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Chen W, Wang W, Gao M, Chen Y, Guo W, Dong S, Sun H, Pan Z, Pearce EN, Tan L, Shen J, Zhang W. Iodine Intakes of <150 μg/day or >550 μg/day are Not Recommended during Pregnancy: A Balance Study. J Nutr 2023; 153:2041-2050. [PMID: 37100687 DOI: 10.1016/j.tjnut.2022.10.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/25/2022] [Accepted: 10/28/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Adequate iodine intake during pregnancy is critical for maintaining maternal and fetal thyroid function and development. There are only limited data from iodine-balance studies to inform iodine requirements during pregnancy. OBJECTIVES This is an iodine-balance study conducted to explore the associations among iodine intake, excretion, and retention to provide information regarding iodine requirements during pregnancy. METHODS A 7-d iodine-balance experiment enrolled 93 healthy pregnant Chinese women from Hebei, Tanjin, and Shandong. Duplicates of all foods and beverages consumed were systematically collected and measured for iodine content. Iodine excretion was measured by collecting 24-h urine and feces samples. Simple linear regression models were used to assess relationships between total iodine intake and iodine retention, whereas mixed effect models were used to assess the relationship between daily iodine intake and iodine retention. RESULTS The mean ± SD age of participating pregnant women was 29 ± 2 y at a median 22 (IQR: 13-30) wk of gestation. The mean 7-d iodine retention was 43.0 ± 1060 μg/7 d. A negative iodine balance was present in 56% of women whereas 44% had a positive balance. Pregnant women with iodine intakes <150 μg/d were in negative balance whereas those with intakes >550 μg/d were in positive balance. The daily iodine intake at zero balance was 343 μg/d, which was higher in women from Shandong (492 μg/d) than in those from Hebei and Tianjin (202 μg/d). CONCLUSIONS Iodine intake at zero balance determined in pregnant women with adequate iodine nutrition is 202 μg/d, and the calculated recommended nutrient intake (RNI) is 280 μg/d. Iodine intakes of <150 μg/d and >550 μg/d are not recommended during pregnancy. This trial was registered at clinicaltrials.gov as NCT03710148.
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Affiliation(s)
- Wen Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China; Department of Endocrinology and Metabolism, Health care and Prevention, Tianjin Medical University General Hospital, Tianjin, China
| | - Wei Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China; The Department of Health Services and Management, School of Management, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Min Gao
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yanting Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wenxing Guo
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Shuyao Dong
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Hao Sun
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Ziyun Pan
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Elizabeth N Pearce
- Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, MA, USA
| | - Long Tan
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Jun Shen
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wanqi Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China; Department of Endocrinology and Metabolism, Health care and Prevention, Tianjin Medical University General Hospital, Tianjin, China.
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Liu ZM, Wu Y, Long HH, Chen CG, Wang C, Ye YB, Shen ZY, Ye MT, Zhang SJ, Li MM, Pan WJ. Associations of Maternal Serum Iodine Concentration with Obstetric Complications and Birth Outcomes-Longitudinal Analysis Based on the Huizhou Mother-Infant Cohort, South China. Nutrients 2023; 15:2868. [PMID: 37447195 DOI: 10.3390/nu15132868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/13/2023] [Accepted: 06/15/2023] [Indexed: 07/15/2023] Open
Abstract
This study aimed to explore the temporal associations between maternal serum iodine concentration (SIC) and common pregnancy outcomes in Chinese women. Eligible singleton pregnant women aged 20-34 years were selected, and their fasting blood samples were collected during early (T1, n = 1101) and mid-pregnancy (T2, n = 403) for SIC testing by inductively coupled plasma mass spectrometry. Multivariable linear regression indicated that log10SIC at T1 (β = -0.082), T2 (β = -0.198), and their % change (β = -0.131) were inversely associated with gestational weight gain (GWG, all p < 0.05). Maternal log10SIC at both T1 (β = 0.077) and T2 (β = 0.105) were positively associated with the Apgar score at 1 min (both p < 0.05). Women in the third quartile (Q3) of SIC at T1 had a lower risk of small for gestational age (SGA, OR = 0.405, 95% CI: 0.198-0.829) compared with those in Q4. Restricted cubic spline regression suggested a U-shaped association between SIC and SGA risk, and SIC above 94 μg/L at T1 was the starting point for an increased risk of SGA. The risk of premature rupture of membrane (PROM) increased by 96% (OR = 1.960, 95% CI: 1.010-3.804) in Q4 compared to that in Q1. Our longitudinal data from an iodine-replete region of China indicated that high maternal SIC could restrict GWG and improve Apgar scores at delivery, but might increase the risk of SGA and PROM.
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Affiliation(s)
- Zhao-Min Liu
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, North Campus, Guangzhou 510080, China
| | - Yi Wu
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, North Campus, Guangzhou 510080, China
| | - Huan-Huan Long
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, North Campus, Guangzhou 510080, China
| | - Chao-Gang Chen
- Department of Clinical Nutrition, Second Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Cheng Wang
- Department of Clinical Nutrition, Second Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Yan-Bin Ye
- Department of Clinical Nutrition, The First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| | - Zhen-Yu Shen
- Department of Paediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Ming-Tong Ye
- Huizhou First Maternal and Child Health Care Hospital, Huizhou 516000, China
| | - Su-Juan Zhang
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, North Campus, Guangzhou 510080, China
| | - Min-Min Li
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, North Campus, Guangzhou 510080, China
| | - Wen-Jing Pan
- Huizhou First Maternal and Child Health Care Hospital, Huizhou 516000, China
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Ju DL, Cho SW, Chung CW, Lee YA, Cheon GJ, Park YJ, Shin CH, Jun JK, Chung JK, Park SK, Song Y. High intakes of iodine among women during pregnancy and the postpartum period has no adverse effect on thyroid function. Eur J Nutr 2023; 62:239-249. [PMID: 35947162 DOI: 10.1007/s00394-022-02960-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/08/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE Given the high consumption of seaweed soup by pregnant and lactating Korean women, concerns have been raised about excessive iodine intake. We evaluated the effects of maternal iodine intake on maternal thyroid function and birth outcomes. We also evaluated iodine intake via seaweed soup during late pregnancy and the early postpartum period. METHODS A total of 349 pregnant women of the Ideal Breast Milk cohort were recruited in late pregnancy, of whom 302 revisited after delivery. Three-day dietary records were assessed at each visit. Blood was collected for thyroid function test. Obstetrical and birth outcomes were obtained. RESULTS The median dietary iodine intake was 459 μg/day (interquartile range [IQR] 326.5-647.4 μg/day) during pregnancy. Dietary iodine intake by quartile was not significantly associated with maternal thyroid status, or obstetrical or neonatal outcomes. However, the dietary iodine intake in the early postpartum period was 1759 μg/day (IQR 1026.7-2491.1 μg/day) because of a marked increase in seaweed soup consumption. Of all women, 25.8% consumed seaweed soup more than once over the 3 days of dietary records when pregnant, but the figure rose to 93.4% postpartum. Of postpartum women who consumed seaweed soup daily, the median dietary iodine intakes were 1355, 2394, and 3063 μg/day (soup at one, two, and three-or-four meals). CONCLUSIONS In these iodine-replete pregnant women, dietary iodine intake during pregnancy showed no effect on maternal thyroid function or birth outcomes. However, iodine intake in the early postpartum period was markedly increased by the frequency of seaweed soup consumption.
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Affiliation(s)
- Dal Lae Ju
- Department of Nutrition, SMG-SNU Boramae Medical Center, Seoul, 07061, Korea
| | - Sun Wook Cho
- Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, 03080, Korea
| | - Chae Won Chung
- Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, 03080, Korea
| | - Young Ah Lee
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, 03080, Korea
| | - Gi Jeong Cheon
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, 03080, Korea
| | - Young Joo Park
- Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, 03080, Korea.,Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Sicence and Technology, Seoul National University, Seoul, Korea
| | - Choong Ho Shin
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, 03080, Korea
| | - Jong Kwan Jun
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, 03080, Korea
| | - June-Key Chung
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, 03080, Korea
| | - Sue K Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, 03080, Korea. .,Cancer Research Institute, Seoul National University, Seoul, 03080, Korea. .,Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Seoul, Korea.
| | - YoonJu Song
- Department of Food Science and Nutrition, Catholic University of Korea, 43 Jibong-ro Wonmi-gu, Bucheon-si, 14662, Republic of Korea.
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Đurović D, Đorđević Z, Mugoša B, Bajić B, Nikolić-Kokić A, Miletić S, Spasić S. Half of expectant women in Montenegro show iodine deficiency, indicating that supplementation during pregnancy is necessary. Int J Gynaecol Obstet 2023; 160:691-697. [PMID: 35899694 DOI: 10.1002/ijgo.14370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 06/29/2022] [Accepted: 07/17/2022] [Indexed: 01/20/2023]
Abstract
OBJECTIVE In this study, iodine level in pregnant women of Montenegro and their needs for supplementation were investigated. METHODS A urinary iodine concentration (UIC) study of 326 pregnant women between September and December 2017 in three regions of Montenegro was performed. UIC was related to creatinine (UI/Cr ratio). RESULTS The median UIC (133 ± 5 μg/L) was indicative of iodine deficiency, as the WHO recommended UIC is 150-249 μg/L. The UI/Cr ratio (160 ± 6 μg/g creatinine) was just above the WHO/UNICEF/IGN recommendation. Approximately 50% of the surveyed women had a lower UIC than that recommended. CONCLUSION Iodine deficiency is present in pregnant women in Montenegro. Monitoring the UIC during routine analyses in pregnant women in Montenegro is recommended, along with iodine supplementation for individuals that need it.
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Affiliation(s)
- Dijana Đurović
- Institute of Public Health of Montenegro, Džona Džeksona bb, Podgorica, Montenegro
| | - Zorica Đorđević
- Institute of Public Health of Montenegro, Džona Džeksona bb, Podgorica, Montenegro
| | - Boban Mugoša
- Institute of Public Health of Montenegro, Džona Džeksona bb, Podgorica, Montenegro
| | - Borko Bajić
- Institute of Public Health of Montenegro, Džona Džeksona bb, Podgorica, Montenegro
| | - Aleksandra Nikolić-Kokić
- Department of Physiology, Institute for Biological Research "Siniša Stanković"-National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Srđan Miletić
- Department of Chemistry, Institute of Chemistry, Technology and Metallurgy-National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Snežana Spasić
- Department of Chemistry, Institute of Chemistry, Technology and Metallurgy-National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
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Tayier R, Wang C, Ma P, Yuan Y, Zhang Y, Wu S, Zhang L. Iodine Nutritional Status of Pregnant Women After 14 Years of Lipiodol Supplementation: a Cross-Sectional Study in Historically Iodine-Deficient Areas of China. Biol Trace Elem Res 2023; 201:14-22. [PMID: 35322354 DOI: 10.1007/s12011-022-03123-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/17/2022] [Indexed: 01/11/2023]
Abstract
Southern Xinjiang has a history of serious iodine deficiency. Since 2007, pregnant women in this area have taken iodized salt and oral lipiodol preparations to prevent iodine deficiency disorders. However, the current status of iodine nutrition and thyroid function in this population is unknown. A cross-sectional study was conducted on 555 pregnant women from 5 counties (cities) in southern Xinjiang and 429 pregnant women from 3 counties in northern Xinjiang. The participants were given a questionnaire and serum concentrations of free triiodothyronine (FT3), free thyroxine (FT4), thyrotropic stimulating hormone (TSH), thyroglobulin antibody (Tg-Ab), and thyroid peroxidase antibody (TPO-Ab), and the urine iodine concentration (UIC) was measured. The median UIC and interquartile range [M (IQR)] of the 984 pregnant women in the study was 189.38 (143.15, 288.77) μg/L. Positive Tg-Ab and TPO-Ab titers were detected in 6.74% and 9.55%, 8.30% and 9.84%, and 7.39% and 10.55% in T1, T2, and T3, respectively. The incidence of subclinical hypothyroidism, clinical hypothyroidism, and isolated hypothyroxinemia in pregnant women in areas where lipiodol pills were taken was 4.32%, 0%, and 1.44%, respectively, which was significantly lower than those in areas where lipiodol pills were not taken. The median UIC (IQR) of pregnant women in the two regions was 213.80 (130.44, 331.77) μg/L and 168.30 (155.0, 254.8) μg/L, the UIC of pregnant women who took lipiodol pills was higher than in those who did not take lipiodol pills, and the difference was statistically significant (p < 0.05). According to WHO standards, all pregnant women in southern Xinjiang are in a state of adequate iodine nutrition. Taking lipiodol pills has improved the iodine nutrition level of pregnant women in this area. The results of this study did not find that oral lipiodol pills had adverse effects on pregnant women's thyroid function, but it is necessary to further study the effect of oral lipiodol pills on the offspring.
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Affiliation(s)
- Rishalaiti Tayier
- College of Public Health, Xinjiang Medical University, Urumqi, 830011, Xinjiang, People's Republic of China
| | - Chenchen Wang
- Xinjiang Uighur Autonomous Region Centre for Disease Control and Prevention, Urumqi, 830011, People's Republic of China
| | - Pinjiang Ma
- Xinjiang Uighur Autonomous Region Centre for Disease Control and Prevention, Urumqi, 830011, People's Republic of China
| | - Yimu Yuan
- Xinjiang Production and Construction Corps Hospital, Urumqi, 830011, Xinjiang, People's Republic of China
| | - Yuxia Zhang
- Urumqi Maternal and Child Health Hospital, Urumqi, 830011, Xinjiang, People's Republic of China
| | - Shunhua Wu
- Department of Occupational and Environmental Health, School of Public Health, Xinjiang Medical University, Urumqi, 830001, People's Republic of China.
| | - Ling Zhang
- Xinjiang Uighur Autonomous Region Centre for Disease Control and Prevention, Urumqi, 830011, People's Republic of China.
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Dhar PK, Dey SK, Rahman A, Sayed MA, Ara MH. Probabilistic Health Risk Assessment of Iodine Exposure in Bangladesh. Biol Trace Elem Res 2023; 201:65-81. [PMID: 35249208 DOI: 10.1007/s12011-022-03141-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 01/27/2022] [Indexed: 01/11/2023]
Abstract
In this study, the concentrations of iodine in household salt samples (n = 690) were determined by following the iodometric titration method, and the health risks of Bangladeshi people were assessed based on the semi-probabilistic approach and the US Environmental Protection Agency (USEPA) deterministic model. After adjusting 20% of cooking losses, the iodine concentration (mean, range) in salt samples of Phultala, Dighalia, Terokhada, Rupsha, Batiaghata, Dumuria, Paikgacha, Koyra, Dacope, and KCC was (29.68 ± 8.67, 14.39-48.26), (31.05 ± 6.68, 15.24-43.18), (26.94 ± 5.57, 16.09-45.72), (24.33 ± 5.61, 12.70-37.26), (26.69 ± 6.73, 10.16-44.87), (27.20 ± 8.44, 9.31-53.34), (27.71 ± 8.09, 8.46-47.42), (28.39 ± 7.80, 11.01-46.57), (28.20 ± 7.97, 3.38-49.10), and (29.21 ± 6.62, 18.62-40.64) mg/kg, respectively. The iodine contents in 97.25% of samples were within the standard fortification level of Bangladesh (15-50 mg/kg), while 2.61% of samples were below this limit. The semi-probabilistic risk assessment studies showed that 80.14% of samples at a low ingestion rate could provide optimal nutrition (150-299 μg/day) to the whole population. Contrarily, at medium, moderate-high, and high consumption rates 34.93%, 65.22%, and 85.94% of samples, respectively, belonged to above the requirements to excessive exposure categories (300-1100 μg/day), which might cause iodine-induced diseases. The target hazard quotient (THQ) values for the adults in most of the samples were within the threshold risk limit (THQ < 1.0), whereas THQ values in 6.82% to 85.97% of samples for the children at low to high ingestion rates, respectively exceeded this limit, which revealed that the adults were almost safe, but the children might face non-carcinogenic health effects. Therefore, regular monitoring of iodine concentration in iodized salts should be done to prevent iodine deficiency or iodine-induced disorders.
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Affiliation(s)
| | | | - Asifur Rahman
- Chemistry Discipline, Khulna University, Khulna-9208, Bangladesh
| | - Md Abu Sayed
- Chemistry Discipline, Khulna University, Khulna-9208, Bangladesh
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Zhou Y, Chen F, Wang L, Tian C, Zhang S, Ding F, Deng J. Establishment of an iodine model for prevention of iodine-excess-induced thyroid dysfunction in pregnant women. Open Life Sci 2021; 16:1357-1364. [PMID: 35071770 PMCID: PMC8760181 DOI: 10.1515/biol-2021-0142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 11/08/2021] [Accepted: 11/21/2021] [Indexed: 11/30/2022] Open
Abstract
This study aims to explore the relationship between the iodine status and thyroid dysfunction (TD) in pregnant women and establish a model to guide them to prevent excessive iodine intake. A total of 515 pregnant women were enrolled in the study. Urinary iodine concentration (UIC), thyroid hormones, and thyroid autoantibodies were measured, and then a logistic regression model was established. The median UIC of pregnant women was 174 ± 120 μg/L. Multivariate logistic regression analysis indicated that multivitamin supplements containing iodine and frequent seafood consumption were risk factors for excessive iodine (UIC ≥500 μg/L). Besides, excessive iodine was a risk factor for TD. Iodine excess was associated with a high prevalence of TD in pregnant women, especially TPOAb-positive women (P < 0.05). A logistic regression model based on potential risk factors was established to predict the risk of excessive iodine intake among pregnant women and provide guidance to minimize the risk of excessive iodine intake, thus reducing the risk of TD.
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Affiliation(s)
- Yuhan Zhou
- Department of Obstetrics, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine , No. 15 Jiefang Road, Fancheng District , Xiangyang , 441000 , People’s Republic of China
| | - Fen Chen
- Department of Obstetrics, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine , No. 15 Jiefang Road, Fancheng District , Xiangyang , 441000 , People’s Republic of China
| | - Lingyu Wang
- Department of Obstetrics, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine , No. 15 Jiefang Road, Fancheng District , Xiangyang , 441000 , People’s Republic of China
| | - Chunhui Tian
- Department of Obstetrics, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine , No. 15 Jiefang Road, Fancheng District , Xiangyang , 441000 , People’s Republic of China
| | - Shuo Zhang
- Department of Technology, Biotecan Medical Diagnostics Co., Ltd, Zhangjiang Center for Translational Medicine , Shanghai 201204 , People’s Republic of China
| | - Feifei Ding
- Department of Technology, Biotecan Medical Diagnostics Co., Ltd, Zhangjiang Center for Translational Medicine , Shanghai 201204 , People’s Republic of China
| | - Jie Deng
- Department of Obstetrics, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine , No. 15 Jiefang Road, Fancheng District , Xiangyang , 441000 , People’s Republic of China
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Tian W, Yan W, Liu Y, Zhou F, Wang H, Sun W. The Status and Knowledge of Iodine among Pregnant Women in Shanghai. Biol Trace Elem Res 2021; 199:4489-4497. [PMID: 33462796 DOI: 10.1007/s12011-021-02587-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 01/10/2021] [Indexed: 11/27/2022]
Abstract
Iodine plays an important role in thyroid function. However, in daily practices, people lack the related details including the knowledge concerned iodine usage, attitudes towards it, and practice among pregnant women. The aim of the present study is to assess the iodine status of pregnant women in Shanghai, and their knowledge regarding iodine, with the goal of investigating the relationship between iodine and thyroid function during pregnancy. This is a cross-sectional study. We recruited 3 groups of participants including 145 pregnant women (12-16 weeks gestation), 101 pregnant women (24-28 weeks gestation), and 108 pregnant women (34-38 weeks gestation). Iodine status and dietary intake were calculated from 24-h urinary iodine concentration (UIC). Knowledge regarding iodine was collected through a questionnaire. We additionally examined TSH, FT3, FT4, and TPOAb of the participants. The median of UIC of the 354 pregnant women was 119.2 μg/L, and 68.9% had urinary iodine levels below 150 μg/L. The proportion of daily iodized salt consumption in pregnant women was only 78.0%. The median UIC of the pregnant women who had consumed iodized salt was significantly higher than that of the pregnant women without iodized salt intake (Z = - 5.087, P < 0.001). Pregnant women in weeks 34-38 with a high level of knowledge had significantly lower TSH levels than those with low knowledge level (P = 0.046). Among the 349 pregnant women, few were aware of the harm to the fetus (8.3%). Significant differences were found in the scores for the knowledge level of women with different educational levels (Z = - 5.413, P < 0.001). Pregnant women in Shanghai have mild iodine deficiency. Approaches to improve iodine status among pregnant women in Shanghai include raising their awareness of iodine intake and changing their dietary habits. Otherwise, the risk of iodine deficiency in pregnant women may continue to increase.
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Affiliation(s)
- Wenxia Tian
- College of Food Science and Technology, Shanghai Ocean University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wenqing Yan
- College of Food Science and Technology, Shanghai Ocean University, Shanghai, China
| | - Yang Liu
- Obstetrics and Gynecology, Shanghai Sixth People's Hospital East Campus, Shanghai, China
| | - Fangfang Zhou
- Obstetrics and Gynecology, Shanghai Sixth People's Hospital East Campus, Shanghai, China
| | - Haixia Wang
- College of Food Science and Technology, Shanghai Ocean University, Shanghai, China
| | - Wenguang Sun
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.
- Shanghai Municipal Key Clinical Specialty, Shanghai, China.
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
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Exploration of the optimal range of urinary iodine concentration in Chinese pregnant women in mildly iodine-deficient and -sufficient areas. Eur J Nutr 2021; 61:1221-1230. [PMID: 34739565 DOI: 10.1007/s00394-021-02693-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 09/28/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE There is some uncertainty about the optimal ranges for urinary iodine concentration (UIC) during pregnancy. This study aimed to explore associations between maternal UIC and thyroid function in iodine sufficient and mildly iodine deficient areas. METHODS It was a cross-sectional study in which 1461 healthy pregnant women were enrolled to collect their blood and urine samples during their routine antenatal care in Tianjin and Wuqiang, China. Wuqiang was a mildly iodine-deficient region, while Tianjin was iodine sufficient. UIC, free triiodothyronine (FT3), free thyroid hormone (FT4), thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), serum iodine concentration (SIC) including total serum iodine concentration (tSIC) and non-protein bound serum iodine concentration (nbSIC) were assessed during the routine antenatal care visits. RESULTS The median UIC in pregnant women was 174 (113, 249) μg/L in Tianjin and 111 (63, 167) μg/L in Wuqiang, respectively. Compared with Tianjin, UIC, FT3 and TSH were lower, and FT4, tSIC, nbSIC, rates of TPOAb and TgAb positivity and the thyroid dysfunction rate (TDR) were higher in Wuqiang (P < 0.001). FT3, FT4, tSIC and nbSIC increased during pregnancy in Tianjin with increasing UIC, while only FT3 and nbSIC increased in Wuqiang (P < 0.05). In Tianjin, the TDR increased with UIC and peaked at UIC ≥ 500 μg/L (P = 0.002), while in Wuqiang, the TDR showed a weak "U-shaped" relationship with UIC and the rate was lowest with UIC 100-149 μg/L. CONCLUSIONS In iodine-deficient areas, there was a lower TDR in pregnant women with UIC 100-149 μg/L. We suspected that the optimal UIC criteria recommended by WHO may be a little high for pregnant women in mild-to-moderate iodine-deficient countries.
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Zwolińska J, Augustyn B, Baj K, Krukowska J. The effect of galvanization and potassium iodide iontophoresis of the throat and larynx on thyroid parameters: a randomized controlled trial. Sci Rep 2021; 11:15590. [PMID: 34341406 PMCID: PMC8329291 DOI: 10.1038/s41598-021-95145-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 06/30/2021] [Indexed: 11/20/2022] Open
Abstract
Few studies have assessed the application and side effects of potassium iodide (KI) iontophoresis. Using a double-blinded randomized controlled trial with a 1:1 parallel-group, we investigated the effect of galvanization and the KI iontophoresis in the throat and larynx on three thyroid parameters. A total of 50 healthy volunteers with normal TSH, FT3, and FT4 levels and lacking focal changes in the thyroid ultrasonography were subjected to 10 electrotherapy treatments. The TSH, FT3, and FT4 levels were determined prior to the 10 electrotherapeutic treatments (T1), 2-weeks after treatment (T2) and 6-months after treatment (T3). At T2 and T3, both groups had normal levels of TSH, FT3, and FT4. Regarding the change of TSH, FT3, and FT4 levels between T1 vs. T2 and T1 vs. T3, no significant differences between the galvanization and iontophoresis groups were found. However, both groups had lower levels of all three hormones at T3. Together, these data indicate that KI iontophoresis does not affect thyroid hormone levels in the short- nor long-term. Additional follow-up studies with larger groups are required to better confirm the safety of galvanization and iontophoresis procedures in the pharynx and larynx. Trial registration ClinicalTrials.gov (NCT04013308; URL: www.clinicaltrials.gov). Day of first registration 09/07/2019.
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Affiliation(s)
- Jolanta Zwolińska
- Institute of Health Sciences, Medical College, University of Rzeszow, Rzeszow, Poland.
| | - Barbara Augustyn
- Scientific Club of Physical Energy Used in Physiotherapy, University of Rzeszow, Rzeszow, Poland
| | - Katarzyna Baj
- Scientific Club of Physical Energy Used in Physiotherapy, University of Rzeszow, Rzeszow, Poland
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11
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Ren B, Wan S, Liu L, Qu M, Wu H, Shen H. Distributions of serum thyroid-stimulating hormone in 2020 thyroid disease-free adults from areas with different iodine levels: a cross-sectional survey in China. J Endocrinol Invest 2021; 44:1001-1010. [PMID: 32816248 DOI: 10.1007/s40618-020-01395-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 08/13/2020] [Indexed: 01/09/2023]
Abstract
PURPOSE The aim of the present study was to describe the distributions of serum thyroid- stimulating hormone (TSH) levels in thyroid disease-free adults from areas with different iodine levels in China. Meanwhile, we aimed to evaluate the influence of age and gender on the distribution of TSH, assess the relationship between concentrations of TSH and free thyroxine (FT4), and analyze the factors that may affect TSH levels. METHODS 2020 adults were included from April 2016 to June 2019. Urinary iodine concentration, serum iodine concentration, serum TSH, FT4, free triiodothyronine, thyroid peroxidase antibodies and thyroglobulin antibodies were measured, and thyroid ultrasonography was performed. RESULTS The median of TSH in iodine-fortification areas (IFA), iodine-adequate areas (IAA), iodine-excessive areas (IEA) were 2.32, 2.11 and 2.34 mIU/L, respectively. Serum TSH concentrations were significantly higher in IFA and IEA than that in IAA (p = 0.005 and < 0.0001). The TSH values of most adults were distributed within the range of 1.01-3.00 mIU/L with the same trend in three groups. In our study, TSH levels did not change with age, and the TSH level of females was higher than that of males (p < 0.0001). There was a negative correlation between FT4 and TSH in IAA (r = - 0.160, p < 0.0001) and IEA (r = - 0.177, p < 0.0001), but there was no correlation between FT4 and TSH in IFA (r = - 0.046, p = 0.370). BMI, smoking status, education levels, and marital status were associated with TSH. CONCLUSION Our study provides a basis for establishing the reference intervals of TSH in different iodine level areas.
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Affiliation(s)
- B Ren
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - S Wan
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
- Department of Preventive Medicine, Qiqihar Medical University, Qiqihar, Heilongjiang, China
| | - L Liu
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - M Qu
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - H Wu
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - H Shen
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China.
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12
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Korobitsyna R, Aksenov A, Sorokina T, Trofimova A, Sobolev N, Grjibovski AM, Chashchin V, Thomassen Y. Iodine Status of Women and Infants in Russia: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8346. [PMID: 33187335 PMCID: PMC7697687 DOI: 10.3390/ijerph17228346] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/03/2020] [Accepted: 11/09/2020] [Indexed: 12/13/2022]
Abstract
This systematic review presents a critical synthesis of the available information on the iodine status among women and infants in Russia. Literature search was performed in accordance with PRISMA guidelines using PubMed, Scopus Web of Science databases as well as eLIBRARY-the Russian national source. Altogether, 277 papers were identified and 19 of them were eligible for the review. The data on median urinary iodine concentration (UIC) in women and infants from 25 Russian regions were presented. A substantial variability in UIC across the country with no clear geographical pattern was observed. Despite substantial heterogeneity in research methodology and data presentation the results suggest that the iodine status among pregnant women and infants in Russia is below the recommended levels. Our findings demonstrate that iodine deficiency is a re-emerging public health problem in Russia. Urgent public health measures on national, regional and individual levels are warranted.
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Affiliation(s)
- Rimma Korobitsyna
- Arctic Biomonitoring Laboratory, Northern (Arctic) Federal University Named After M. V. Lomonosov, Naberezhnaya Severnoy Dvini 17, 163002 Arkhangelsk, Russia; (A.A.); (T.S.); (A.T.); (N.S.); (Y.T.)
| | - Andrey Aksenov
- Arctic Biomonitoring Laboratory, Northern (Arctic) Federal University Named After M. V. Lomonosov, Naberezhnaya Severnoy Dvini 17, 163002 Arkhangelsk, Russia; (A.A.); (T.S.); (A.T.); (N.S.); (Y.T.)
| | - Tatiana Sorokina
- Arctic Biomonitoring Laboratory, Northern (Arctic) Federal University Named After M. V. Lomonosov, Naberezhnaya Severnoy Dvini 17, 163002 Arkhangelsk, Russia; (A.A.); (T.S.); (A.T.); (N.S.); (Y.T.)
| | - Anna Trofimova
- Arctic Biomonitoring Laboratory, Northern (Arctic) Federal University Named After M. V. Lomonosov, Naberezhnaya Severnoy Dvini 17, 163002 Arkhangelsk, Russia; (A.A.); (T.S.); (A.T.); (N.S.); (Y.T.)
| | - Nikita Sobolev
- Arctic Biomonitoring Laboratory, Northern (Arctic) Federal University Named After M. V. Lomonosov, Naberezhnaya Severnoy Dvini 17, 163002 Arkhangelsk, Russia; (A.A.); (T.S.); (A.T.); (N.S.); (Y.T.)
| | - Andrej M Grjibovski
- Central Scientific Research Laboratory, Northern State Medical University of the Ministry of Healthcare of the Russian Federation, Troitskiy Ave. 51, 163000 Arkhangelsk, Russia;
- Department of Health Policy and Management, Al-Farabi Kazakh National University, Almay 050040, Kazakhstan
- Department of Epidemiology and Modern Vaccination Technologies, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
- West Kazakhstan Marat Ospanov Medical University, Aktobe 0300190, Kazakhstan
| | - Valery Chashchin
- North-Western State Medical University named after I.I. Mechnikov, Kirochnaya ul. 41, 191015 Saint-Petersburg, Russia;
- Institute of Ecology, National Research University Higher School of Economics, Myasnitskaya str. 20, 101000 Moscow, Russia
| | - Yngvar Thomassen
- Arctic Biomonitoring Laboratory, Northern (Arctic) Federal University Named After M. V. Lomonosov, Naberezhnaya Severnoy Dvini 17, 163002 Arkhangelsk, Russia; (A.A.); (T.S.); (A.T.); (N.S.); (Y.T.)
- Institute of Ecology, National Research University Higher School of Economics, Myasnitskaya str. 20, 101000 Moscow, Russia
- National Institute of Occupational Health, P.O. Box 5330 Majorstua, N-0304 Oslo, Norway
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13
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Gao M, Chen W, Dong S, Chen Y, Zhang Q, Sun H, Zhang Y, Wu W, Pan Z, Gao S, Lin L, Shen J, Tan L, Wang G, Zhang W. Assessing the impact of drinking water iodine concentrations on the iodine intake of Chinese pregnant women living in areas with restricted iodized salt supply. Eur J Nutr 2020; 60:1023-1030. [PMID: 32577887 DOI: 10.1007/s00394-020-02308-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 06/15/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The supply of non-iodized salt and the water improvement project have been conducted to reduce the iodine concentration in drinking water in areas with elevated water iodine. We aimed to assess the impact of water iodine concentration (WIC) on the iodine intake of pregnant women in areas with restricted iodized salt supply, and determine the cutoff values of WIC in areas with non-iodized salt supply. METHODS Overall, 534 pregnant women who attended routine antenatal outpatient visits in Zibo Maternal and Child Health Hospital in Gaoqing County were recruited. The 24-h urine iodine excretion (UIE) in 534 samples and the iodine concentration in 534 drinking water samples were estimated. Urinary iodine excretion, daily iodine intake, and daily iodine intake from drinking water (WII) were calculated. The relationship between WIC and daily iodine take was analyzed. RESULTS The median WIC, spot urine iodine concentration (UIC), and 24-h UIE were 17 (6, 226) μg/L, 145 (88, 267) μg/L, and 190 (110, 390) μg/day, respectively. A significant positive correlation was found between WIC and UIE (R2 = 0.265, p < 0.001) and UIC (R2 = 0.261, p < 0.001). The contribution rate of WII to total iodine intake increased from 3.0% in the group with WIC of < 10 μg/L to 45.7% in the group with WIC of 50-99 μg/L. CONCLUSION The iodine content in drinking water is the major iodine source in pregnant women living in high-water iodine areas where iodized salt supply is restricted. The contribution rate of daily iodine intake from drinking water increases with the increase in water iodine concentration.
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Affiliation(s)
- M Gao
- The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - W Chen
- The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China.,Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - S Dong
- The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Y Chen
- The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Q Zhang
- The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - H Sun
- The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Y Zhang
- The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - W Wu
- The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Z Pan
- The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - S Gao
- The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - L Lin
- Tianjin Institution of Endocrinology, Tianjin Medical University, Tianjin, China
| | - J Shen
- The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - L Tan
- The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - G Wang
- The Center for Disease Control and Prevention of Gaoqing County, Gaoqing, China
| | - W Zhang
- The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China. .,Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China. .,Department of Healthcare and Medical, Tianjin Medical University General Hospital, Tianjin, China. .,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China.
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14
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Ma ZF. Iodine Nutrition and Thyroid Function in Pregnant Women Exposed to Different Iodine Sources. Biol Trace Elem Res 2020; 193:574-575. [PMID: 30993491 DOI: 10.1007/s12011-019-01719-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 04/03/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China.
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15
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Chen Y, Chen W, Zhang W. Reply to: Iodine Nutrition and Thyroid Function in Pregnant Women Exposed to Different Iodine Sources. Biol Trace Elem Res 2020; 193:576. [PMID: 31302819 DOI: 10.1007/s12011-019-01724-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Yanting Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wen Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wanqi Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China.
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Wang Y, Cui Y, Chen C, Duan Y, Wu Y, Li W, Zhang D, Li F, Hou C. Stopping the supply of iodized salt alone is not enough to make iodine nutrition suitable for children in higher water iodine areas: A cross-sectional study in northern China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2020; 188:109930. [PMID: 31727496 DOI: 10.1016/j.ecoenv.2019.109930] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 11/04/2019] [Accepted: 11/05/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND For the sake of children's health, iodized salt supply has been stopped in many areas with excessive iodine in the drinking water, but children's iodine nutrition status and thyroid function after terminating the iodized salt supply is unknown. Objective We assessed the iodine nutrition, thyroid function and influencing factors for thyroid abnormalities in children from areas with different concentrations of water iodine; the supply of iodized salt has been stopped in high water iodine areas. This study aimed to evaluate whether the strategy of stopping the supplies of iodized salt alone is enough to avoid thyroid dysfunction in all areas with excess water iodine while still meeting the iodine nutrition needs of children. METHODS A cross-sectional study was conducted in children from four areas with different drinking water iodine concentrations in Tianjin, China. The drinking water samplings and spot urine samples were collected to estimate the external and internal iodine exposure levels. The thyroid volume was measured, and blood samples were collected to assess thyroid function. Logistic regression analysis was used to analyze risk factors for thyroid abnormalities. A dietary survey was conducted to determine the sources of iodine nutrition among the areas with different iodine concentrations in the drinking water. RESULTS In the area with a drinking water iodine concentration ≥300 μg/L, the median urinary iodine concentration (UIC) in children was 476.30 (332.20-639.30) μg/L, which was higher than that in other groups (all P < 0.05), and the prevalence of thyroid nodules and the thyroid goiter rate were higher than those in the <100 μg/L, 100-150 μg/L and 150-300 μg/L areas (all P < 0.01). Binary logistic regression analysis indicated that the risk of thyroid abnormalities was significantly increased in the UIC 200-299 μg/L group (OR: 4.534; 95% CI: 1.565, 13.135; bootstrapped 95% CI: 1.689, 21.206, P = 0.004) and in the UIC ≥ 300 μg/L group (OR: 6.962; 95% CI: 2.490, 19.460; bootstrapped 95% CI: 2.838, 32.570, P = 0.001) compared to the 100-199 μg/L group. The iodine contribution rates from water in areas with water iodine concentrations ≥300 μg/L are up to 63.04%. CONCLUSIONS After termination of the iodized salt supply, the level of iodine nutrition of children in the area with drinking water iodine concentrations ≥300 μg/L is still excessive. The water source needs to be replaced in this area. In the area with a water iodine concentration of 150-300 μg/L, it is proposed that stopping the supply of iodized salt is sufficient to achieve the proper iodine nutrition status in children.
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Affiliation(s)
- Yang Wang
- Tianjin Centers for Disease Control and Prevention, 6 Huayue Road, Hedong District, Tianjin, 300011, PR China
| | - Yushan Cui
- Tianjin Centers for Disease Control and Prevention, 6 Huayue Road, Hedong District, Tianjin, 300011, PR China
| | - Chen Chen
- Tianjin Health Education Center, 6 Huayue Road, Hedong District, Tianjin, 300011, PR China
| | - Yani Duan
- Tianjin Centers for Disease Control and Prevention, 6 Huayue Road, Hedong District, Tianjin, 300011, PR China
| | - Yinghong Wu
- Tianjin Centers for Disease Control and Prevention, 6 Huayue Road, Hedong District, Tianjin, 300011, PR China
| | - Wenfeng Li
- Tianjin Centers for Disease Control and Prevention, 6 Huayue Road, Hedong District, Tianjin, 300011, PR China
| | - DanDan Zhang
- Tianjin Centers for Disease Control and Prevention, 6 Huayue Road, Hedong District, Tianjin, 300011, PR China
| | - Fang Li
- Tianjin Centers for Disease Control and Prevention, 6 Huayue Road, Hedong District, Tianjin, 300011, PR China
| | - Changchun Hou
- Tianjin Centers for Disease Control and Prevention, 6 Huayue Road, Hedong District, Tianjin, 300011, PR China.
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Chen Y, Gao M, Bai Y, Hao Y, Chen W, Cui T, Guo W, Pan Z, Lin L, Wang C, Shen J, Zhang W. Variation of iodine concentration in breast milk and urine in exclusively breastfeeding women and their infants during the first 24 wk after childbirth. Nutrition 2019; 71:110599. [PMID: 31901706 DOI: 10.1016/j.nut.2019.110599] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 09/15/2019] [Accepted: 09/19/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The aim of this study was to observe the variation of iodine concentration in breast milk and urine in exclusively breastfeeding women and their infants during the first 24 wk after childbirth. METHODS In all, 634 exclusively breastfeeding mother-infant pairs were enrolled at hospital and followed at the 1, 4, 8, 12, 16, and 24 wk postpartum. Spot infant urinary iodine concentration (I-UIC), maternal urinary iodine concentration UIC (M-UIC), and breast milk iodine concentration (BMIC) in bilateral breasts were measured. RESULTS During the first 24 wk, the median I-UIC was 216 (139-362) and 122 (68-217) μg/L in lactating mothers, both indicating iodine sufficiency. A strong correlation and no difference were found between BMIC in bilateral breasts. The mean BMIC (M-BMIC) of the two breasts was 165 (112-257) μg/L with a Bland-Altman index of 2.1%. Positive correlations were found between M-BMIC and I-UIC (r = 0.353, P < 0.001), between M-BMIC and M-UIC (r = 0.339, P < 0.001), and between I-UIC and M-UIC (r = 0.222, P < 0.001). M-BMIC was significantly higher than M-UIC (P < 0.001) and lower than I-UIC (P < 0.001). M-BMIC declined from week 1 to week 8 postpartum, both I-UIC and M-UIC dropped from week 1 to week 4 postpartum and stabilized thereafter. CONCLUSION The iodine nutrition in lactating women and infants were adequate during the first 24 wk after childbirth. M-BMIC declined from week 1 to week 8 postpartum. Both I-UIC and M-UIC dropped from week 1 to week 4 postpartum. Further studies are needed to explore a more definitive BMIC and UIC range for an optimal iodine status in lactating women and breastfed infants.
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Affiliation(s)
- Yanting Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Min Gao
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yanbo Bai
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yunmeng Hao
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wen Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Tingkai Cui
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wenxing Guo
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Ziyun Pan
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Laixiang Lin
- The Key Laboratory of Hormone and Development (Ministry of Health), Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Chongdan Wang
- Department of Obstetrics and Inpatient, Tanggu Maternity Hospital, Tianjin, China
| | - Jun Shen
- Department of Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China.
| | - Wanqi Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China; The Key Laboratory of Hormone and Development (Ministry of Health), Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China; Department of Endocrinology, Tianjin Medical University General Hospital, Tianjin, China.
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