Normal Iodine Research Articles

Trimester specific thyroid hormone reference range in mild iodine deficiency compared to normal iodine nutrition

Trimester specific thyroid hormone reference range in mild iodine deficiency compared to normal iodine nutrition

Mechanism of multi-organ compensation under different iodine intake in pregnant rats: results from a repeated-measures study of iodine metabolism.

This study aimed to explore the differences in iodine metabolism and expression of NIS and Pendrin in pregnant rats under different iodine nutritional status. Female Wistar rats were divided into four groups: low iodine (LI), normal iodine (NI), tenfold high iodine (10HI), and fifty fold high iodine (50HI). The intervention began after one week of adaptive feeding. Iodine metabolism experiments were performed beginning on the 15th day of pregnancy. 24-h iodine intake and excretion were calculated. The concentrations of iodine in urine, fecal, thyroid, and placenta were measured by ICP-MS. PCR and Western Blot were used to detect the mRNA levels and cell membrane protein of sodium/iodide symporter (NIS) and Pendrin in the small intestine, thyroid, kidney, and placenta. Fecal iodine excretion (FIE) and urinary iodine excretion (UIE) in the 50HI group were significantly higher than those in the NI group (P < 0.05). The NIS protein and mRNA in the kidney and small intestine have an upward trend in iodine deficiency and a downward trend in iodine excess. Thyroid and placental iodine storage in the 50HI group were significantly higher than those in the NI group (P < 0.05). NIS, Pendrin protein, and mRNA in the thyroid and placenta tend to increase when iodine is deficient and decrease when there is excess. Iodine excretion and iodine stores in the placenta and thyroid gland are positively correlated with iodine intake. NIS and Pendrin are also regulated by iodine intake.

Chronic Iodine Intake Excess Damages the Structure of Articular Cartilage and Epiphyseal Growth Plate.

This study aimed to explore the influence of excess iodine on the articular cartilage and epiphyseal growth plate in rats. Wistar rats (n = 200) were randomly divided into five groups with 40 rats in each: normal iodine (NI), 5-fold high iodine group (5HI), 10-fold high iodine group (10HI), 50-fold high iodine group (50HI), and 100-fold high iodine group (100HI). The rats were executed in 6 and 12months. 24-h urinary iodine concentration (UIC) was monitored by arsenic-cerium catalytic spectrophotometry. The chemiluminescence method was used to determine the thyroid function. The pathological changes in the epiphyseal plate, articular cartilage, and thickness of the epiphyseal plate were observed. The mRNA expression of collagen II (ColII), collagen X, matrix metalloproteinase-13 (MMP-13), and fibroblast growth factor receptor 1 in articular chondrocytes was detected by RT-PCR. 24-h UIC increased as iodine intake increased. In the 12th month, there was a significant increase in serum sTSH and a decrease in serum FT4 in HI groups, compared to the NI group. There was a decrease in the number of proliferating cells in the epiphyseal plate and an increase in the number of mast cell layers. The chondrocytes appeared disorganized, and the tidal lines were disturbed or even broken. Growth plate thickness decreased with increasing iodine intake. Compared with the NI group, ColII and MMP-13 mRNA expression in chondrocytes in all HI groups significantly increased. Chronic iodine overdose increases the risk of hypothyroidism. Chronic iodine overdose leads to abnormal morphology of epiphyseal growth plates and articular cartilage, increasing the risk of osteoarthritis.

Thyroid Volume in Pregnancy is Associated with Parity, Gestational Age, and Body Mass Index in an Iodine-sufficient Area.

We compared thyroid volume (TV) and presence of nodular goiter (NG) in pregnant vs. non-pregnant women in an iodine-sufficient area. We also evaluated the relationship between gestational age, parity, and TV in the pregnant women group, and determined the 2.5th and 97.5th percentiles of normal TV in pregnancy. This cross-sectional study included 299 healthy women (216 pregnant) without previous thyroid diseases. Thyroid ultrasounds were performed and compared between pregnant and non-pregnant women. The range of normal distribution of TV (2.5th and 97.5th percentiles) in pregnancy was determined after excluding individuals with positive thyroid antibodies, NG, and/or abnormal serum thyrotropin (TSH) or free thyroxine (FT4). Thyroid volume was larger among pregnant compared to non-pregnant women (8.6 vs 6.1 cm3; p < 0.001) and was positively correlated with gestational age (rs = 0.221; p = 0.001), body mass index (BMI, rs 0.165; p = 0.002), and FT4 levels (rs 0.118 p = 0.021). Nodular goiter frequency did not differ between the two groups. There was a negative correlation between TV and TSH (rs -0.13; p = 0.014). Thyroid volume was lower among primiparous compared to multiparous patients (7.8 vs 8.9; p < 0.001) and was positively correlated with parity (rs 0.161; p = 0.016). The 2.5th and 97.5th percentiles of TV were 4.23 and 16.47 cm3, respectively. Thyroid volume was higher in pregnant compared to non-pregnant women and was positively related to parity, BMI, and gestational age in a normal iodine status population. Pregnancy did not interfere with the development of NG.

Прогностические факторы, влияющие на частоту ремиссии болезни Грейвса после тиреостатической терапии

Graves' disease (GD) is among the most prevalent organ-specific diseases and is one of the most common causes of hyperthyroidism in regions with normal iodine supply. Current therapeutic strategies for the treatment of patients with GD include antithyroid drugs (ATD), thyroid ablation with radioiodine and surgery, which of them is associated with certain risks of complications. The main task of the doctor is to choose the most optimal method to achieve stable remission. In this regard, much attention is paid to the study of predictors of remission, especially after antithyroid drug treatment due to their widespread use as initial therapy. This article is devoted to the consideration of prognostic factors for Graves' disease remission after antithyroid drug treatment.

Iodotyrosines Are Biomarkers for Preclinical Stages of Iodine-Deficient Hypothyroidism in Dehal1-Knockout Mice.

Background: Iodine is required for the synthesis of thyroid hormone (TH), but its natural availability is limited. Dehalogenase1 (Dehal1) recycles iodine from mono- and diiodotyrosines (MIT, DIT) to sustain TH synthesis when iodine supplies are scarce, but its role in the dynamics of storage and conservation of iodine is unknown. Methods: Dehal1-knockout (Dehal1KO) mice were generated by gene trapping. The timing of expression and distribution was investigated by X-Gal staining and immunofluorescence using recombinant Dehal1-beta-galactosidase protein produced in fetuses and adult mice. Adult Dehal1KO and wild-type (Wt) animals were fed normal and iodine-deficient diets for 1 month, and plasma, urine, and tissues were isolated for analyses. TH status was monitored, including thyroxine, triiodothyronine, MIT, DIT, and urinary iodine concentration (UIC) using a novel liquid chromatography with tandem mass spectrometry method and the Sandell-Kolthoff (S-K) technique throughout the experimental period. Results: Dehal1 is highly expressed in the thyroid and is also present in the kidneys, liver, and, unexpectedly, the choroid plexus. In vivo transcription of Dehal1 was induced by iodine deficiency only in the thyroid tissue. Under normal iodine intake, Dehal1KO mice were euthyroid, but they showed negative iodine balance due to a continuous loss of iodotyrosines in the urine. Counterintuitively, the UIC of Dehal1KO mice is twofold higher than that of Wt mice, indicating that S-K measures both inorganic and organic iodine. Under iodine restriction, Dehal1KO mice rapidly develop profound hypothyroidism, while Wt mice remain euthyroid, suggesting reduced retention of iodine in the thyroids of Dehal1KO mice. Urinary and plasma iodotyrosines were continually elevated throughout the life cycles of Dehal1KO mice, including the neonatal period, when pups were still euthyroid. Conclusions: Plasma and urine iodotyrosine elevation occurs in Dehal1-deficient mice throughout life. Therefore, measurement of iodotyrosines predicts an eventual iodine shortage and development of hypothyroidism in the preclinical phase. The prompt establishment of hypothyroidism upon the start of iodine restriction suggests that Dehal1KO mice have low iodine reserves in their thyroid glands, pointing to defective capacity for iodine storage.

COVID-19-related cardiomyopathy: Can dual-energy computed tomography be a diagnostic tool?

No study on dual energy computed tomography (DECT) has been found in the literature to evaluate possibly fatal cardiac/myocardial problems in corona virus disease 2019 (COVID-19) patients. Myocardial perfusion deficits can be found in COVID-19 patients even without any significant coronary artery occlusion, and these deficits can be shown via DECT with a perfect interrater agreement. To assess lung perfusion alterations in COVID-19 patients. To our knowledge, no study using DECT has been performed to evaluate possibly fatal cardiac/ myocardial problems in COVID-19 patients. The purpose of this study is to evaluate the role of DECT in the detection of COVID-19-related cardiac diseases. Two blinded independent examiners evaluated CT images using the 17-segment model according to the American Heart Association's classification of the segmentation of the left ventricular myocardium. Additionally, intraluminal diseases and abnormalities in the main coronary arteries and branches were investigated. Following segment-by-segment analysis, perfusion deficiencies identified on the iodine map pictures on DECT were identified. The study enrolled a total of 87 patients. Forty-two of these individuals were classified as COVID-19 positive, and 45 were classified as controls. Perfusion deficits were identified in 66.6% (n = 30) of the cases. All control patients had a normal iodine distribution map. Perfusion deficits were found on DECT iodine map images with subepicardial (n = 12, 40%), intramyocardial (n = 8, 26.6%), or transmural (n = 10, 33.3%) anatomical locations within the left ventricular wall. There was no subendocardial involvement in any of the patients. Myocardial perfusion deficits can be found in COVID-19 patients even without any significant coronary artery occlusion. These deficits can be shown via DECT with a perfect interrater agreement. Additionally, the presence of perfusion deficit is positively correlated with D-dimer levels.

Оценка йодной обеспеченности детей-вегетарианцев

Objective. To study the iodine supply of children on a vegetarian diet and to evaluate the effectiveness of iodized salt for the prevention of iodine deficiency. Methods. 65 vegetarian children( from 7 to 11 years) were examined. The control group included 40 healthy children of the same age which had no any dietary restrictions. All children lived in the Donetsk Republic. The study of iodine supply was carried out by determining the median of ioduria in the group. Taking into account the identified changes in the iodine supply of children of the surveyed groups, we prescribed them the prevention of iodine deficiency using iodised salt. The effectiveness was evaluated in 6 months. Results. In the main group, the median iodine was 68.4 μg/L, which is mild iodine deficiency. At the same time, 33.9% of children of the main group had a level of ioduria &lt;50 μg / l. In the control group, the median iodine was 97.1 μg/L. Ioduria &lt;50 μg/L had 25.0% of children. In 6 months from the beginning of iodised salt use in the main group, the median iodine was 107.8 μg/L, which is normal iodine supply, and the proportion of children with an iodine concentration in the urine &lt;50 μg/L was 16.9%. In turn, in the control group, after preventive use, the median iodine was 122.5 μg/L, and the proportion of children with ioduria &lt;50 μg/L decreased to 12.5%. Conclusion. The children living in the Donbass have a mild iodine deficiency. Vegetarianism without the use of iodised salt leads to an even more pronounced iodine deficiency. The received data allows to consider that vegetarian children have a risk of iodine deficiency. Regular iodized salt use is an effective prevention of iodine deficiency not only in traditionally fed children, but also in vegetarian children. Key words: vegetarianism, iodine, iodine deficiency, children, iodised salt

Protection of Vitamin C on Oxidative Damage Caused by Long-Term Excess Iodine Exposure in Wistar Rats.

Vitamin C was reported to be able to protect against oxidative damage due to its reducibility. 120 Wistar rats were randomly divided into 4 × 2 groups, including normal iodine (NI), high iodine (HI), low vitamin C (HI + LC), and high vitamin C (HI + HC); potassium iodide (KI) and potassium iodate (KIO3) were commonly used as additives for iodized salt, so every group was also divided into KI and KIO3 groups. After 6 months' feed, the activities of antioxidant enzymes and Lipid Peroxide (MDA) content in serum, liver, kidney, brain, thyroid and lens were determined. In serum, for males, long-term excess iodine intake caused oxidative damage; in the liver, male rats in the HI + LC group had the highest MDA content, which showed that low-dose vitamin C might promote oxidative damage; in kidneys, the MDA content in the HI and HI + LC groups of females was higher; in the brain, high-dose vitamin C could increase the activity of superoxide dismutase (SOD), which was decreased by high iodine intake, and it also decreased MDA content; in the thyroid, for KIO3, the activity of SOD in the HI group was lower than NI and HI + LC; in the lens, the MDA content in females was lower than males. Long-term excess iodine exposure caused oxidative damage and showed sex difference, and vitamin C had a protective effect on it, especially for high-dose vitamin C.

Phenol and Phthalate Effects on Thyroid Hormone Levels during Pregnancy: Relying on In Vitro Assays and Adverse Outcome Pathways to Inform an Epidemiological Analysis.

Studies characterizing associations between phenols, phthalates and thyroid hormones during pregnancy produce inconsistent results. This divergence may be partly attributable to false positives due to multiple comparison testing of large numbers of chemicals, and measurement error as studies rely on small numbers of biospecimens despite high intra-individual variability in urinary chemical metabolite concentrations. This study employs a priori chemical filtering and expanded urinary biomonitoring to evaluate associations between phenol/phthalate exposures and serum thyroid hormones assessed during pregnancy. A two-tiered approach was implemented: a) In vitro high-throughput screening results from the ToxCast/Tox21 database, as informed by a thyroid Adverse Outcome Pathway network, were evaluated to select phenols/phthalates with activity on known and putative molecular initiating events in the thyroid pathway; and b) Adjusted linear regressions were used to study associations between filtered compounds and serum thyroid hormones measured in 437 pregnant women recruited in Grenoble area (France) between 2014 and 2017. Phenol/phthalate metabolites were measured in repeated spot urine sample pools (median: 21 samples/women). The ToxCast/Tox21 screening reduced the chemical set from 16 to 13 and the associated number of statistical comparisons by 19%. Parabens were negatively associated with free triiodothyronine (T3) and the T3/T4 (total thyroxine) ratio. Monobenzyl phthalate was positively associated with total T4 and negatively with the T3/T4 ratio. Effect modification by iodine status was detected for several compounds (among them and mono-n-butyl phthalate) that were associated with some hormones among women with normal iodine levels. For these chemicals, screening for compounds with an increased likelihood for thyroid-related effects and relying on repeated urine samples to assess exposures improved the overall performance of multichemical analyses of thyroid disruption. This approach may improve future evaluations of human data for the thyroid pathway with implication for fetal health and may serve as a model for evaluating other toxicity outcomes. https://doi.org/10.1289/EHP10239.

PSAT327 Can Cannabis Use Lead to Central Hypothyroidism

Abstract Background Marijuana has been legalized for medical use in 36 states and for recreational use in 18 states. Its effects on thyroid function and hypothalamic-pituitary-thyroid axis in humans is not known. Clinical Case 72 years old male presented to his primary care physician with occasional difficulty swallowing. He reported fatigue for 4-5 years, trouble falling asleep for 2 months, weight gain 8 pounds over last few weeks, occasional diarrhea, and intermittent episodes of heat intolerance. His past medical history included controlled type 2 diabetes mellitus, recurrent herpes simplex infection, arthritis of hip joints, short-term memory loss, anemia, carpal tunnel syndrome and benign prostatic hyperplasia. Medications included glimepiride, lisinopril, acyclovir, tamsulosin, finasteride, escitalopram. He had been smoking marijuana regularly since he was a teenager. He denied using any other supplements. His physical exam was normal with stable vital signs and normal BMI. His labs showed a low TSH (0.096 mcIU/mL, n: 0.358-3.8 mcIU/mL), normal free T4 (0.90 ng/dL, n: 0.76-1.46 ng/dL), normal total T3 (70 ng/dL, n: 60-180 ng/dL). Review of his labs showed low TSH for last 4 years progressively getting worse with normal free T4 levels. TSH-receptor antibody and TPO Antibody level were negative. His white cell count, hemoglobin and platelets were normal. His electrolytes, kidney function and liver function tests were also normal. Thyroid Ultrasound showed 2 small sub-centimeter hypoechoic nodules in the left thyroid lobe. Two years ago, a radioactive Iodine scan showed normal iodine uptake. A recent radioactive iodine uptake scan showed generalized decreased iodine uptake with no evidence of graves’ disease or toxic multinodular goiter. Conclusion Currently there are no controlled studies on the effect of marijuana use on thyroid function in humans. A cross-sectional analysis using National Health and Nutrition Examination Survey (NHANES) from 2007 to 2012 showed recent marijuana use was significantly associated with lower levels of TSH but was not associated with thyroid dysfunction (1). This study suggests that marijuana use is associated with low TSH levels. This could be due to hypothalamic suppression of TSH or may indicate a protective role against hypothyroidism. Older studies in rodents showed that cannabis exposure may lead to suppression of TSH and hypothalamic function (2). The data related to human subjects is scarce. Therefore, pathophysiologic mechanisms are speculative, although animal data support potential mechanism of hypothalamic suppression.

Effects of maternal iodine nutritional status on neurodevelopmental and cognitive function of rat offspring.

This study aimed to explore the effect of maternal iodine status on the brain development of offspring in rats. Since in human studies, the interference of environmental factors and other nutrients cannot be removed. A total of 48 female Wistar rats were randomly divided into four groups: low iodine (LI), normal iodine (NI), 10-fold high iodine (10HI), and 50-fold high iodine (50HI). The rats were killed on the 15th day of pregnancy and lactation after collecting 24-h urine. The iodine concentration in 24-h urine, blood, and placenta of pregnant rats, and 24-h urine, milk, blood, and mammary glands of lactating rats was determined by inductively coupled plasma mass spectrometry. The thyroid hormone of pregnant and lactating rats was detected by chemiluminescence. The offspring were subjected to the Morris water maze on the 10th day after birth. Serum was collected to detect the thyroid hormone of offspring. The protein expression of neuroendocrine-specific protein (NSP)-A and brain-derived neurotrophic factor (BDNF) in the offspring brain were studied. Iodine storage in the placenta during pregnancy and mammary glands during lactation was positively correlated with iodine intake, and iodine storage in the placenta and mammary glands in the 50HI group was significantly higher than that in the NI group (P = 0.045 and P = 0.040). Compared with the NI group, the offspring thyroid-stimulating hormone (TSH) level was significantly higher in the 10HI group (P = 0.046), and the FT4 level was significantly lower in the 50HI group (P = 0.032). The Morris water maze showed that LI and 50HI groups required longer time and distance to find the platform than the NI group (P < 0.001). The platform crossing numbers in the LI and 50HI groups decreased significantly (P < 0.001). The expression of NSP-A in offspring brain was lower in the 10HI and 50HI groups than in the NI group (P = 0.026 and P = 0,008). BDNF expression levels were significantly lower in the LI, 10HI, and 50HI groups than in the NI group (P < 0.001). Maternal iodine intake affects iodine storage in the placenta and lactating mammary gland, which in turn affects thyroid function and BDNF and NSP-A expression in the offspring.

Mechanisms of Sodium/Iodide Symporter-Mediated Mammary Gland Iodine Compensation during Lactation.

This research aimed to investigate the compensation mechanism of iodine deficiency and excess in the mammary gland during lactation. Female rats were divided into the low iodine group (LI), the normal iodine group (NI), the 10-fold high iodine group (10HI) and the 50-fold high iodine group (50HI). We measured the iodine levels in the urine, blood, milk, and mammary gland. The protein expression of sodium/iodide symporter (NIS), DPAGT1, and valosin-containing protein (VCP) in the mammary gland was also studied. The 24-hour urinary iodine concentration, serum total iodine concentration, serum non-protein-bound iodine concentration, breast milk iodine concentration, and mammary gland iodine content in the 50HI group were significantly higher than those in the NI group (p < 0.05). Compared with the NI group, NIS expression in the 50HI group significantly decreased (p < 0.05). DAPGT1 expression was significantly higher in the LI group than in the NI group (p < 0.05). The expression level of VCP was significantly increased in the 10HI and 50HI groups. In conclusion, milk iodine concentration is positively correlated with iodine intake, and the lactating mammary gland regulates the glycosylation and degradation of NIS by regulating DPAGT1 and VCP, thus regulating milk iodine level. However, the mammary gland has a limited role in compensating for iodine deficiency and excess.

FEATURES OF RELATIONSHIPS BETWEEN ULTRASTRUCTURES OF THE ENERGY CAPABILITY PROFILE OF FOLLICULAR THYROCYTES IN THE CORRECTION OF ALIMENTARY IODINE DEFICIENCY WITH A LOW DOSE OF ORGANIC AND INORGANIC IODINE

&#x0D; The considerable spread of dietary iodine deficiency and the medical and social significance of the pathology caused by it justifies the use of mathematical methods to study the specific activity of follicular thyrocytes when correcting the manifestations of hypothyroidism with iodine of different chemical nature. The aim of this research was to examine the features of the relationship between the energy direction ultrastructures of follicular thyrocytes when taking a low dose of organic and inorganic iodine under the conditions of dietary iodine deficiency. The study was conducted on the thyroid glands of 40 white nonlinear male rats with an initial body weight of 140-160 g using electron microscopy, linguistic description of electronograms, the method of semi-quantitative analysis of electronograms, the method of specifying the profiles of special capabilities of hormone-poietic cells, and correlation analysis. On the basis of designing the correlation portraits, the interpretation of the results from the standpoint of cytophysiology was carried out. Analysis of correlation portraits of the energy capability profile of follicular thyrocytes showed that low iodine intake of both drugs reduced the functional stress caused by iodine deficiency. This was indicated by changes in mitochondria: an increase in their number and ribosomes on their cristae, a decrease in degenerative changes, granular structure of the matrix, restoration of topographic connection with the rough endoplasmic reticulum and Golgi apparatus. Normal iodine intake was characterized by very high (r=1.000) connections between the moderate number of mitochondria with their well-defined cristae and between the granular structure of the mitochondrial matrix with no degenerative changes in the mitochondria. When consuming inorganic iodine for the energy supply of follicular thyrocytes at a level sufficient for their activity, a very high (r=1.000) connection of round shape mitochondria with the existing topographic connection of mitochondria, rough endoplasmic reticulum, and Golgi apparatus was indicated and high (r=0.881) association of moderate numbers of mitochondria with medium size mitochondria. Nevertheless, in a certain part of thyrocytes, such signs of functional stress as degenerative changes in mitochondria and their cristae, disturbance of topographic interaction of mitochondria with rough endoplasmic reticulum, and Golgi apparatus remained. The studies have established a multilevel adaptation of follicular thyrocytes to function in adverse conditions while enriching the diet with a low dose of iodine increases their energy capability. Organic iodine consumed in low doses, more than inorganic iodine increases the energy supply of follicular thyrocytes’ specific activity.&#x0D;

Multimodal Characterization of a PSMA-Positive Thyroid Nodule Using 68Ga-PSMA and 124Iodine PET/US Fusion Imaging.

A 54-year-old male diagnosed with prostate cancer was referred for 68Gallium-PSMA-11 PET/CT. The scan revealed a solitary PSMA-positive thyroid lesion. On PET/ultrasound fusion imaging, a nodule with moderate risk of malignancy (TIRADS 4B) could be unambiguously correlated. Additional 124Iodine PET/ultrasound fusion imaging revealed normal iodine uptake within the PSMA-positive thyroid nodule. Fine-needle aspiration cytology was performed using an ultrasound needle-guidance system. The cytopathological investigation confirmed a benign thyroid nodule and excluded a thyroid carcinoma as well as a prostate cancer metastasis. Immunohistochemistry was positive for thyroglobulin staining.

Urinary Iodine Concentration as an Indicator of Iodine Status and its Correlation with the Thyroid Hormones and Hemoglobin Levels in First Trimester Pregnant Women - An Exploratory Study

During pregnancy, the daily requirement of iodine increases making those most at-risk population for iodine deficiency disorders. The available confined data shows that pregnant women are iodine deficient even in iodine sufficient regions with this background the objectives of the current study were to assess the urinary iodine concentration (UIC) and evaluate the relationship between the levels of hemoglobin, UIC, and thyroid status in first-trimester pregnant women. A cross-sectional hospital-based study with a total sample size of n=110 pregnant women at the13th week of gestation in the Mysuru district was selected. The UIC, anthropometric measurements, iodine intake, and selected biochemical parameters (TSH, FT3, FT4, and Hb) were assessed. The data was analysed using SPSS (v 16.0). Spearman’s rank correlation test was used to analyse correlations. The Mann- Whitney U test was used to compare differences between groups. ANOVA was used to study the comparison of pregnancy complications with UIC and hemoglobin. The median UIC (mUIC) was 194.2 µg/L and Hb was 10.5 g/dL. Even though the mUIC was normal, around 38.2% had insufficient UIC. Significant inverse relationship between UIC and TSH (r = -0.487, p&lt;0.001), Hb and TSH (r = -0.355, p &lt; 0.001), and between TSH and iodine intake (r=-0.476, p&lt;0.001) were observed. It was interesting to observe that those with insufficient UIC were found to have mild anaemia and low FT4 levels and those with excess UIC had lower TSH levels. The pregnant women in the present study were found to have the normal median urinary iodine concentration and were mildly anaemic. Increased attention among pregnant women should be focused on iodine status along with iron status and thyroid functions. Larger comparative studies need to be performed to study the impact of altered iodine status on neonatal outcomes.

Стан йодного забезпечення дітей та жінок репродуктивного віку в західному регіоні України

Актуальність. В Україні за останні роки спостерігається зростання частоти тиреоїдної патології. Абсолютна кількість випадків захворювання щитоподібної залози за останні 10 років зросла з 689 000 до 1 486 000, згідно з даними щодо поширення, що становить 941,6 і 4210,4 випадку на 100 000 населення відповідно. Частота патології щитоподібної залози (станом на 01.01.2018) становить 46 % від усіх ендокринологічних захворювань і посідає перше місце серед них. Основною причиною є незбалансованість мікроелементного і вітамінного складу в раціоні на тлі погіршення екологічної ситуації та техногенного забруднення довкілля. Метою дослідження було оцінити ступінь йодного дефіциту в населення західного регіону України та надати теоретичне обґрунтування подальшого подолання йододефіцитних станів. Матеріали та методи. Вивчення стану йодного забезпечення населення проводили серед вагітних жінок у першому триместрі вагітності (19–44 роки) та дітей шкільного віку (12–14 років), які проживають у західному регіоні України. Йодне забезпечення оцінювали з використанням неонатального скринінгу концентрації тиреотропного гормону в новонароджених, даних щодо частоти зоба за результатами пальпаторного обстеження, ультрасонографічного обстеження щитоподібної залози та медіани екскреції йоду з сечею. Результати. За даними неонатального скринінгу частота гіпертиреотропінемії становила в середньому 3,52 ± 0,30 % в популяції, що відповідає легкому ступеню йодної недостатності. За результатами ультрасонографічного обстеження щитоподібної залози частота виявлення зоба в дітей становить 38 %, а у вагітних жінок — 36 %, що є характерним для тяжкого ступеня йодного дефіциту. Результати визначення медіани йодурії в дітей показали недостатнє йодне забезпечення в 20 %, концентрація йоду в сечі в середньому становила 99,69 ± 35,42 мкг/л. У 30 % дітей спостерігалось надлишкове надходження йоду в організм, та 50 % обстежених дітей мали оптимальне забезпечення йодом. Нестачу йоду в раціоні вагітних було виявлено в 43,3 % обстежених (медіана йодурії 81,96 ± 42,53 мкг/л). У 26,7 % вагітних концентрація йоду в сечі відповідала нормальному інтервалу, надлишкове надходження йоду в організм при медіані понад 230 мкг/л було виявлене в 30 % вагітних. Висновки. Оцінка йодного забезпечення населення західного регіону України свідчить про тяжкий ступінь йодної недостатності, що вимагає термінового впровадження загальнонаціональної програми профілактики.

Effects of iodine excess on serum thyrotropin-releasing hormone levels and type 2 deiodinase in the hypothalamus of Wistar rats.

Iodine is an important element in thyroid hormone biosynthesis. Thyroid function is regulated by the hypothalamic-pituitary-thyroid axis. Excessive iodine leads to elevated thyroid-stimulating hormone (TSH) levels, but the mechanism is not yet clear. Type 2 deiodinase (Dio2) is a Se-containing protease that plays a vital role in thyroid function. The purpose of this study was to explore the role of hypothalamus Dio2 in regulating TSH increase caused by excessive iodine and to determine the effects of iodine excess on thyrotropin-releasing hormone (TRH) levels. Male Wistar rats were randomised into five groups and administered different iodine dosages (folds of physiological dose): normal iodine, 3-fold iodine, 6-fold iodine, 10-fold iodine and 50-fold iodine. Rats were euthanised at 4, 8, 12 or 24 weeks after iodine administration. Serum TRH, TSH, total thyroxine (TT4) and total triiodothyronine (TT3) were determined. Hypothalamus tissues were frozen and sectioned to evaluate the expression of Dio2, Dio2 activity and monocarboxylate transporter 8 (MCT8). Prolonged high iodine intake significantly increased TSH expression (P < 0·05) but did not affect TT3 and TT4 levels. Prolonged high iodine intake decreased serum TRH levels in the hypothalamus (P < 0·05). Dio2 expression and activity in the hypothalamus exhibited an increasing trend compared at each time point with increasing iodine intake (P < 0·05). Hypothalamic MCT8 expression was increased in rats with prolonged high iodine intake (P < 0·05). These results indicate that iodine excess affects the levels of Dio2, TRH and MCT8 in the hypothalamus.

Применение рентгеновской компьютерной томографии для оценки концентрации интратиреоидного йода и запасов тиреоидных гормонов непосредственно в щитовидной железе

In this lecture, the need of using X-ray computed tomography (CT) to assess the intrathyroidal iodine concentration and its storage in the thyroid gland has being discussed. Due to the fact that 80 % of intrathyroidal iodine is located in the phenolic ring of thyroid hormones, which are structurally located in colloid-thyroglobulin follicles as a hormonal depot, the parameter of intrathyroidal iodine (PII) is an indicator of the stores of iodine-containing thyroid hormones directly in the organ. A decrease in intrathyroidal iodine indicates a significant functional impairment of storing thyroid hormones in the colloid of thyroglobulin of the thyroid follicles and is an early highly accurate prognostic sign of the formation of gland dysfunction. Due to the compensatory capabilities of the body, this dysfunction may appear late onset (for example, 2 months after detecting a decrease in intrathyroidal iodine). The most convenient and affordable method for determining intrathyroidal iodine is CT with two types of tomographs: 1) standard by which intrathyroidal iodine is determined by the density of the thyroid gland in Hounsfield units (HU); 2) tomographs with the option of assessing the concentration of intrathyroidal iodine (CII) in the most common units of measurement – mg/g or μg/g (used since 2016). If necessary, the conversion of some units of intrathyroidal iodine to others has the formula: &#x0D; CII (in μg/g) = ([density in HU] – 65) / 104. &#x0D; Based on the literature and our own research results, for the first time, we calculated the limits of normal intrathyroidal iodine fluctuations in euthyroid individuals, which are 85–140 HU units or 200–700 μg/g intrathyroidal iodine. Identification of the examined intrathyroidal iodine beyond the indicated fluctuations indicates the functional impairment of storing thyroid hormones, which ultimately will lead to hypothyroidism or hyperthyroidism (except when the patient is taking levothyroxine, mercazole, β-blockers – drugs that reduce intrathyroidal iodine).&#x0D; For the first time, an algorithm is presented for differential diagnosis of iodine-deficient and iodine-induced thyroid dysfunctions, which can only be done using CT: if there is a functional impairment of the thyroid gland with intrathyroidal iodinelevel less than 85 units of HU or 200 μg/g CII, then it is considered iodine deficient; with intrathyroidal iodinelevel more than 140 units of HU or 700 μg/g of CII, it is considered iodine-induced. &#x0D; The algorithm for the prevention of iodine-induced thyroid pathology with iodine prophylaxis is that iodine prophylaxis should not be prescribed or continued when intrathyroidal iodinelevel is 140 units of HU or 700 μg/g of CII or more.

To find out the effectiveness of normal saline versus povidone iodine on Pin Site Infection among patients with external skeletal fixators admitted in a tertiary care hospital, Thiruvananthapuram

To find out the effectiveness of normal saline versus povidone iodine on Pin Site Infection among patients with external skeletal fixators admitted in a tertiary care hospital, Thiruvananthapuram