodine intake (UIC > or = 500 microg/L), 13.8% (29/210) had more than adequate iodine intake( UIC within 250 - 499 microg/L), 0.5% (1/210) had adequate iodine intake (UIC within 150 - 249 microg/L) and 1.4% (3/210) had insufficient iodine intake (UIC < 150 microg/L). The average serum level of FT3, FT4 in neonates were (2.93 +/- 0.59), (15.03 +/- 1.92) pmol/L, respectively. The median (inter-quartile range) of serum sTSH in neonates were 7.33 (5.59) mU/L 78.1% (164/210) of the neonates' serum TSH were beyond 5 mU/L. There were no correlation between pregnant women's urinary iodine level and neonates' serum FT3 and sTSH level (P > 0.05), but there was a positive correlation between pregnant women's urinary iodine level and neonates' serum FT4 level (P < 0.01). Serum FT4 level of the neonates with whose mothers had insufficient iodine intake ((12.99 +/- 1.10) pmol/L) were statistically lower than those with their mothers had excessive iodine intake (15.16 +/- 1.83) pmol/L) (P < 0.05). Most of the pregnant women in high iodine area were excessive for iodine nutrition, but still a few pregnant women had insufficient iodine nutrition. The level of neonates' serum sTSH were relatively high and monitoring of risk of hypothyroidism and subclinical hypothyroidism should be strengthened.

Investigation of thyroid function abnormalities in children in high water iodine areas of Hebei province

To understand the level of thyroid function and the prevalence of the thyroid diseases of children in high water iodine areas. Two primary schools were selected by purposive sampling from Haixing county, Hebei province in April 2010. A total of 371 children were selected from six classes by cluster sampling in the schools. Morning-urine and venous blood (5 ml) were collected to measure the levels of urinary iodine, free triiodothyronine (FT(3)), free thyroxine (FT(4)) and sensitive thyroid-stimulating hormone (sTSH) in serum and to evaluate the iodine status and thyroid function of children. The median urinary iodine of the children was 1032.08 µg/L. Overall, 96.2% (357/371) of the children's urinary iodine were ≥ 300 µg/L and 68.5% (254/371) were ≥ 800 µg/L. The level of FT(3) and FT(4) were (6.28 ± 0.81) pmol/L and (16.37 ± 2.72) pmol/L, respectively. The median of sTSH was 4.01 mU/L. The FT(4) among boys ((16.63 ± 2.60) pmol/L) was significantly higher than that among girls ((15.99 ± 2.85) pmol/L) (P < 0.05). Overall, 44 subjects were diagnosed as thyroid disease (11.9%), 25 were subclinical hypothyroidism (57% of the total patients), 4 were hypothyroidism (9%), 10 were hyperthyroidism (23%) and 5 were subclinical hyperthyroidism (11%). In the urinary iodine of 200 - 799 µg/L, the prevalence of thyroid disease and hypothyroidism were 6.3% (7/111) and 14.6% (27/254), respectively. When urinary iodine ≥ 800 µg/L, the prevalence of thyroid diseases and hypothyroidism were 3.6% (4/111) and 8.3% (21/254), respectively. Most of the children in high water iodine areas had excessive iodine intake. Levels of the children's thyroid hormone were within the normal range. The prevalence of thyroid disease were high, in these areas and the thyroid disease were mainly the subclinical hypothyroidism.

Study of intelligence and psychomotor function in children aged 6 - 15 years and born pre and post universal salt iodization in Henan province in 2009

Objective Investigation and analysis of intelligence and psychomotor function in children born after implementingt universal salt iodization(USI). Methods Historical serious illness areas of water iodine below 10μg/L were selected as study sites, water iodine in 50 - 100 μg/L in the historical non-endemic areas were as control points in Henan, 2008. Cluster sampling was used to select children aged 6 - 15 years as observing subjects,IQ were measured with CRT- Man Test(CRT-C2). A Tianjin Medical psychomotor test battery (JPB) was carry out to test psychomotor function. Results In IDD regions 230 children were surveyed post-USI and 1284 children preUSI. The IQs post and pre USI were 99.3 and 99.9, respectively, and the proportion of IQ ≤69 were 2.17%(6/230) and 2.80%(36/1284), respectively. In non-IDD regions 650 children were surveyed post-USI and 2079children pre-USI. The IQs post and pre USI were 95.3 and 93.8, respectively, and the proportion of IQ ≤ 69 were 2.31%(15/650) and 3.37%(70/2079), respectively. In IDD regions, the abnormal rate of T scores and damage index post USI were 3.6%(2/56), 5.3%(3/56), respectively, significantly lower than pre USI [18.1%(29/160),18.1%(29/160), x2 = 7.54, 6.86, all P ＜ 0.01]. Conclusions USI could increase the IQs of children and decrease the positive rate of JPB, and significantly improve the quality of whole nation and persistently eliminating IDD. Key words: Iodides; Salts; Intelligence; Psychomotor function

Omental fat tissue influence on bone healing: Radiological and histomorphometric study

Reid found selenium (Se) deficient soils were a common factor in two populations with the highest incidence of SIDS world-wide (Indian population of King County Washington State, USA and the population of Canterbury, New Zeland) (1).Reid compared a map of the selenium responsive livestock areas in New Zealand with areas of low soil iodine (I). She found that the 1989 report of areas of the highest SIDS incidence coincided with Se responsive livestock areas combined with low soil iodine (2–4).Foster found the 1983–1984 incidence of SIDS in USA has the strongest positive correlation with the incidence of goitre in World War I troops (1916). Sodium and strontium were positively related (5).Emery found a hypernatraemic SIDS victim in a very cold environment (6). Robertson and Parker associated increased sodium (Na) (used in Scunthorpe, England, as a water softener) with increased incidence of SIDS (7).Godwin's study of White Muscle Disease in lambs describes Se protection (8). Skeletal muscle mitochondria from dystrophic animals showed lowered respiratory rates with palmitoyl-dl-carnitine and acetyl-dl-carnitine as substrate. Dystrophic organelles failed to respond to ADP.Rognun found elevated hypoxanthine and an enhanced immune response in most SIDS victims (9).A syndrome associated with potassium deficiency has been described as a killer of healthy, young Asian men, most often during sleep (19).This paper describes the interactions of sodium (Na), potassium (K), selenium (Se), and iodine (I) to some factors affecting the utilization of oxygen and the production of energy.

Iodine and Anaplastic Thyroid Carcinoma

s programs of iodine prophylaxis have been im-plemented in many European countries in the recentpast, the report of Besic and colleagues (1) about associatedalterationsinthefrequencyofanaplasticthyroidcancer(ATC)is particularly timely. Alterations in dietary iodine supplyhave been shown to result in changes in the presentation of avariety of thyroid disorders (2). These include hyperthyroid-ism,whichcanpresentastoxicnodulargoiterwhentheiodinesupply is increased in a previously iodine-deficient popula-tion (Jod Basedow), or hypothyroidism as a consequence ofdisruption of thyroid hormonogenesis when a significantlyincreased amount of iodine is ingested (Wolff–Chaikhoff ef-fect). Even small changes in iodine supply have been shownby Laurberg and his colleagues (2) to alter the prevalence ofdisorders of thyroid function. These reported changes in thepresentation ofthyroid disorders do not only apply to alteredthyroid function. Many studies have shown that the rate ofdifferentiated thyroid cancer (DTC) presenting in the follicu-lar (FTC) or anaplastic histologic form was relatively morefrequentinareasofiodinedeficiency,whilethepapillaryform(PTC) predominated in iodine-replete populations (3). Whatis less clear is whether the overall rate of thyroid cancer isinfluenced by the dietary iodine status of a population (3,4).Although conclusive evidence exists showing that thyroidcancer rates are higher in animals fed an iodine-deficient dietand that carcinogen-induced thyroid carcinomas can be po-tentiated by iodine deficiency, proof of a direct causative rolefor iodine deficiency remains elusive (5–7). It has also beensuggested that iodine administration can prevent the trans-formation of DTC to ATC (8).Manystudieshaveshownanincreaseinthepapillaryformof thyroid cancer following iodine prophylaxis (5). Althoughthe rate of ATC has been reported as being greater in areas ofiodine deficiency, there have been few reports on the effect ofiodine prophylaxis on ATC frequency. Besic et al. cite twoconflicting reports on ATC rate from different regions ofAustria (9,10). In Carinthia, the incidence was the same (9),and in Tyrol (10), the incidence was lower, when the iodiza-tion of salt was changed from 10mg I/kg to 20mg I/kg. Thereport of Besic and colleagues is in agreement with that fromtheTyrolinthattheynotedafallintheincidenceofATCfrom3.25 per million (lower salt iodization 10mg I/kg) to 1.9 permillion (higher salt iodization 25mg I/kg). There are alwayscaveats, particularly relating to diagnostic methodology (5),which must be factored in when comparing epidemiologicalfindings for thyroid cancer incidence. However, this is prob-ably less relevant when dealing with ATC, and Besic andcolleagues detail how diagnostic criteria did not change overthe two study periods in their study.While the debate continues as to the importance of iodineprophylaxis in altering the rate of all thyroid cancers, in-cluding ATC, the significance of the findings in terms oftherapeutic possibilities that increasing iodine intake maydiminish the frequency of ATC remains unclear. In practice,excess iodide, by inhibiting thyroid hormone production(Wolff–Chaikhoff effect), may stimulate thyroid growth viaincreased thyrotropin (TSH). However this effect is self-limiting because iodide is also known to suppress iodidetransportviaNa

Serum calciotropic hormone levels, and dental fluorisis in children exposed to different concentrations of fluoride and iodine in drinking water

Background High fluoride exposure can result in dental fluorosis. Fluoride and iodine are coexistent in the drinking water of areas in China and may affect the prevalence of dental fluorosis and osteogenesis. The aim of this study was to investigate the relationship between serum calciotropic hormone level, and dental fluorisis in children exposed to different concentrations of fluoride and iodine in drinking water. Methods A pilot study was conducted in three villages located in the Kaifeng and Tongxu counties of Henan Province, China in 2006. Children aged 8 to 12 years, born and raised in the three villages were recruited. The fluoride levels in the samples of urine from these children were detected by fluoride ion selective electrode. Calcitonin and osteocalcin levels in the serum, and serum calcium were measured by radioimmunassay and flame atomic absorption spectrometry, respectively. Results Fluoride levels in urine were significantly lower in children from control area (CA) as compared with those from the high fluoride &amp; iodine areas (HFIA) and the high fluoride area (HFA) (P &lt;0.05 respectively), and no statistically significant difference was found between the children from HFIA and HFA. Additionally, calcitonin levels in the serum were significantly lower in children from CA and HFA as compared with that from HFIA (P &lt;0.05 respectively), and osteocalcin levels in the serum was lower in children from CA than those from HFIA (P&lt;0.05). No statistically significant difference in serum osteocalcin concentrations was found between children from HFA and HFIA. Conclusion This study provides an evidence that iodine exposure may modify the serum calciotropic hormone levels related to fluorine exposure.