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Alimardani B, Hashemipour M, Hovsepian S, Mozafarian N, Khoshhali M, Kelishadi R. Association between maternal and cord blood thyroid hormones, and urine iodine concentration with fetal growth. J Pediatr Endocrinol Metab 2024; 37:516-524. [PMID: 38685764 DOI: 10.1515/jpem-2023-0570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 04/10/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVES We planned to evaluate the association of fetal and maternal thyroid hormones and maternal iodine status with neonates' anthropometric parameters. METHODS In this cross-sectional study, levels of thyrotropin were measured in maternal serum in the first trimester of pregnancy, and thyrotropin (TSH) and free thyroxin (fT4) were measured in cord blood serum samples at birth. Urinary iodine concentration (UIC) levels in random urine samples of mothers were measured in the third trimester of pregnancy. The relationship between UIC and thyroid hormone levels of mothers with neonates' anthropometric birth parameters of neonates was evaluated. RESULTS One hundred eighty-eight mother-newborn pairs completed the study. Mean (SD) of cord blood TSH (CB-TSH), cord blood-free thyroxin (CB-FT4) values, and maternal TSH (M-TSH) levels were 8.8 (7.3) mIU/L, 1.01 (0.2) ng/dL, and 2.2 (0.9) mIU/L, respectively. After adjusting for confounders, there was a positive significant association between female neonate length and maternal TSH and log log-transformed CB TSH (LN_CB-TSH) (p<0.05). Median UIC (Q1-Q3) was 157 (53-241) μg/L, and there was no association between birth weight, birth length, and head circumferences of neonates and mothers' UIC (p>0.05). CONCLUSIONS We found a positive correlation between maternal TSH in the first trimester of pregnancy and the birth length of newborns, and a negative correlation was observed between CB-TSH and birth length in girls, but it did not provide conclusive evidence for the relationship between maternal and neonatal thyroid hormone levels and birth weight. There was no association between maternal UIC levels in the third trimester and birth anthropometric parameters.
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Affiliation(s)
- Bita Alimardani
- 48455 Metabolic Liver Diseases Research Center, Isfahan University of Medical Sciences , Isfahan, Iran
| | - Mahin Hashemipour
- 48455 Metabolic Liver Diseases Research Center, Isfahan University of Medical Sciences , Isfahan, Iran
- 48455 Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences , Isfahan, Iran
| | - Silva Hovsepian
- 48455 Metabolic Liver Diseases Research Center, Isfahan University of Medical Sciences , Isfahan, Iran
- 48455 Imam Hossein Children's Hospital, Isfahan University of Medical Sciences , Isfahan, Iran
| | - Nafiseh Mozafarian
- 48455 Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences , Isfahan, Iran
| | - Mehri Khoshhali
- 48455 Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences , Isfahan, Iran
| | - Roya Kelishadi
- 48455 Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences , Isfahan, Iran
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Azizi F, Delshad H, Hedayati M, Mirmiran P. Iodine status in Iran: from deficient to replete. Lancet Diabetes Endocrinol 2023; 11:903-904. [PMID: 37996199 DOI: 10.1016/s2213-8587(23)00318-2] [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: 11/25/2023]
Affiliation(s)
- Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Hossein Delshad
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Hedayati
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Department of Clinical Nutrition and Human Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Filipowicz D, Szczepanek-Parulska E, Mikulska-Sauermann AA, Karaźniewicz-Łada M, Główka FK, Szymanowski K, Ołtarzewski M, Schomburg L, Ruchała M. Iodine deficiency and real-life supplementation ineffectiveness in Polish pregnant women and its impact on thyroid metabolism. Front Endocrinol (Lausanne) 2023; 14:1068418. [PMID: 37396162 PMCID: PMC10313195 DOI: 10.3389/fendo.2023.1068418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 05/23/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction Iodine is a pivotal component of thyroid hormones, and its deficiency leads to negative pregnancy outcomes. Therefore, during gestation, additional iodine supplementation is recommended. Objectives By evaluating a group of women from western Poland, the study updated on iodine status during pregnancy and the effectiveness of iodine supplementation in relation to the maternal and neonatal thyroid function. Patients and methods A total of 91 women were recruited before the delivery between 2019 and 2021. During the medical interview, the patients declared their dietary supplements intake. Thyroid parameters (TSH, ft3, ft4, a-TPO, a-Tg, and TRAb) were measured in the serum of mothers and in the cord blood of newborns after birth. Urinary iodine concentration (UIC) and urine/creatinine (UIC/crea) ratio were assessed in single urine samples using a validated high-performance liquid chromatography with ultraviolet detection (HPLC-UV). Neonatal TSH screening from dried blood spot was analyzed. Results Pregnant women showed a median (interquartile range) UIC of 106 (69-156) µg/liter and UIC/crea ratio of 104 (62-221) µg/g, whereas approximately 20% had UIC/crea below 50 µg/g, indicating iodine deficiency. The iodine supplementation ratio was 68%. No significant differences in UIC, UIC/crea and thyroid parameters were found between iodine supplemented and non-supplemented groups; however, the highest ioduria was detected when iodine was supplemented in addition to levothyroxine in comparison with both substances administered separately. Patients with UIC/crea within 150-249 µg/g demonstrated the lowest TSH and a-TPO levels. Screening TSH was above 5 mIU/liter in 6% of children. Conclusions Despite the national salt iodization and the recommendation to supplement iodine during gestation, the status of the abovementioned microelement and real-life intake revealed the ineffectiveness of the current iodine-deficiency prophylaxis model in pregnancy.
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Affiliation(s)
- Dorota Filipowicz
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Ewelina Szczepanek-Parulska
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Marta Karaźniewicz-Łada
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Franciszek K. Główka
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Krzysztof Szymanowski
- Department of Perinatology and Gynaecology, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Lutz Schomburg
- Institute of Experimental Endocrinology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Marek Ruchała
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
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Matta Coelho C, Guimarães J, Bracchi I, Xavier Moreira N, Pinheiro C, Ferreira P, Pestana D, Barreiros Mota I, Cortez A, Prucha C, Martins C, Pinto E, Almeida A, Delerue-Matos C, Dias CC, Moreira-Rosário A, Ribeiro de Azevedo LF, Cruz Fernandes V, Ramalho C, Calhau C, Brantsæter AL, Costa Leite J, Keating E. Noncompliance to iodine supplementation recommendation is a risk factor for iodine insufficiency in Portuguese pregnant women: results from the IoMum cohort. J Endocrinol Invest 2022; 45:1865-1874. [PMID: 35635644 DOI: 10.1007/s40618-022-01813-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 04/27/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE After a recommendation for iodine supplementation in pregnancy has been issued in 2013 in Portugal, there were no studies covering iodine status in pregnancy in the country. The aim of this study was to assess iodine status in pregnant women in Porto region and its association with iodine supplementation. METHODS A cross-sectional study was conducted at Centro Hospitalar Universitário São João, Porto, from April 2018 to April 2019. Pregnant women attending the 1st trimester ultrasound scan were invited to participate. Exclusion criteria were levothyroxine use, gestational age < 10 and ≥ 14 weeks, non-evolutive pregnancy at recruitment and non-signing of informed consent. Urinary iodine concentration (UIC) was measured in random spot urine by inductively coupled plasma-mass spectrometry. RESULTS Median UIC was 104 μg/L (IQR 62-189) in the overall population (n = 481) of which 19% had UIC < 50 µg/L. Forty three percent (n = 206) were not taking an iodine-containing supplement (ICS) and median UIC values were 146 µg/L (IQR 81-260) and 74 µg/L (IQR 42-113) in ICS users and non-users, respectively (p < 0.001). Not using an ICS was an independent risk factor for iodine insufficiency [adjusted OR (95% CI) = 6.00 (2.74, 13.16); p < 0.001]. Iodised salt use was associated with increased median iodine-to-creatinine ratio (p < 0.014). CONCLUSIONS A low compliance to iodine supplementation recommendation in pregnancy accounted for a mild-to-moderately iodine deficiency. Our results evidence the need to support iodine supplementation among pregnant women in countries with low household coverage of iodised salt. Trial registration number NCT04010708, registered on the 8th July 2019.
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Affiliation(s)
- C Matta Coelho
- CINTESIS@RISE, Department Biomedicine, Unit of Biochemistry, Faculty of Medicine, University of Porto, 4200-319, Porto, Portugal
| | - J Guimarães
- CINTESIS@RISE, Department Biomedicine, Unit of Biochemistry, Faculty of Medicine, University of Porto, 4200-319, Porto, Portugal
| | - I Bracchi
- CINTESIS@RISE, Department Biomedicine, Unit of Biochemistry, Faculty of Medicine, University of Porto, 4200-319, Porto, Portugal
| | - N Xavier Moreira
- CINTESIS@RISE, Faculty of Medicine, University of Porto, Porto, Portugal
- Fluminense Federal University, Niterói, Rio de Janeiro, Brasil
| | - C Pinheiro
- CINTESIS@RISE, Department Biomedicine, Unit of Biochemistry, Faculty of Medicine, University of Porto, 4200-319, Porto, Portugal
| | - P Ferreira
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
| | - D Pestana
- CINTESIS@RISE, Nutrition and Metabolism, NOVA Medical School│FCM, Universidade Nova de Lisboa, Porto, Portugal
| | - I Barreiros Mota
- CINTESIS@RISE, Nutrition and Metabolism, NOVA Medical School│FCM, Universidade Nova de Lisboa, Porto, Portugal
| | - A Cortez
- Medicina Laboratorial Dr. Carlos Torres, Porto, Portugal
| | - C Prucha
- Department of Obstetrics, Centro Hospitalar Universitário S. João, Porto, Portugal
| | - C Martins
- Department of Obstetrics, Centro Hospitalar Universitário S. João, Porto, Portugal
| | - E Pinto
- REQUIMTE//LAQV, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
- Department of Environmental Health, School of Health, P.Porto, Porto, Portugal
| | - A Almeida
- REQUIMTE//LAQV, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - C Delerue-Matos
- REQUIMTE/LAQV, Instituto Superior de Engenharia, Politécnico do Porto, Porto, Portugal
| | - C C Dias
- CINTESIS@RISE, Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
| | - A Moreira-Rosário
- CINTESIS@RISE, Nutrition and Metabolism, NOVA Medical School│FCM, Universidade Nova de Lisboa, Porto, Portugal
| | - L F Ribeiro de Azevedo
- CINTESIS@RISE, Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
| | - V Cruz Fernandes
- REQUIMTE/LAQV, Instituto Superior de Engenharia, Politécnico do Porto, Porto, Portugal
| | - C Ramalho
- Department of Obstetrics, Centro Hospitalar Universitário S. João, Porto, Portugal
- Department of Ginecology-Obstetrics and Pediatrics, Faculty of Medicine, University of Porto, Porto, Portugal
- Instituto de Investigação e Inovação em Saúde, i3S, Universidade Do Porto, Porto, Portugal
| | - C Calhau
- CINTESIS@RISE, Nutrition and Metabolism, NOVA Medical School│FCM, Universidade Nova de Lisboa, Porto, Portugal
| | - A-L Brantsæter
- Division of Climate and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - J Costa Leite
- CINTESIS@RISE, Faculty of Medicine, University of Porto, Porto, Portugal
| | - E Keating
- CINTESIS@RISE, Department Biomedicine, Unit of Biochemistry, Faculty of Medicine, University of Porto, 4200-319, Porto, Portugal.
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