Median Urinary Iodine Concentration Level Research Articles

Excessive iodine status among school‐aged children in the State of Qatar: Results of the National Iodine Deficiency Disorder Survey

AbstractBackgroundIodine deficiency poses a significant public health challenge worldwide, particularly in preschool children and pregnant women. Assessing the iodine intake at a population level is essential, as both deficient and excessive iodine status can have adverse health consequences. The main objective of this survey is to understand the iodine deficiency status in schoolchildren aged 6–12 years in the State of Qatar.MethodsA cross‐sectional survey was conducted from March to June 2014 among school‐aged children using a two‐stage cluster sampling technique. Anthropometric, biochemical, clinical, and dietary parameters for seafood were collected. Spot urine samples were collected from 967 participants, and a repeat random subsample urine was collected from 288 participants. Overall median urinary iodine concentration (UIC) was calculated. Iodine content in household salt samples was estimated by qualitative and quantitative methods. Mann–Whitney U test was used for comparison.ResultsThe median UIC was 333.2 μg/L (IQR = 228.6). UIC prevalence rates between 300–999 and >1000 μg/L were 56.7% and 2.8%, respectively. The goiter prevalence was 0.4%. A significant difference was noted in overall median UIC levels between boys and girls (p = 0.003). Adequate iodized salt consumption was reported by 74.9% of households, and weekly seafood consumption was reported by one third of the respondents.ConclusionThe results indicate an excess intake of iodine among the studied population in the State of Qatar, and national efforts are needed to bring iodine intake and concentration levels within the cutoff value for the concerned survey population's age group. In addition, a surveillance system needs to be set up for continuous monitoring of iodine content and salt intake at the population level in the State of Qatar.

Regional Influences on Nutritional Iodine Status of Pregnant Women in Pakistan.

Pregnant women are particularly vulnerable to iodine deficiency. Considering the rural-urban disparities in nutritional status in Pakistan, this study aimed to assess regional influences on nutritional iodine status of pregnant women in Pakistan. Data were collected from 1246 pregnant women in all trimesters of pregnancy who visited antenatal clinics for routine checkups in five Khyber Pakhtunkhwa province districts. Information concerning iodized salt intake and knowledge of iodine deficiency disorders (IDD) was obtained through an interview questionnaire. Goiter and urinary iodine concentration (UIC) levels were assessed by the palpation method and Sandell-Kolthoff reaction, respectively. Logistic regression analysis was used to quantify associations between residence (rural-urban), pregnancy trimester, and previous pregnancy outcomes with knowledge about IDD, iodized salt intake, presence of goiter, and UIC <150 μg/L. Among study participants, 87.7% had no knowledge about IDD, and only 21.0% were consuming iodized salt. Goiter was present in 25.5% of the women. The median UIC level was 131 μg/L, and 41.3% of study participants had a UIC ≥150 μg/L. There were no significant differences between pregnant women from rural and urban settings in regions with a solid socioeconomic status with respect to knowledge about IDD, iodized salt intake, iodine deficiency, and goiter prevalence. Urban-rural differences were observed only in socioeconomically disadvantaged districts. Only pregnant women living in the Lakki Marwat district had higher odds of having knowledge of IDD and iodized salt intake than those from rural regions. Trimesters of pregnancy and previous pregnancy outcomes had no significant effect on the outcome measures. Relative to a national nutrition survey conducted in Pakistan in 2011, the results from this study indicate that UIC levels remained stable with mild iodine deficiency, whereas rates of goiter and iodized salt intake remained high and low, respectively, especially in rural areas. Rural-urban disparities were observed only in socioeconomically disadvantaged districts, and these disparities limit the effectiveness of the IDD prevention program in rural areas in Pakistan. Thus, implementation of mandatory salt iodization requires improvement, and program effectiveness should be continuously monitored to prevent adverse health effects of iodine deficiency during pregnancy.

An Increase in Consuming Adequately Iodized Salt May Not Be Enough to Rectify Iodine Deficiency in Pregnancy in an Iodine-Sufficient Area of China.

Universal salt iodization (USI) has been implemented for two decades in China. It is crucial to periodically monitor iodine status in the most vulnerable population, such as pregnant women. A cross-sectional study was carried out in an evidence-proved iodine-sufficient province to evaluate iodine intake in pregnancy. According to the WHO/UNICEF/ICCIDD recommendation criteria of adequate iodine intake in pregnancy (150–249 µg/L), the median urinary iodine concentration (UIC) of the total 8159 recruited pregnant women was 147.5 µg/L, which indicated pregnant women had iodine deficiency at the province level. Overall, 51.0% of the total study participants had iodine deficiency with a UIC < 150 µg/L and only 32.9% of them had adequate iodine. Participants living in coastal areas had iodine deficiency with a median UIC of 130.1 µg/L, while those in inland areas had marginally adequate iodine intake with a median UIC of 158.1 µg/L (p < 0.001). Among the total study participants, 450 pregnant women consuming non-iodized salt had mild-moderate iodine deficiency with a median UIC of 99.6 µg/L; 7363 pregnant women consuming adequately iodized salt had a lightly statistically higher median UIC of 151.9 µg/L, compared with the recommended adequate level by the WHO/UNICEF/ICCIDD (p < 0.001). Consuming adequately iodized salt seemed to lightly increase the median UIC level, but it may not be enough to correct iodine nutrition status to an optimum level as recommended by the WHO/UNICEF/ICCIDD. We therefore suggest that, besides strengthening USI policy, additional interventive measure may be needed to improve iodine intake in pregnancy.

Iodine nutritional status in Uttarakhand State, India.

Introduction:Uttarakhand (UK) state is a known endemic region to iodine deficiency (ID).Objective:To assess the current status of iodine nutrition in a population of UK.Methodology:Three districts, namely Udham Singh Nagar (USN), Nainital (N), and Pauri Garhwal (PG) were selected. In each district, 30 clusters were identified by utilizing the population proportional to size cluster sampling methodology. Total of 6143 school age children (SAC) (USN; 1807, N; 2269, PG: 2067), 5430 adolescent girls (AGs) (USN; 1823, N; 1811, PG: 1796), 1727 pregnant mothers (PMs) (USN; 632, N; 614, PG: 481), and 2013 Neonates (USN; 649, N; 670, PG: 694), were included in the study. Clinical examination of thyroid of each child, AG and PM was conducted. Spot urine and salt samples were collected from children, AGs and PMs. Cord blood samples were collected from neonates for estimation of thyroid stimulating hormone (TSH).Results:In SAC, total goiter rate (TGR) was 13.2% (USN), 15.9% (N), and 16.8% (PG). Median urinary iodine concentration (UIC) level was 150 μg/l (USN), 125 μg/l (N), and 115 μg/l (PG). In AGs, TGR was 6.8% (USN), 8.2% (N) and 5.6% (PG). Median UIC level was 250 μg/l (USN), 200 μg/l (N), and 183 μg/l (PG). In PMs, TGR was 16.1% (USN), 20.2% (N), and 24.9% (PG). Median UIC level was 124 μg/l (USN), 117.5 μg/l (N) and 110 μg/l (PG), respectively. In Neonates, TSH levels of >5 mIU/L were found in 55.3 (USN), 76.4 (N) and 72.8 (PG) percent of neonates.Conclusion:UIC level in PMs and TSH levels among neonates indicate the prevalence of ID in three districts surveyed.

Iodine Nutritional Status among Adolescent Girls in Uttarakhand, India.

Uttarakhand (UK) state is a known endemic region for Iodine deficiency. To assess iodine nutritional status among adolescent girls in districts: Udham Singh Nagar (USN), Nainital (N) and Pauri (P) of UK state. In each district, 30 clusters (schools) were identified by using population proportionate to size cluster sampling. In each school, 60 girls (12-18 years) attending the schools were included. Total of 5430 girls from USN (1823), N (1811) and P (1796) were studied. Clinical examination of thyroid of each girl was conducted. From each cluster, spot urine and salt samples were collected. Total goiter rate was found to be 6.8% (USN), 8.2% (N) and 5.6% (P). Median urinary iodine concentration levels were 250 μg/l (USN), 200 μg/l (N) and 183 μg/l (P). Findings of the study documented that adolescent girls had adequate iodine nutritional status in the three districts of UK.

Marginal Iodine Status and High Rate of Subclinical Hypothyroidism in Washington DC Women Planning Conception

Subclinical hypothyroidism during pregnancy has been associated with adverse maternal and fetal outcomes. A subset of pregnant women in the United States have been shown to have mild iodine deficiency. No study has evaluated the thyroid and iodine status of women who are planning to become pregnant in the near future. Thyroid function tests, thyroid antibodies, and urine iodine levels were evaluated in women presenting for preconception screening and counseling. A thyrotropin (TSH) level above 3.0 mIU/L was considered abnormal. One hundred and forty one women enrolled in the study. The median TSH level was 1.70 mIU/L (range 0.43-5.3 mIU/L). Sixteen women (11%) had a TSH above the upper limit of normal (>3.0 mIU/L). Eleven women (8%) were positive for TPO-Ab and 21 women (15%) for TgAb. Twenty-three women (16%) were positive for at least one thyroid antibody (TPOAb and/or TgAb). Median serum TSH concentrations were higher in women with detectable antithyroid antibodies than in women who were antibody negative (2.2 mIU/L vs. 1.7 mIU/L; p=0.005). The median urinary iodine concentration was 100.5 μg (range 19-843 μg/L). The present cohort exhibited the lowest median urinary iodine concentration levels to date reported in the United States for women in their childbearing years. One out of every nine women (11%) had thyroid function tests consistent with subclinical hypothyroidism.

Iodine Deficiency amongst School Age Children in Pauri District of Uttarakhand, India

Objectives: To assess the status of iodine deficiency amongst school age children (6-12 years) in district Pauri, Uttarakhand. Methods: Thirty clusters were selected by utilizing the population proportionate to size (PPS) cluster sampling methodology. A total of 2067 children in the age group of 6-12 years were included. The clinical examination of the thyroid of each child was conducted. “On the spot” urine and salt samples were collected from children. Results: The Total Goiter Rate (TGR) was found to be 16.8%. The proportion of children with Urinary Iodine Concentration (UIC) level <20, 20-49, 50-99, 100-199 and ≥200 μg/l was found to be nil, 25.3, 17.2, 34.0 and 23.5 percent, respectively. The median UIC level was 115 μg/l. Only 40.4% of the salt samples had stipulated level of iodine of 15 ppm and more. Conclusions: Findings of the present study indicates that the population is possibly in transition phase from iodine deficient as revealed by TGR of 16.8% to iodine sufficient as revealed by median UIC level of 115 μg/l. There is a need to further strengthen the existing monitoring system for the quality of iodized salt in the district in order to achieve the elimination of IDD. © 2015 Sareen et al.; This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Conference Abstract

Iodine nutritional status in Himachal Pradesh state, India.

Introduction:Iodine deficiency (ID) is the preventable causes of mental retardation worldwide. Himachal Pradesh (HP) state is a known endemic region to ID.Objective:the objective was to assess the current status of iodine nutrition in a population of HP, India.Methodology:There are three regions in HP namely: Kangra, Mandi, and Shimla. In each region, one district was selected namely: Kangra, Kullu, and Solan. In each district, 30 clusters were identified by utilizing population proportional-to-size cluster sampling methodology. A total of 5748 school-age children (SAC) (Kangra; 1864, Kullu; 1986, Solan: 1898), 1711 pregnant mothers (PMs) (Kangra; 647, Kullu; 551, Solan: 513), and 1934 neonates (Kangra; 613, Kullu; 638, Solan: 683), were included in study. Clinical examination of thyroid of each child and PM was conducted. Casual urine samples were collected from children and PMs. Cord blood samples were collected for estimation of thyroid stimulating hormone (TSH) among neonates.Results:In SAC, total goiter rate (TGR) was 15.8% (Kangra), 23.4% (Kullu), and 15.4% (Solan). Median urinary iodine concentration (UIC) level was 200 μg/l (Kangra), 175 μg/l (Kullu), and 62.5 μg/l (Solan). In PMs, TGR was 42.2% (Kangra), 42.0% (Kullu), and 19.9% (Solan). Median UIC level was 200 μg/l (Kangra), 149 μg/l (Kullu), and 130 μg/l (Solan). In Neonates, TSH levels of > 5 mIU/L were found in 73.4 (Kangra), 79.8 (Kullu), and 63.2 (Solan) percent of neonates.Conclusion:As per, UIC level (<100 μg/l) in SAC, ID was found in district Solan. In Kullu and Solan districts, there were ID (UIC level < 150 μg/l) among PMs. TSH levels indicated ID in all districts surveyed.

Need for neonatal screening program in India: A national priority.

In India, out of 342 districts surveyed, 286 have been identified as endemic to iodine deficiency (ID). Research studies conducted in school age children (SAC), Adolescent girls, Pregnant Mothers (PMs) and Neonates have documented poor iodine nutritional status. As observed by total goiter rate of more than 5% and median urinary iodine concentration level of <100 μg/l in SAC and <150 μg/l in PMs as prescribed cutoff of World Health Organization. And higher thyroid stimulating hormone levels among neonates. ID leads to compromised mental development and hence which remain hidden and not visible to family, program managers and administrator. The present review describes the current status of ID in different parts of the country. With a view to strongly recommend the implementation of Neonatal screening program for ID so that the optimal mental development of children can be achieved.

Iodine deficiency status amongst school children in Pauri, Uttarakhand.

To assess the iodine deficiency status amongst school age children in district Pauri, Uttarakhand. 2067 children (age of 6-12 years) were included. Clinical examination of thyroid gland of each child was conducted. On-the-spot urine and salt samples were collected from children. Total Goitre Rate was found to be 16.8% and median Urinary Iodine Concentration level was 115 µg/L. Only 40.4% of salt samples had e 15 ppm of iodine. There is a mild degree of iodine deficiency in school age children in district Pauri. There is a need of strengthening the National Iodine Deficiency Disorder Control Program.

Iodine nutrition in adults on long-term home parenteral nutrition

ObjectiveThe aim of this study was to evaluate iodine nutrition in adults on long-term home parenteral nutrition (HPN) and to compare it with iodine supplemented with PN, categorized as below or according to the European Society for Clinical Nutrition and Metabolism guidelines (ESPEN-GL) recommendation. MethodsIodine nutrition was evaluated retrospectively in 31 stable adults on long-term HPN. We analyzed urinary iodine concentration (UIC) and serum thyroid-stimulating hormone (TSH). A median UIC value ≥100 μg/L was considered indicative of adequate iodine intake, a value between 50 and 100 was indicative of moderate iodine deficiency, and a value <50 μg/L was indicative of overt iodine deficiency. ResultsPN iodine amount was according to ESPEN-GL in 26% of patients and lower in 19%; 55% did not receive iodine with PN. The median UIC was 63 μg/L (95% confidence interval [CI], 26–99 μg/L) in the whole group of patients, 56 μg/L (95% CI, 24–100) in the group including patients who did not receive any PN iodine supplementation and those who received PN iodine supply lower than the ESPEN-GL recommendation, and slightly higher (77 μg/L) in eight patients with PN iodine supply according to the ESPEN-GL (P = 0.42). TSH was normal in 74% of patients, increased in 23%, and reduced in 3%. Results did not change when patients with reduced glomerular filtration rate were excluded from the analysis. ConclusionsThe analyzed patients on long-term HPN had a low iodine intake as shown by low median UIC level, as did the group of patients who received PN iodine supplementation according to ESPEN-GL. A condition of subclinical hypothyroidism was observed in a small percentage of patients.

The Prevalence of Goiter and Hypothyroidism among School Children 6 Years after Introduction of a Mandatory Salt Iodination Program in a Severely Iodine-Deficient Area of the West Black Sea Region of Turkey

The objective of the current study was to determine the prevalence and the degree of iodine deficiency after mandatory salt iodization in Yığılca's school-aged children. A total of 806 school children aged 6-19 years were evaluated. The prevalence of goiter in children aged 6-12 and 13-19 years was 20.3 and 23.8%, respectively. The prevalence of hypothyroidism in children aged 6-12 and 13-19 years was 10.4 and 18.9%, respectively. The median serum free tetraiodothyronine (fT4) levels in children aged 6-12 and 13-19-years were 1.16 ng/dL and 0.91 ng/dL, respectively. The median urinary iodine concentration levels in children aged 6-12 and 13-19 years were 83 µg/l and 78 µg/l, respectively. The frequency of autoimmune thyroid disease was 2.1% in Yığılca's SAC. Goiter and iodine deficiency problems remain in rural areas of the West Black Sea Region of Turkey.